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1.
Cardiol Rev ; 30(3): 109-110, 2022.
Article in English | MEDLINE | ID: covidwho-1806656
2.
Cardiol Rev ; 30(3): 123-128, 2022.
Article in English | MEDLINE | ID: covidwho-1778950

ABSTRACT

Cardiometabolic disease describes a combination of metabolic abnormalities that increases the risk of type 2 diabetes and cardiovascular diseases, including pathological changes such as insulin resistance, hyperglycemia, dyslipidemia, abdominal obesity, and hypertension, and environmental risk factors such as smoking, sedentary lifestyle, poor diet, and poverty. As the number of coronavirus disease 2019 (COVID-19) patients continues to rise, type 2 diabetes, cardiovascular disease, hypertension, and obesity, all components of, or sequelae of cardiometabolic disease, were identified among others as key risk factors associated with increased mortality in these patients. Numerous studies have been done to further elucidate this relationship between COVID-19 and cardiometabolic disease. Cardiometabolic disease is associated with both increased susceptibility to COVID-19 and worse outcomes of COVID-19, including intensive care, mechanical ventilation, and death. The proinflammatory state of cardiometabolic disease specifically obesity, has been associated with a worse prognosis in COVID-19 patients. There has been no evidence to suggest that antihypertensives and antidiabetic medications should be discontinued in COVID-19 patients but these patients should be closely monitored to ensure that their blood pressure and blood glucose levels are stable. Assessment of vaccination efficacy in cardiometabolic disease patients is also discussed.


Subject(s)
COVID-19 , Cardiovascular Diseases , Diabetes Mellitus, Type 2 , Hypertension , COVID-19/complications , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Humans , Hypertension/complications , Hypertension/drug therapy , Hypertension/epidemiology , Obesity/complications , Obesity/epidemiology , Risk Factors
3.
Cardiol Rev ; 29(6): 281-282, 2021.
Article in English | MEDLINE | ID: covidwho-1706595
4.
Cardiol Rev ; 29(6): 281-282, 2021.
Article in English | MEDLINE | ID: covidwho-1354314
6.
Cardiol Rev ; 30(3): 129-133, 2022.
Article in English | MEDLINE | ID: covidwho-1320339

ABSTRACT

Coronavirus disease 2019 (COVID-19) is characterized by a clinical spectrum of diseases ranging from asymptomatic or mild cases to severe pneumonia with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) has been used as rescue therapy in appropriate patients with COVID-19 complicated by ARDS refractory to mechanical ventilation. In this study, we review the indications, challenges, complications, and clinical outcomes of ECMO utilization in critically ill patients with COVID-19-related ARDS. Most of these patients required venovenous ECMO. Although the risk of mortality and complications is very high among patients with COVID-19 requiring ECMO, it is similar to that of non-COVID-19 patients with ARDS requiring ECMO. ECMO is a resource-intensive therapy, with an inherent risk of complications, which makes its availability limited and its use challenging in the midst of a pandemic. Well-maintained data registries, with timely reporting of outcomes and evidence-based clinical guidelines, are necessary for the careful allocation of resources and for the development of standardized utilization protocols.


Subject(s)
COVID-19 , Extracorporeal Membrane Oxygenation , Respiratory Distress Syndrome , COVID-19/complications , COVID-19/therapy , Extracorporeal Membrane Oxygenation/methods , Humans , Pandemics , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , SARS-CoV-2
7.
Cardiol Rev ; 29(6): 285-288, 2021.
Article in English | MEDLINE | ID: covidwho-1320338

ABSTRACT

As the global coronavirus disease-19 (COVID-19) pandemic caused by severe acute respiratory distress syndrome coronavirus 2 continues to cause higher mortality and hospitalization rates among older adults, strategies such as frailty screening have been suggested for resource allocation and clinical management. Frailty is a physiologic condition characterized by a decreased reserve to stressors and is associated with disability, hospitalization, and death. Measuring frailty can be a useful tool to determine the risk and prognosis of COVID-19 patients in the acute setting, and to provide higher quality of care for vulnerable individuals in the outpatient setting. A literature review was conducted to examine current research regarding frailty and COVID-19. Frailty can inform holistic care of COVID-19 patients, and further investigation is needed to elucidate how measuring frailty should guide treatment and prevention of COVID-19.


Subject(s)
COVID-19/epidemiology , Frailty/epidemiology , Length of Stay/statistics & numerical data , Mortality , Activities of Daily Living , COVID-19/mortality , Comorbidity , Frailty/physiopathology , Hospitalization , Humans , Mass Screening , Prognosis , SARS-CoV-2
8.
Cardiol Rev ; 29(6): 292-295, 2021.
Article in English | MEDLINE | ID: covidwho-1310959

ABSTRACT

The coronavirus 2019 (COVID-19) pandemic has presented many new challenges to the healthcare community with the sheer number of individuals affected and the range of symptoms at presentation. Early findings have shown that increased age is an independent risk factor for COVID-19 severity. Diabetes and hypertension were also found to be strong independent risk factors for severe COVID-19. It was later discovered that obesity is a strong risk factor for severe disease as well. Possible mechanisms for the increased risk associated with metabolic disease include the increased prevalence of acute respiratory syndrome, immune cell dysfunction, and chronic inflammatory states associated with obesity and diabetes. Acknowledging these risk factors has consequences for addressing vaccination strategies as well as healthcare disparities.


Subject(s)
COVID-19/epidemiology , Diabetes Mellitus/epidemiology , Hypertension/epidemiology , Obesity/epidemiology , COVID-19/metabolism , COVID-19/mortality , COVID-19/physiopathology , Comorbidity , Diabetes Mellitus/metabolism , Diabetes Mellitus/physiopathology , Humans , Hypertension/metabolism , Hypertension/physiopathology , Inflammation/metabolism , Obesity/metabolism , Obesity/physiopathology , Respiratory Distress Syndrome/epidemiology , Respiratory Distress Syndrome/physiopathology , Risk Factors , SARS-CoV-2 , Severity of Illness Index
9.
Cardiol Rev ; 29(6): 289-291, 2021.
Article in English | MEDLINE | ID: covidwho-1310958

ABSTRACT

The ongoing coronavirus infection-2019 (COVID-19) global pandemic has had devastating impacts on the global population since 2019. Cardiac complications are a well-documented sequala of COVID-19, with exposed patients experiencing complications such as myocardial infarction, myocarditis, and arrythmias. This article aims to review prominent literature regarding COVID-19 and its link with arrhythmias, as well as to discuss some of the possible mechanisms by which arrhythmogenesis may occur in patients with COVID-19.


Subject(s)
Arrhythmias, Cardiac/epidemiology , COVID-19/epidemiology , Anti-Bacterial Agents/adverse effects , Antirheumatic Agents/adverse effects , Arrhythmias, Cardiac/chemically induced , Arrhythmias, Cardiac/physiopathology , Azithromycin/adverse effects , COVID-19/drug therapy , COVID-19/physiopathology , Humans , Hydroxychloroquine/adverse effects , Intensive Care Units , SARS-CoV-2 , Severity of Illness Index
11.
Cardiol Rev ; 30(3): 123-128, 2022.
Article in English | MEDLINE | ID: covidwho-1294799

ABSTRACT

Cardiometabolic disease describes a combination of metabolic abnormalities that increases the risk of type 2 diabetes and cardiovascular diseases, including pathological changes such as insulin resistance, hyperglycemia, dyslipidemia, abdominal obesity, and hypertension, and environmental risk factors such as smoking, sedentary lifestyle, poor diet, and poverty. As the number of coronavirus disease 2019 (COVID-19) patients continues to rise, type 2 diabetes, cardiovascular disease, hypertension, and obesity, all components of, or sequelae of cardiometabolic disease, were identified among others as key risk factors associated with increased mortality in these patients. Numerous studies have been done to further elucidate this relationship between COVID-19 and cardiometabolic disease. Cardiometabolic disease is associated with both increased susceptibility to COVID-19 and worse outcomes of COVID-19, including intensive care, mechanical ventilation, and death. The proinflammatory state of cardiometabolic disease specifically obesity, has been associated with a worse prognosis in COVID-19 patients. There has been no evidence to suggest that antihypertensives and antidiabetic medications should be discontinued in COVID-19 patients but these patients should be closely monitored to ensure that their blood pressure and blood glucose levels are stable. Assessment of vaccination efficacy in cardiometabolic disease patients is also discussed.


Subject(s)
COVID-19 , Cardiovascular Diseases , Diabetes Mellitus, Type 2 , Hypertension , COVID-19/complications , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Humans , Hypertension/complications , Hypertension/drug therapy , Hypertension/epidemiology , Obesity/complications , Obesity/epidemiology , Risk Factors
12.
Cardiol Rev ; 29(3): 143-149, 2021.
Article in English | MEDLINE | ID: covidwho-1148006

ABSTRACT

The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 has affected the health of people across the globe. Cardiovascular diseases (CVDs) have a significant relationship with COVID-19, both as a risk factor and prognostic indicator, and as a complication of the disease itself. In addition to predisposing to CVD complications, the ongoing pandemic has severely affected the delivery of timely and appropriate care for cardiovascular conditions resulting in increased mortality. The etiology behind the cardiac injury associated with severe acute respiratory syndrome coronavirus-2 is likely varied, including coronary artery disease, microvascular thrombosis, myocarditis, and stress cardiomyopathy. Further large-scale investigations are needed to better determine the underlying mechanism of myocardial infarction and other cardiac injury in COVID-19 patients and to determine the incidence of each type of cardiac injury in this patient population. Telemedicine and remote monitoring technologies can play an important role in optimizing outcomes in patients with established CVD. In this article, we summarize the various impacts that COVID-19 has on the cardiovascular system, including myocardial infarction, myocarditis, stress cardiomyopathy, thrombosis, and stroke.


Subject(s)
COVID-19/physiopathology , Cardiovascular Diseases/physiopathology , COVID-19/complications , COVID-19/epidemiology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Comorbidity , Coronary Artery Disease/epidemiology , Coronary Artery Disease/etiology , Coronary Artery Disease/physiopathology , Coronary Thrombosis/etiology , Coronary Thrombosis/physiopathology , Heart Disease Risk Factors , Humans , Ischemic Stroke/epidemiology , Ischemic Stroke/etiology , Ischemic Stroke/physiopathology , Microvessels , Myocardial Infarction/epidemiology , Myocardial Infarction/etiology , Myocardial Infarction/physiopathology , Myocarditis/etiology , Myocarditis/physiopathology , SARS-CoV-2 , Stroke/epidemiology , Stroke/etiology , Stroke/physiopathology , Takotsubo Cardiomyopathy/etiology , Takotsubo Cardiomyopathy/physiopathology , Thrombosis/etiology , Thrombosis/physiopathology
14.
Cardiol Rev ; 29(1): 43-47, 2021.
Article in English | MEDLINE | ID: covidwho-965899

ABSTRACT

The novel coronavirus (severe acute respiratory syndrome CoV-2 [SARS-CoV-2]), also known as COVID-19, is a single-stranded enveloped RNA virus that created a Public Health Emergency of International Concern in January 2020, with a global case burden of over 15 million in just 7 months. Infected patients develop a wide range of clinical manifestations-typically presenting with fever, cough, myalgia, and fatigue. Severely ill patients may fall victim to acute respiratory distress syndrome, acute heart injuries, neurological manifestations, or complications due to secondary infections. These critically ill patients are also found to have disrupted coagulation function, predisposing them to consumptive coagulopathies, and both venous and thromboembolic complications. Common laboratory findings include thrombocytopenia, elevated D-dimer, fibrin degradation products, and fibrinogen, all of which have been associated with greater disease severity. Many cases of pulmonary embolism have been noted, along with deep vein thrombosis, ischemic stroke, myocardial infarction, and systemic arterial embolism. The pathogenesis of coronavirus has not been completely elucidated, but the virus is known to cause excessive inflammation, endothelial injury, hypoxia, and disseminated intravascular coagulation, all of which contribute to thrombosis formation. These patients are also faced with prolonged immobilization while staying in the hospital or intensive care unit. It is important to have a high degree of suspicion for thrombotic complications as patients may rapidly deteriorate in severe cases. Evidence suggests that prophylaxis with anticoagulation may lead to a lower risk of mortality, although it does not eliminate the possibility. The risks and benefits of anticoagulation treatment should be considered in each case. Patients should be regularly evaluated for bleeding risks and thrombotic complications.


Subject(s)
Blood Coagulation Disorders/blood , COVID-19/blood , Embolism/blood , Thrombosis/blood , Anticoagulants/therapeutic use , Blood Coagulation Disorders/drug therapy , Blood Coagulation Disorders/etiology , Blood Coagulation Disorders/metabolism , COVID-19/complications , COVID-19/drug therapy , COVID-19/metabolism , Cytokine Release Syndrome/blood , Cytokine Release Syndrome/complications , Cytokine Release Syndrome/metabolism , Disseminated Intravascular Coagulation/blood , Disseminated Intravascular Coagulation/etiology , Disseminated Intravascular Coagulation/metabolism , Disseminated Intravascular Coagulation/prevention & control , Embolism/etiology , Embolism/metabolism , Embolism/prevention & control , Endothelium, Vascular/metabolism , Fibrin Fibrinogen Degradation Products/metabolism , Fibrinogen/metabolism , Humans , Hypoxia/blood , Hypoxia/etiology , Hypoxia/metabolism , Immobilization , Inflammation/blood , Inflammation/etiology , Inflammation/metabolism , Ischemic Stroke/blood , Ischemic Stroke/etiology , Ischemic Stroke/metabolism , Ischemic Stroke/prevention & control , Myocardial Infarction/blood , Myocardial Infarction/etiology , Myocardial Infarction/metabolism , Myocardial Infarction/prevention & control , Practice Guidelines as Topic , Pulmonary Embolism/blood , Pulmonary Embolism/etiology , Pulmonary Embolism/metabolism , Pulmonary Embolism/prevention & control , Severity of Illness Index , Thrombocytopenia/blood , Thrombocytopenia/etiology , Thrombosis/etiology , Thrombosis/metabolism , Thrombosis/prevention & control , Venous Thrombosis/blood , Venous Thrombosis/etiology , Venous Thrombosis/metabolism
15.
Cardiol Rev ; 29(1): 39-42, 2021.
Article in English | MEDLINE | ID: covidwho-900593

ABSTRACT

Patients older than 65 years hospitalized with COVID-19 have higher rates of intensive care unit admission and death when compared with younger patients. Cardiovascular conditions associated with COVID-19 include myocardial injury, acute myocarditis, cardiac arrhythmias, cardiomyopathies, cardiogenic shock, thromboembolic disease, and cardiac arrest. Few studies have described the clinical course of those at the upper extreme of age. We characterize the clinical course and outcomes of 73 patients with 80 years of age or older hospitalized at an academic center between March 15 and May 13, 2020. These patients had multiple comorbidities and often presented with atypical clinical findings such as altered sensorium, generalized weakness and falls. Cardiovascular manifestations observed at the time of presentation included new arrhythmia in 7/73 (10%), stroke/intracranial hemorrhage in 5/73 (7%), and elevated troponin in 27/58 (47%). During hospitalization, 38% of all patients required intensive care, 13% developed a need for renal replacement therapy, and 32% required vasopressor support. All-cause mortality was 47% and was highest in patients who were ever in intensive care (71%), required mechanical ventilation (83%), or vasopressors (91%), or developed a need for renal replacement therapy (100%). Patients older than 80 years old with COVID-19 have multiple unique risk factors which can be associated with increased cardiovascular involvement and death.


Subject(s)
Acute Kidney Injury/therapy , COVID-19/therapy , Hospital Mortality , Renal Replacement Therapy/statistics & numerical data , Respiration, Artificial/statistics & numerical data , Vasoconstrictor Agents/therapeutic use , Academic Medical Centers , Accidental Falls , Acute Kidney Injury/etiology , Aged, 80 and over , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/physiopathology , Aspartate Aminotransferases/metabolism , C-Reactive Protein/metabolism , COVID-19/complications , COVID-19/metabolism , COVID-19/physiopathology , Cardiovascular Diseases/etiology , Cardiovascular Diseases/metabolism , Cardiovascular Diseases/physiopathology , Cause of Death , Consciousness Disorders/physiopathology , Dyspnea/physiopathology , Female , Ferritins/metabolism , Fever/physiopathology , Fibrin Fibrinogen Degradation Products/metabolism , Hospitalization , Humans , Hypoxia/physiopathology , Hypoxia/therapy , Independent Living , Intensive Care Units/statistics & numerical data , Intracranial Hemorrhages/etiology , Intracranial Hemorrhages/physiopathology , Leukocyte Count , Liver Diseases/etiology , Liver Diseases/metabolism , Lymphocyte Count , Male , Muscle Weakness/physiopathology , Natriuretic Peptide, Brain/metabolism , Nursing Homes , Oxygen Inhalation Therapy , Procalcitonin/metabolism , Stroke/etiology , Stroke/physiopathology , Troponin I/metabolism
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