ABSTRACT
Manifestations caused by coronavirus family have presented it in many ways during the previous years. The aim of this systematic review was to gather all possible cardiovascular manifestations of the coronavirus family in the literature. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Scopus, Web of Science, Cochrane and ProQuest which were updated on May 1, 2020 for the last time. Regarding to the novelty and speed of publications on COVID-19, we searched Google Scholar and also references of included studies and review articles in the systematic search results were searched manually. The searched keywords were the combination of the following MeSH terms: "COVID-19", "SARS", "MERS" and "cardiovascular presentation". The systematic review was registered with ID CRD42020180736 in International Prospective Register of Systematic Reviews (PROSPERO). After screening, 28 original articles and ten case studies (five case reports and five case series) were included. Most of the studies were focused on COVID-19 (20 original articles and four case studies) while the only studies about Middle East Respiratory Syndrome (MERS) were a case report and a case series. Almost all the cardiovascular presentations and complications including acute cardiac injury, arrhythmias and the thrombotic complications were more prevalent in COVID-19 than severe acute respiratory syndrome (SARS) and MERS. The cardiac injury was the most common cardiovascular presentation and complication in COVID-19 whereas thrombotic complications were commonly reported in SARS. The cardiac injury was the predictor of disease severity and mortality in both COVID-19 and SARS.Coronavirus 2019 may present with cardiovascular manifestations and complications in signs and symptoms, laboratory data and other paraclinical findings. Also, cardiovascular complications in the course of COVID-19 may result in worse outcomes.
ABSTRACT
BACKGROUND: The 2019 coronavirus disease (COVID-19) is threatening public health in many ways. The psychological situation of individuals is important and limited data is available from Iran. In this study, we aimed to illustrate the psychological distress of the general population and evaluate the factors affecting it. METHODS: An online cross-sectional survey was conducted from 29th to 31st March 2020 in South Khorasan province, affected later than other parts of the country. We included sociodemographic questions, Hospital Anxiety, and Depression Scale (HADS) questionnaire, and questions addressing various symptoms and diseases. Most questions had multiple choices to select from and some were open questions. Univariate and multivariate analysis in SPSS software was used to find significant relationships. RESULTS: A total of 844 responses were collected, of which 788 records were included in the analysis. The mean age of responders was 36.61±10.97 (age range: 18-88) and 484 (61.4%) of them were females. The mean scores in the anxiety and depression subscale of the HADS questionnaire were 7.01±3.68 and 6.72±3.71 respectively. Experiencing cardiovascular and COVID-19 related symptoms was significantly associated with a higher number of individuals having abnormal anxiety and depression results (p<0.001). Widowed individuals, females, and those experiencing the above-stated symptoms showed a significant association with increased anxiety and depression in multivariate analysis. CONCLUSION: Although many existing elements influence the psychological well-being of society during a pandemic, experiencing symptoms related to other diseases or having multiple chronic diseases may cause an extra burden on the psychological state of the society.