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1.
Wiener Klinische Wochenschrift ; 134(SUPPL 2):116-116, 2022.
Article in English | Web of Science | ID: covidwho-1894049
2.
American Journal of Respiratory and Critical Care Medicine ; 205:1, 2022.
Article in English | English Web of Science | ID: covidwho-1880300
3.
Journal Fur Kardiologie ; 29(3-4):76-+, 2022.
Article in German | Web of Science | ID: covidwho-1782100

ABSTRACT

Using methods on cardiac catheterization from ANCALAR complete data from reporting year 2020 are now available. The rate of diagnostic coronary angiography procedures (CAG;-8,7%), total acute plus non-acute PCI (-9.9%), including non-acute PCI (-9.5%), interventions for acute PCI (-10.6%) and including STEMI-PCI (-6.8%) declined during the pandemic year 2020 for the first time compared to the years before. Moreover left ventricular angiography (-12.2%), right heart catheterization (-17.3%), myocardial biopsies (-42.5%), PCI for chronic total occlusions (CTO;-14.1%), clot catcher (-10.3%), and rotablator procedures (-6.7%), as well as electrophysiologic diagnostics (-8.3%) und therapies (ablations;-6.9%) decreased in 2020 compared to 2019 in 27 Austrian Catheterization Laboratories. It is possible that patients suffering from acute, subacute or chronic symptoms presented less frequently in tertiary centres. Private Institutions rather increased the rate of elective procedures during the pandemic year 2020 (elective non acute PCI +9.7%) in contrast to the Austrian trend. Private Institutions but decreased the rate of acute PCI (-40,5%) on a basis of low numbers in pre-existing procedures. On the other hand in non-private Institutions in five centres there was an increase in STEMI-PCI by 23% in contrast to the Austrian decreasing trend. Possibly due to limited access to surgical intensive care wards during the pandemic, percutaneous aortic valve implantations (TAVI;+4.3%), percutaneous Mitral-Clipping (+28%) and defect closure procedures (+2.2%) within Cathlabs increased in 2020 within the whole country, compared to all the years before. This new trend in cardiac procedures within catheterization laboratories was not expected fora whole year and is now documented for Austria correlating to results in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). The presentation is also available at http://iik.i-med.ac.at.

4.
European Heart Journal ; 42(SUPPL 1):3393, 2021.
Article in English | EMBASE | ID: covidwho-1554244

ABSTRACT

Background: COVID-19 has been associated with a high prevalence of myocardial injury and increased cardiovascular morbidity. Copeptin, a marker of vasopressin release, has been previously established as a risk marker in both infectious and cardiovascular disease. Purpose: Investigate the prognostic impact of copeptin and high-sensitive cardiac troponin I (hs-cTnI) in COVID-19. Methods: This prospective, observational study of patients with laboratoryconfirmed COVID-19 infection was conducted from June 6th to November 26th, 2020 in a tertiary care hospital. Copeptin and hs-cTnI levels on admission were collected and tested for their association with the primary composite endpoint of ICU admission or 28-day mortality. Results: A total of 213 eligible patients with COVID-19 were included of whom 55 (25.8%) reached the primary endpoint. Median levels of copeptin and hs-cTnI at admission were significantly higher in patients with an adverse outcome (Copeptin 29.6 pmol/L, [IQR, 16.2-77.8] vs 17.2 pmol/L [IQR, 7.4-41.0] and hs-cTnI 22.8 ng/L [IQR, 11.5-97.5] vs 10.2 ng/L [5.5-23.1], P<0.001 respectively). ROC analysis demonstrated an optimal cutoff of 19.6 pmol/L for copeptin and 16.2 ng/L for hs-cTnI and an increase of either biomarker was significantly associated with the primary endpoint. The combination of raised hs-cTnI and copeptin yielded a superior prognostic value to individual measurement of biomarkers and was a strong prognostic marker upon multivariable logistic regression analysis (OR 4.274 [95% CI, 1.995-9.154], P<0.001). Addition of copeptin and hs-cTnI to established risk models improved C-statistics and net reclassification indices. Conclusion: The combination of raised copeptin and hs-cTnI upon admission is an independent predictor of deterioration (ICU admission) or 28-day mortality in hospitalized patients with COVID-19.

5.
Journal fur Kardiologie ; 28(1-2):10-13, 2021.
Article in German | EMBASE | ID: covidwho-1298304

ABSTRACT

The COVID-19 pandemic poses a significant burden on national health-care systems with serious impact on patients with cardiovascular disease. The clinical course of COVID-19 is often aggravated by arterial or venous thromboembolic complications due to systemic inflammation and activation of the coagulation system. As a consequence of this prothrombotic milieu, thromboembolic complications occur in up to 30% of patients treated on the intensive care unit. Considering the high rates of thromboembolic complications, antithrombotic therapy plays a decisive role. Several recommendations from different expert panels have been published encouraging routine standard dose and increased intensity thromboprophylaxis with low-molecular weight heparin. Quantification of plasma levels of D-Dimer as a marker of the activated coagulation system and for risk stratification has been demonstrated to be of great value. Patients with cardiovascular diseases are a vulnerable patient cohort with an increased risk for an aggravated clinical course of the COVID-19 disease. Interventional treatment of patients with the diagnosis STEMI or high-risk NSTEMI has to be performed without delay regardless of the current state of the pandemic. Careful precautionary measures need to be implemented to protect the patients, but also the health-care personnel and the infrastructure of the hospital.

6.
Europace ; 23(SUPPL 3):iii430, 2021.
Article in English | EMBASE | ID: covidwho-1288015

ABSTRACT

Introduction: The first wave of the COVID-19 crisis was associated with a reduction of patients presenting with acute cardiovascular disease. However, there is only limited data showing the trend of pacemaker implantations and their indications. Purpose: To evaluate pacemaker implantations before, during and after the first COVID-19 wave, stratified by indication. Methods: We analysed the weekly rates of pacemaker implantation at our centre during the first national lockdown for COVID-19 at the between 16 March 2020 and 29 April 2020 (weeks 12-17 / 2020), compared to the implantation rates 6 weeks before (weeks 6-11 / 2020), 6 weeks afterwards (weeks 18-23 / 2020), and the same time frame in 2017-2019. To reduce bias due to postponed planned procedures, we stratified pacemaker implantations into the following groups: total implantations (including box changes), new pacemaker implantations, implantation due to AV block, implantation due to supraventricular conduction disturbances, and other implantations. Results: The total number of total weekly implantations was reduced from 10.7 (weeks 6-11 / 2020) to 4.2 (weeks 12-17 / 2020;-60.1%, p = 0.02). We found no significant reduction in the same time frame in 2017-2019 (6.5 vs. 6.1 per week, p = 0.29). We found a similar effect in 'new' pacemaker implantations (8.5 vs. 3.2 per week, -62.7%, p = 0.02) and AV block (5.0 vs. 1.5 per week, -70%, p = 0.03). There was no reduction in pacemaker implantation due to sick sinus syndrome (2.5 vs. 0.8 per week, -66.7%, p = 0.12) and other indications (1.0 vs. 0.8 per week, -16.7%, p = 0.86). In the six following weeks (18-23 / 2020), the total numbers (6.0 per week) and indications other than AV block rose to baseline (p > 0.05), but patients with AV block were still less prevalent (1.7 per week, p = 0.04). Conclusion: The reduction of total and new pacemaker implantations during the COVID-19 lockdown was mainly based on a reduced pacemaker implantation rate for AV block. This effect persisted even after the national lockdown. This analysis implies that a significant number of patients with AV block may have avoided medical contact during and after the lockdown and therefore have experienced increased mortality.

9.
Journal Fur Kardiologie ; 28(5-6):166-172, 2021.
Article in German | Web of Science | ID: covidwho-1250512

ABSTRACT

Using methods on cardiac catheterization from ANCALAR we compared data from year 2020 to data from 2019 and previous years by conducting a late breaking survey. 12 centres voluntarily provided data for comparative analyses. During the COVID-19 pandemic in 2020 cardiac catheterization procedures decreased markedly and for the first time. The rate of diagnostic coronary angiographic procedures (CAG) declined by -8.2 % (p < 0.001), total acute plus non-acute PCI by -10.0 % (p < 0.001), interventions for acute PCI declined by -12.5 % (p < 0.001) and STEMI-PCI declined by -2.0 % (p = 0.6). Data scattering concerning urban or rural areas, concerning private or public institutions was present but not causative. Moreover left ventricular angiography, right heart catheterization, myocardial biopsies, PCI for chronic total occlusions (CTO), clot catcher, and rotablator procedures, as well as electrophysiologic dia-gnostics und therapies (ablations) decreased. On the other hand percutaneous aortic valve implantation (TAVI), Mitral-Clipping and defect closures within CathLabs increased in 2020. It is possible that patients suffering from acute or subacute symptoms presented less frequently in tertiary centres or that pandemic-related delays for elective procedures have led to later presentations as acute coronary syndromes. This trend of mostly declining cardiac procedures in catheterization laboratories for the whole year was not expected and studies on details and on future clinical impact are warranted.

10.
Occup Med (Lond) ; 71(2): 86-94, 2021 04 09.
Article in English | MEDLINE | ID: covidwho-1087789

ABSTRACT

BACKGROUND: Emerging cross-sectional reports find that the COVID-19 pandemic and related social restrictions negatively affect lifestyle behaviours and mental health in general populations. AIMS: To study the longitudinal impact of COVID-19 on work practices, lifestyle and well-being among desk workers during shelter-at-home restrictions. METHODS: We added follow-up after completion of a clinical trial among desk workers to longitudinally measure sedentary behaviour, physical activity, sleep, diet, mood, quality of life and work-related health using validated questionnaires and surveys. We compared outcomes assessed before and during COVID-19 shelter-at-home restrictions. We assessed whether changes in outcomes differed by remote working status (always, changed to or never remote) using analysis of covariance (ANCOVA). RESULTS: Participants (N = 112; 69% female; mean (SD) age = 45.4 (12.3) years; follow-up = 13.5 (6.8) months) had substantial changes to work practices, including 72% changing to remote work. Deleterious changes from before to during shelter-at-home included: 1.3 (3.5)-h increase in non-workday sedentary behaviour; 0.7 (2.8)-point worsening of sleep quality; 8.5 (21.2)-point increase in mood disturbance; reductions in five of eight quality of life subscales; 0.5 (1.1)-point decrease in work-related health (P < 0.05). Other outcomes, including diet, physical activity and workday sedentary behaviour, remained stable (P ≥ 0.05). Workers who were remote before and during the pandemic had greater increases in non-workday sedentary behaviour and stress, with greater declines in physical functioning. Wake time was delayed overall by 41 (61) min, and more so in workers who changed to remote. CONCLUSIONS: Employers should consider supporting healthy lifestyle and well-being among desk workers during pandemic-related social restrictions, regardless of remote working status.


Subject(s)
COVID-19 , Communicable Disease Control/methods , Life Style , Occupations , Pandemics , Quality of Life , Work , Adult , Affect , Diet , Exercise , Female , Health Status , Humans , Longitudinal Studies , Male , Middle Aged , Mood Disorders/etiology , SARS-CoV-2 , Sedentary Behavior , Sleep , Stress, Psychological , Surveys and Questionnaires
11.
Wiener Klinische Wochenschrift ; 132(SUPPL 5):S218-S218, 2020.
Article in English | Web of Science | ID: covidwho-938074
12.
Wiener Klinische Wochenschrift ; 132(SUPPL 5):S180-S182, 2020.
Article in English | Web of Science | ID: covidwho-937991
13.
14.
Journal fur Kardiologie ; 27(5):156-158, 2020.
Article in English | EMBASE | ID: covidwho-762887

ABSTRACT

Critically ill COVID-19 patients often develop a severe pro-thrombotic milieu, as reflected by the markedly increased d-dimer levels. Several cohort studies have reported high rates of thrombotic complications, including deep venous thrombosis (DVT) and pulmonary embolism (PE), myocardial infarction, stroke and microvascular thrombosis. Accordingly, COVID-19 patients who are hospitalized either at a normal, non-intensive care unit (ICU) or at the ICU need to receive appropriate dosages of anticoagulant therapy to prevent or treat these thrombotic complications. This manuscript summarizes the institutional guidance for the antithrombotic prophylaxis and treatment of VTE as outlined by a multidisciplinary team of experts during the first weeks of the COVID-19 pandemic in Europe. Controlled studies are needed to verify the optimal anticoagulation for both prophylaxis and treatment.

15.
Journal fur Kardiologie ; 27(5):160-163, 2020.
Article in German | EMBASE | ID: covidwho-762729

ABSTRACT

Using methods on cardiac catheterization from ANCALAR we compared data from March 2020 to data from March 2019 by conducting a "snapshot"-survey. 11 centres voluntarily provided data for comparative analyses. During the COVID-19 pandemic in 2020 cardiac catheterisation procedures markedly decreased. The rate of diagnostic angiographic procedures declined by 26%, non-acute PCI by 29%, and interventions for acute coronary syndromes by 14% [(STEMI-PCI (-18%) and NSTEMI-PCI (-15%)]. As expected, this trend of declining cardiac procedures in catheterisation laboratories may influence outcomes and further decision making. Further studies are warranted to confirm this trend and future clinical impact.

16.
Journal fur Kardiologie ; 27(5):146-150, 2020.
Article in German | EMBASE | ID: covidwho-762659

ABSTRACT

The patient forum of the European Society of Cardiology (ESC) has received multiple questions about the Coronavirus (COVID-19). Also the Acute CardioVascular Care Associaion (ACVC) of the ESC was frequently contacted with this respect. This manuscript summarized the most often asked questions with respect to COVID-19 and cardiovascular diseases and aims to provide helpful answers that were given by ESC and ACVC experts. ESC as well as ACVC have entitled J KARDIOL as well as other national cardiovascular journals to translate the content into national languages and offer this document to our colleagues in order to help answering difficult questions for our patients. The authors have done this by performing partially a relative liberal translation in order to reflect Austrian conditions.

17.
Journal fur Kardiologie ; 27(5):140-145, 2020.
Article in German | EMBASE | ID: covidwho-762641

ABSTRACT

The COVID-19 pandemic poses a threat to patients with acute coronary syndromes (ACS) and interventional cardiologists as well as other healthcare workers. The number of COVID-19 positive or suspected positive patients requiring hospital admission has overwhelmed many health systems and negatively affected standard of care for ACS patients in these countries. This manuscript aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. Modified diagnostic and treatment algorithms, which have been developed in countries heavily beaten by this unpredictable challenge, are discussed as are various clinical scenarios and management algorithms for patients with a confirmed or suspected COVID-19 infection presenting with ST segment elevation myocardial infarction (STEMI) or non-ST elevation ACS (NSTE-ACS). Further described topics include the need for re-organization of pre-hospital (STEMI networks) and in-hospital structures (emergency rooms and cardiac units), with examples coming from multiple European countries. Finally, this manuscript aims to help re-organizing of catheterization laboratory structures and personnel and to discuss measures for protection of healthcare providers involved with invasive procedures.

18.
Journal fur Kardiologie ; 27(5):152-155, 2020.
Article in German | EMBASE | ID: covidwho-762461

ABSTRACT

Viral illnesses such as COVID-19 can cause respiratory infections and pneumonia that may lead to lung damage (ARDS) and even death in severe cases. The most critical cases include septic shock, respiratory failure, and multiple organ dysfunction/failure that may result in worse outcome. Additionally, SARS-CoV-2 infection can cause cardiac damage and injury even in patients without underlying heart conditions, and may have fatal consequences for people with cardiovascular disease. SARS-CoV-2 infection can cause acute coronary syndromes, myocarditis, arrhythmias, and exacerbation or development of heart failure. All efforts implemented to limit the spreading of SARS-CoV-2 infection and to treat COVID-19 should not compromise contemporary standard-of-care for the treatment of cardiovascular diseases. This has to be done by a close collaboration with other specialists including involved in the management of COVID-19 patients including infectious disease experts, pulmonologists, and intensive care specialists. Finally, strategies to appropriately manage cardiovascular diseases in both COVID-19-positive and uninfected patients have to be defined while the safety of healthcare professionals has to be guaranted.

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