COVID myocardial involvement presenting as left ventricular aneurysm and clot associated with normal coronary anatomy, deep vein thrombosis, and abnormal brachial artery flow-mediated dilatation.

A 40-year-old non-diabetic, non-hypertensive male patient presented with complaints of dyspnea of a few days duration and coronavirus -19 disease (COVID) pneumonia. The electrocardiography (ECG) revealed sinus tachycardia with T inversion in V1 only. The ECG revealed a left ventricular aneurysm with a clot and severe left ventricular dysfunction. He had deep vein thrombosis involving the left lower leg. The cardiac magnetic resonance imaging revealed a left ventricular posterodorsal aneurysm with a large clot. Computed tomography angiography revealed normal coronaries and no evidence of pulmonary embolism or aortitis. The d-dimer was raised. A brachial artery Doppler revealed severe impairment of flow-mediated dilatation, suggesting endothelial dysfunction. He was stabilized with anti-platelets and anticoagulants, and diuretics.

Evaluation of Remote Monitoring Device for Monitoring Vital Parameters against Reference Standard: A Diagnostic Validation Study for COVID-19 Preparedness.

CONTEXT: Vital parameters including blood oxygen level, respiratory rate, pulse rate, and body temperature are crucial for triaging patients to appropriate medical care. Advances in remote health monitoring system and wearable health devices have created a new horizon for delivery of efficient health care from a distance. MATERIALS AND METHODS: This diagnostic validation study included patients attending the outpatient department of the institute. The accuracy of device under study was compared against the gold standard patient monitoring systems used in intensive care units. STATISTICAL ANALYSIS: The statistical analysis involved computation of intraclass correlation coefficient. Bland-Altman graphs with limits of agreement were plotted to assess agreement between methods. P <0.05 was considered statistically significant. RESULTS: A total of 200 patients, including 152 males and 48 females in the age range of 2-80 years, formed the study group. A strong correlation (intraclass correlation coefficient; r > 0.9) was noted between the two devices for all the investigated parameters with significant P value (<0.01). Bland-Altman plot drawn for each vital parameter revealed observations in agreement from both the devices. CONCLUSION: The wearable device can be reliably used for remote health monitoring. Its regulated use can help mitigate the scarcity of hospital beds and reduce exposure to health-care workers and demand of personal protection equipment.