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J Cardiol ; 79(4): 468-475, 2022 04.
Article in English | MEDLINE | ID: covidwho-1648748


Arrhythmias in COVID-19 patients are associated with hypoxia, myocardial ischemia, cytokines, inflammation, electrolyte abnormalities, pro-arrhythmic or QT-prolonging medications, and underlying heart conditions such as severe congestive heart failure, inherited arrhythmia syndromes, or congenital heart conditions. In the pediatric population, multisystem inflammatory syndrome can lead to cardiac injury and arrhythmias. In addition, arrhythmias and cardiac arrests are most prevalent in the critically ill intensive care unit COVID-19 patient population. This review presents an overview of the association between COVID-19 and arrhythmias by detailing possible pathophysiological mechanisms, existing knowledge of pro-arrhythmic factors, and results from studies in adult and pediatric COVID-19 populations, and the clinical implications.

Arrhythmias, Cardiac , COVID-19 , Heart Arrest , Adult , Arrhythmias, Cardiac/virology , COVID-19/complications , Child , Heart Arrest/virology , Humans , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-291065


Introduction: Transplant patients are a vulnerable group due to their immunocompromised status. Understanding how COVID-19 can present in this group is clinically important. Therefore, we conduct a systematic review and meta-analysis on clinical features and management of transplant patients with COVID-19. Methods: Five databases were searched in May 2020 to include all relevant studies reporting clinical features or outcomes of COVID-19 infection in transplant patients. Data on clinical presentation, outcomes, lab values, imaging, and drug regimen were extracted. CMA software was used for meta-analysis. Protocol was registered in PROSPERO (CRD42020189458). Results: A total of 49 studies were finally included for analysis. Patients mainly complained from fever with event rate 74.40 % (95% CI= 69.4-78.8), cough 61.10% (95% CI= 55.8-66), and dyspnea 46.60% (95% CI= 69.4-78.8). Blood urea nitrogen 78.90% (95% CI= 54.7-92), ESR 78.10% (95% CI=52.3-92.1), and D-dimer 74.10% (95 % CI= 53-87.9) were the most elevated observed laboratory values. Ground glass opacities (GGO) were observed with event rate 68.10% (95% CI= 20.4-94.9). For treatment, immunosuppressants were used in 88.80% (95% CI= 77.6-94.8) of patients, followed by antibiotics and antiviral drugs 68.40% (95% CI= 52.4-80.9), 66.80% (95% CI = 45-83.2), respectively. Mechanical ventilation was used in 26.30% (95% CI=21-32.4) patients while 33.7% (95% CI= 20.7-49.9) intubated. Rejection occurred in 11% (95% CI= 4.4-25) of the patients. Finally, 18.20% (95% CI= 12.6-25.7) died. Conclusion: Clinical characteristics and management in transplant COVID patients suggest the similar course in non-transplant. Fever, cough, dyspnoea, elevated blood urea nitrogen level, elevated CRP, elevated d-dimer, GGO, and consolidation were found to be the most frequent abnormalities. No direct, comparative analysis with non-transplant COVID population limited our results;however, numerous studies that examined the infected general population found similar, less augmented findings. Most of the included sample were kidney transplant patients;therefore, more studies are needed to address other types of COVID-19 infected transplant patients.

Rev Med Virol ; 31(6): e2288, 2021 11.
Article in English | MEDLINE | ID: covidwho-1384306


SARS Coronavirus-2 is one of the most widespread viruses globally during the 21st century, whose severity and ability to cause severe pneumonia and death vary. We performed a comprehensive systematic review of all studies that met our standardised criteria and then extracted data on the age, symptoms, and different treatments of Covid-19 patients and the prognosis of this disease during follow-up. Cases in this study were divided according to severity and death status and meta-analysed separately using raw mean and single proportion methods. We included 171 complete studies including 62,909 confirmed cases of Covid-19, of which 148 studies were meta-analysed. Symptoms clearly emerged in an escalating manner from mild-moderate symptoms, pneumonia, severe-critical to the group of non-survivors. Hypertension (Pooled proportion (PP): 0.48 [95% Confident interval (CI): 0.35-0.61]), diabetes (PP: 0.23 [95% CI: 0.16-0.33]) and smoking (PP: 0.12 [95% CI: 0.03-0.38]) were highest regarding pre-infection comorbidities in the non-survivor group. While acute respiratory distress syndrome (PP: 0.49 [95% CI: 0.29-0.78]), (PP: 0.63 [95% CI: 0.34-0.97]) remained one of the most common complications in the severe and death group respectively. Bilateral ground-glass opacification (PP: 0.68 [95% CI: 0.59-0.75]) was the most visible radiological image. The mortality rates estimated (PP: 0.11 [95% CI: 0.06-0.19]), (PP: 0.03 [95% CI: 0.01-0.05]), and (PP: 0.01 [95% CI: 0-0.3]) in severe-critical, pneumonia and mild-moderate groups respectively. This study can serve as a high evidence guideline for different clinical presentations of Covid-19, graded from mild to severe, and for special forms like pneumonia and death groups.

COVID-19/pathology , Cough/pathology , Dyspnea/pathology , Fatigue/pathology , Fever/pathology , SARS-CoV-2/pathogenicity , Antiviral Agents/therapeutic use , COVID-19/drug therapy , COVID-19/mortality , COVID-19/virology , Comorbidity , Cough/drug therapy , Cough/mortality , Cough/virology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/physiopathology , Dyspnea/drug therapy , Dyspnea/mortality , Dyspnea/virology , Fatigue/drug therapy , Fatigue/mortality , Fatigue/virology , Fever/drug therapy , Fever/mortality , Fever/virology , Humans , Hypertension/diagnosis , Hypertension/physiopathology , Immunologic Factors/therapeutic use , Prognosis , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/physiopathology , Severity of Illness Index , Smoking/physiopathology , Survival Analysis