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1.
Turk J Ophthalmol ; 52(5): 342-347, 2022 10 28.
Article in English | MEDLINE | ID: covidwho-2100077

ABSTRACT

Bilateral acute depigmentation of the iris (BADI) and bilateral acute iris transillumination (BAIT) are relatively new clinical entities characterized by acute pigment dispersion from the iris stroma or iris pigment epithelium, respectively. While BADI presents with diffuse or geographic areas of iris stromal depigmentation without transillumination, BAIT cases typically develop diffuse iris transillumination and mydriatic atonic pupils. Prolonged pigment dispersion and ocular hypertension are more common in BAIT. Although the exact etiopathogenesis is still unknown, moxifloxacin toxicity appears to be a probable/likely cause. The underlying cause of BADI or BAIT in patients who were not exposed to fluoroquinolone antibiotics remains unexplained. Systemic viral infections, including coronavirus disease 2019, may be the triggering event in several cases.


Subject(s)
COVID-19 , Iris Diseases , Humans , Iris Diseases/chemically induced , Iris Diseases/diagnosis , Transillumination , Iris/pathology , Fluoroquinolones
2.
Br J Gen Pract ; 2022 Aug 30.
Article in English | MEDLINE | ID: covidwho-2099922

ABSTRACT

BACKGROUND: Ambulatory blood-pressure monitoring (ABPM) has become less frequent in primary care since the COVID-19 pandemic, with home blood-pressure monitoring (HBPM) often the preferred alternative; however, HBPM cannot measure night-time blood pressure (BP), and patients whose night-time BP does not dip, or rises (reverse dipping), have poorer cardiovascular outcomes. AIM: To investigate the importance of measuring night-time BP when assessing individuals for hypertension. DESIGN AND SETTING: Retrospective cohort study of two patient populations - namely, hospital patients admitted to four UK acute hospitals located in Oxfordshire, and participants of the BP in different ethnic groups (BP-Eth) study, who were recruited from 28 UK general practices in the West Midlands. METHOD: Using BP data collected for the two cohorts, three systolic BP phenotypes (dipper, non-dipper, and reverse dipper) were studied. RESULTS: Among the hospital cohort, 48.9% ( n = 10 610/21 716) patients were 'reverse dippers', with an average day-night systolic BP difference of +8.0 mmHg. Among the community (BP-Eth) cohort, 10.8% ( n = 63/585) of patients were reverse dippers, with an average day-night systolic BP difference of +8.5 mmHg. Non-dipper and reverse-dipper phenotypes both had lower daytime systolic BP and higher night-time systolic BP than the dipper phenotype. Average daytime systolic BP was lowest in the reverse-dipping phenotype (this was 6.5 mmHg and 6.8 mmHg lower than for the dipper phenotype in the hospital and community cohorts, respectively), thereby placing them at risk of undiagnosed, or masked, hypertension. CONCLUSION: Not measuring night-time BP puts reverse-dippers (those with a BP rise at night-time) at risk of failure to identify hypertension. As a result of this study, it is recommended that GPs should offer ABPM to all patients aged ≥60 years as a minimum when assessing for hypertension.

3.
Cardiovasc Hematol Disord Drug Targets ; 22(2): 104-117, 2022.
Article in English | MEDLINE | ID: covidwho-2098958

ABSTRACT

BACKGROUND: Hypertension and heart failure are known risk factors for coronavirus disease 2019 (COVID-19) severity and mortality outcomes. Beta-blocker is one of the drugs of choice to treat these conditions. The purpose of this study is to explore the relationship between preadmission beta-blocker use and COVID-19 outcomes. METHODS: PubMed and Europe PMC were used as the database for our search strategy by using combined keywords related to our aims until December 10th, 2020. All articles related to COVID- 19 and beta-blocker were retrieved. Review Manager 5.4 and Comprehensive Meta-Analysis 3 software were used to perform statistical analysis. RESULTS: A total of 43 studies consisting of 11,388,556 patients were included in our analysis. Our meta-analysis showed that the use of beta-blocker was associated with increased risk of COVID-19 [OR 1.32 (95% CI 1.02 - 1.70), p = 0.03, I2 = 99%, random-effect modelling], clinical progression [OR 1.37 (95% CI 1.01 - 1.88), p = 0.04, I2 = 89%, random-effect modelling], and mortality from COVID-19 [OR 1.64 (95% CI 1.22 - 2.19), p = 0.0009, I2 = 94%, random-effect modelling]. Metaregression showed that the association with mortality outcome were influenced by age (p = 0.018) and hypertension (p = 0.005). CONCLUSION: The risk and benefits of using beta-blocker as a drug of choice to treat hypertensive patients should be considered and reviewed individually, case by case, knowing their association with higher incidence and severity of COVID-19 infections. Other first-line antihypertensive drugs may be considered as an alternative therapy if the risk of administering beta blockers outweighs the benefits of COVID-19 infection. REGISTRATION DETAILS: PROSPERO (CRD42021260455).


Subject(s)
COVID-19 , Hypertension , Humans , COVID-19/drug therapy , Antihypertensive Agents/therapeutic use , Hypertension/drug therapy , Adrenergic beta-Antagonists/therapeutic use
4.
Egypt Heart J ; 72(1): 41, 2020 Jul 13.
Article in English | MEDLINE | ID: covidwho-2098495

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic has drastically affected global health. Despite several studies, there is yet a dearth of data regarding the mechanisms of cardiac injury, clinical presentation, risk factors, and treatment of COVID-19-associated cardiovascular disease. This systematic review and meta-analysis is aimed at defining the clinical, electrocardiographic, and pathologic spectrum of cardiovascular disease (CVD), frequency of elevated cardiac and inflammatory biomarkers, and their frequency and relationship with severity of the disease and mortality in COVID-19 patients and to develop a triage risk stratification tool (TRST) that can serve as a guide for the timely recognition of the high-risk patients and mechanism-targeted therapy. We conducted an online search in databases of PubMed and Embase to identify relevant studies. Data selection was in concordance with PRISMA guidelines. Results were presented as pooled frequencies, odds ratio, standardized mean difference (SMD), and forest and funnel plots. RESULTS: We gathered a total of 54 studies and included 35 of them in our meta-analysis. Acute cardiac injury occurred in more than 25% of cases, mortality was 20 times higher, and admission to intensive care unit increased by 13.5 times. Hypertension was the most common pre-existing comorbidity with a frequency of 29.2%, followed by diabetes mellitus (13.5%). The deceased group of patients had higher cardiac and inflammatory biomarkers, with statistically significant SMD, compared with survivors. Pediatric patients were predominantly mildly affected. However, less frequently, the presentation was very similar to Kawasaki disease or Kawasaki shock syndrome. This latter presentation hass been called as multisystem inflammatory syndrome in children (MIS-C). CONCLUSIONS: There is a wide spectrum of cardiac involvement in COVID-19 patients, and hence a Triage Risk Stratification Tool can serve as a guide for the timely recognition of the high-risk patients and mechanism-targeted therapy.

5.
Am J Hypertens ; 35(11): 948-954, 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2097304

ABSTRACT

BACKGROUND: Although hypertension is a risk factor for severe Coronavirus Disease 2019 (COVID-19) illness, little is known about the effects of COVID-19 on blood pressure (BP). Central BP measures taken over a 24-hour period using ambulatory blood pressure monitoring (ABPM) adds prognostic value in assessing cardiovascular disease (CVD) risk compared with brachial BP measures from a single time point. We assessed CVD risk between adults with and without a history of COVID-19 via appraisal of 24-hour brachial and central hemodynamic load from ABPM. METHODS: Cross-sectional analysis was performed on 32 adults who tested positive for COVID-19 (29 ± 13 years, 22 females) and 43 controls (28 ± 12 years, 26 females). Measures of 24-hour hemodynamic load included brachial and central systolic and diastolic BP, pulse pressure, augmentation index (AIx), pulse wave velocity (PWV), nocturnal BP dipping, the ambulatory arterial stiffness index (AASI), and the blood pressure variability ratio (BPVR). RESULTS: Participants who tested positive for COVID-19 experienced 6 ± 4 COVID-19 symptoms, were studied 122 ± 123 days after testing positive, and had mild-to-moderate COVID-19 illness. The results from independent samples t-tests showed no significant differences in 24-hour, daytime, or nighttime measures of central or peripheral hemodynamic load across those with and without a history of COVID-19 (P > 0.05 for all). CONCLUSIONS: No differences in 24-hour brachial or central ABPM measures were detected between adults recovering from mild-to-moderate COVID-19 and controls without a history of COVID-19. Adults recovering from mild-to-moderate COVID-19 do not have increased 24-hour central hemodynamic load.


Subject(s)
COVID-19 , Hypertension , Vascular Stiffness , Adult , Female , Humans , Blood Pressure Monitoring, Ambulatory/methods , Pulse Wave Analysis/methods , Cross-Sectional Studies , Blood Pressure , Vascular Stiffness/physiology , Hemodynamics
6.
World Neurosurg ; 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2096139

ABSTRACT

BACKGROUND: Increasing evidence supports the effectiveness of venous sinus stenting (VSS) with favorable outcomes, safety, and expenses compared to shunting for idiopathic intracranial hypertension. Yet, no evidence is available regarding optimal postoperative recovery, which has growing importance with the burdens on healthcare imposed by the COVID pandemic. We examined adverse events and costs after VSS and propose an optimal recovery pathway to maximize patient safety while reducing stress on healthcare resources. METHODS: Retrospective review of elective VSS operations performed from May 2008 to August 2021 at a single institution. Primary data included hospital length of stay (LOS), intensive care unit (ICU) LOS, adverse events, need for ICU interventions, and hospital costs. RESULTS: 53 patients (98.1% female) met inclusion criteria. Of these, 51 patients (96.2%) discharged on post-operative day-1 (POD-1) and 2 patients discharged on POD-2. Both POD-2 patients remained because of groin hematomas from femoral artery access. There were no major complications nor care that required an ICU. There were 8 patients (15.1%) lateralized to other ICUs or remained in a post-anesthesia care unit due to the neurosciences ICU (NSICU) being above capacity. Total estimated cost for initial recovery day in a NSICU room was $2,361 versus $882 for a neurosurgery/neurology ward room. In our cohort, ward convalescence would save an estimated $79,866 for bed placement alone and increase ICU bed availability. CONCLUSION: Our findings reaffirm the safety of VSS. These patients should recover on a neurosurgery/neurology ward, which would save healthcare costs and increase ICU bed availability.

7.
Medical Science ; JOUR(125), 26.
Article in English | Web of Science | ID: covidwho-2091792

ABSTRACT

Background: Corona virus disease 2019 pandemic had a major impact on the general wellbeing of people. Hypertension patients are more liable to psychological stress. This study aims to assess the prevalence of psychological stress in hypertensive patients affected by Covid-19 in Madinah. Methods: Hypertension patients in Al Madinah were invited to participate in an online questionnaire in the period from December 2020 to May 2021. It included the personal data, questions assessing hypertension and psychological health status using the General Health Questionnaire. Results: Total number of participants in our study was 588. 30.8% of participants were mildly distressed and 6.8% were severely distressed. Females are being more at risk of severe distress. Regarding taking prescribed medications there was a significant relationship between groups. Conclusion: The prevalence was found to be 0.376. Hypertensive patients in Al Madinah are at more risk of psychological stress especially females, students, unemployed, and those who are not adherent to their medications. More psychological care should be provided to them in pandemics. Objectives: To evaluate the prevalence of psychological stress after Covid-19 in hypertensive patients in Madinah.

8.
Ter Arkh ; 94(9): 1052-1056, 2022 Oct 24.
Article in Russian | MEDLINE | ID: covidwho-2091507

ABSTRACT

On December 13, 2021, an expert council was held to determine the position of experts of different specialties regarding the reasons for the low level of diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) in real clinical practice in a pandemic of a new coronavirus infection and possible ways to improve detection in patients with pulmonary embolism (PE) ) in history. The reasons for the low level of diagnosis of CTEPH are the insufficient level of knowledge of specialists, especially primary care physicians; lack of clear regulatory documents and expert centers for the management of this category of patients. Primary diagnosis of CTEPH in a pandemic can be strengthened through the widespread use of telemedicine for consultations of primary care physicians with specialists from expert centers; to maximize the role of echocardiography and computed tomography (CT) as differential diagnostic tools for dyspnea, in particular in patients with COVID-19. To increase the detection rate of CTEPH, diagnostic vigilance is required in patients with risk factors and episodes of venous thromboembolism. To improve the screening of CTEPH, it is necessary to create an algorithm for monitoring patients who have had PE; provide educational activities, including through the media; create materials for patients with accessible information. The regulatory documents should designate the circle of responsible specialists who will be engaged in long-term monitoring of patients with PE. Educational programs are needed for primary care physicians, cardiologists, and other physicians who come into the field of view of patients with CTEPH; introduction of a program to create expert centers for monitoring and managing patients with the possibility of performing ventilation-perfusion lung scintigraphy, cardiopulmonary stress test, CT, right heart catheterization. It seems important to build cooperation with the Ministry of Health of Russia in order to create special protocols, procedures for managing patients with PE and CTEPH.


Subject(s)
COVID-19 , Hypertension, Pulmonary , Pulmonary Embolism , Humans , Hypertension, Pulmonary/diagnosis , Hypertension, Pulmonary/etiology , Chronic Disease , COVID-19/complications , Pulmonary Embolism/diagnosis , Pulmonary Embolism/complications , Echocardiography
9.
Acta Clin Croat ; 61(Suppl 1): 23-27, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-2091289

ABSTRACT

The aim of this study was to determine the frequency of newly verified or worsened existing hypertension in patients who had coronavirus 2019 (COVID-19). To be categorized as a COVID-19 patient, a positive reverse-transcription polymerase chain reaction test at a single point in time was required. The patients' age, history, laboratory values and antihypertensive therapy of patients were recorded. In one year, 32 of 199 patients studied had either newly verified (15) or worsened existing (17) arterial hypertension. Among those patients, the median time from a verified infection to the onset of symptoms was 3 months. When the patients were divided into groups, 4 were in the acute, 11 in the sub-acute, 8 in the chronic and 9 in the "long COVID" group. Compared to the rest of the study population, patients presenting with arterial hypertension had significantly higher systolic (median 141 mmHg vs 130 mmHg, p<0.001) and diastolic (median 93 mmHg vs 80 mmHg, p<0.001) blood pressure and were significantly younger (median 51 vs 59 years, p 0.032). Arterial hypertension following COVID-19, either newly verified or worsened existing, is a relatively common occurrence (16% of our patient pool), indicating that more effort should be directed at evaluating the blood pressure values of patients following COVID-19.


Subject(s)
COVID-19 , Coronavirus , Hypertension , Humans , Retrospective Studies , COVID-19/complications , COVID-19/epidemiology , Tertiary Care Centers , Hypertension/epidemiology , Blood Pressure/physiology
10.
J Pharm Pract ; : 8971900221136629, 2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2089079

ABSTRACT

INTRODUCTION: Studies have shown positive clinical outcomes in chronic conditions, such as hypertension, through pharmacist-delivered medication therapy management and medication adherence services. Given the need for social distancing during the COVID-19 pandemic, increased utilization of telepharmacy strategies has been employed for managing blood pressure control. METHODS: A retrospective single-center cohort study that compared in-person pharmacist visits and telepharmacy visits in primary care patients with hypertension via electronic chart review from January 2018 to July 2022. Subjects were included who were at least 18 years of age with hypertension. Comparator groups were patients who underwent an in-person pharmacy (pre-COVID-19) visit vs a telepharmacy visit (post-COVID-19). The primary outcome was the number of patients with controlled blood pressure based on a blood pressure goal of less than or equal to 130/80 following telepharmacy visit vs in-person visit. Medication adherence, pharmacist intervention, incidence of antihypertensive side-effects, and blood pressure maintenance based on a goal of ≤140/90 were also evaluated. RESULTS: A total of 77 patients were included. There was no difference in the primary outcome following in person pharmacy visits compared to telepharmacy visits (P = .690). There was also no difference found for the secondary endpoints of blood pressure goal less than or equal to 140/90 mmHg (P = .481), medication adherence (P = 1.00), or antihypertensive adverse events (P = .344). CONCLUSION: Telepharmacy visits had a nonsignificant change in blood pressure control when compared to in-person visits. Results suggest that the utilization of either in-person or telepharmacy strategies benefit the management of hypertension.

11.
Hipertens Riesgo Vasc ; 2022 Oct 20.
Article in Spanish | MEDLINE | ID: covidwho-2086271

ABSTRACT

INTRODUCTION AND OBJECTIVES: Cardiovascular prevention measures place the emphasis on controlling cardiovascular risk factors (CVRF). However, the most recent studies provide disappointing data, the impact of which remains to be determined. The objective of this study was to analyse the impact that the different CVRFs, and their degree of control, have on the prognosis of patients after acute coronary syndrome. PATIENTS AND METHODS: Epidemiological, pharmacological, and CVRF control data were collected from 1,689 consecutive patients admitted from 2018 to 2020 for acute coronary syndrome to a tertiary hospital. Finally, the rate of major adverse cardiovascular events was calculated. RESULTS: The patients admitted for acute coronary syndrome were predominantly men, with body mass index>25Kg/m2, smokers (or former smokers) and with poor CVRF control (50% for hypertension and diabetes and 35% for dyslipidaemia), especially those patients with a personal history of ischaemic heart disease. An underutilisation of useful drugs for CVRF control was found. A directly proportional relationship was observed between the number of CVRFs (or their poor control) and the incidence of major adverse cardiovascular events at 2 years, hypertension being the factor with the greatest cardiovascular impact. The SARS-CoV-2 lockdown worsened the degree of CVRF control and cardiovascular prognosis. CONCLUSION: There is still room for improvement in the control of CVRF, which would translate into a prognostic benefit for patients with ischaemic heart disease. The implementation of cardiovascular prevention campaigns seems essential.

12.
Ann Cardiol Angeiol (Paris) ; 2022 Oct 26.
Article in French | MEDLINE | ID: covidwho-2085908

ABSTRACT

PROBLEM: There are no studies on the association between high blood pressure and COVID-19 in South Kivu. OBJECTIVE: to determine the influence of arterial hypertension on the clinical characteristics and prognosis of COVID-19 patients hospitalized in the city of Bukavu. METHODOLOGY: Between June 2020 and June 2022, an open cohort of hypertensive and non-hypertensive COVID-19 patients admitted to two clinics in the city of Bukavu was formed. The primary endpoint was the occurrence of death. Thus, a prospective modeling of mortality by the Kaplan-Meier estimator was carried out. RESULTS: Among the 178 admissions for COVID-19, 68 (38.2%) patients were hypertensive. Compared to non-hypertensives, hypertensive patients were significantly older [61.0 (56.0-71.0) vs. 48.0 (32.7-64.0); p < 0,0001). During the observation period of 1059 patient-days, the incidence of death (3.2/100 patient-days) was non-significantly higher in hypertensive patients (4.3/100 patient-days) (p = 0.06). On the other hand, the independent predictors of death were Sepsis [adjusted HR = 3.7 (1.5-8.7)], CRP > 100 mg/L [adjusted HR = 3.0 (1.2-7, 0)] and SaO2 < 90 % [adjusted HR = 3.9 (1.3-11.8)]. CONCLUSION: This study shows that hypertension was very common in patients admitted for COVID-19 in the city of Bukavu but did not influence the vital prognosis of the latter, thus confirming the finds of most authors who have addressed the question.

13.
Cell Journal ; JOUR(7):424-426, 24.
Article in English | Web of Science | ID: covidwho-2082629

ABSTRACT

There are a lot of data about the correlation of SARS-CoV-2 infection and hypertension (HTN), but most of them are in the increased risk of morbidity and mortality in patients with HTN. SARS-CoV-2 can interfere with host cells through the renin-angiotensin system (RAS) via the angiotensin-converting enzyme 2 (ACE2) receptor. RAS activation is associated with pro-inflammatory effects through the ACE/Ang II/ Angiotensin II type 1 receptor (AT1R) pathway or anti-inflammatory effects through ACE2/Ang1-7/Mas axis. In the current paper, we discuss the pathophysiology of newly diagnosed HTN and its effect on morbidity in patients with coronavirus disease 2019 (COVID-19).

14.
SSRN;
Preprint in English | SSRN | ID: ppcovidwho-346143

ABSTRACT

Background: Hypertension (HTN) has become a key public health problem and a vital reason of mortality and morbidity in developing countries like Bangladesh. The COVID-19 pandemic has induced chronic stress among a significant number of people all over the world;Bangladesh is not an exception in this case. So, the purpose of this study was to evaluate the occurrence of hypertension and its related risk factors during the COVID-19 pandemic within the capital of Bangladesh.Study designA cross-sectional study. Methods: This study has used a multistage random sampling technique to select 305 individuals for conducting this study. Data on personal information, socio-demographic information, anthropometric information, dietary information, lifestyle, and blood pressure were collected through a close-ended questionnaire. Data were analyzed through the use of SPSS version 22 software. Findings: Among the study subjects, about 34.4% prevalence of HTN was identified. Out of 105 hypertensive respondents, 65% of them were newly diagnosed during this study and 11 respondents did not take any medications for hypertension that were pre-diagnosed with hypertension. In this study, we noticed a significant (P<0.001) prevalence of HTN among individuals who used to take inadequate fruits (OR=3.129, 95% CI=1.912-5.122,χ2=21.328), insufficient vegetables (OR=2.199, 95% CI= 1.356-3.565, χ2=10.373), more fatty foods (OR=2.387, 95% CI=1.465-3.890,χ2=12.454) and extra salt intake (OR=2.771, 95% CI=1.677-4.579,χ2=16.310). Moreover, among the overweight (46.70%) and at-risk (22.90%) respondents the prevalence of HTN was higher according to their Body Mass Index (BMI) and Waist to Hip Ratio (WHR) respectively. Risk factors estimation of HTN showed that it had a significant correlation (P<0.001) with smoking (OR=2.824, 95% CI=1.601-4.980,χ2=13.432), general stress (OR=3.692, 95% CI=2.179-6.255,χ2=24.896), and stress-related to COVID-19 (OR=3.511, 95% CI=2.116-5.826,χ2=24.712). Conclusions: The nationwide survey, surveillance, and clinical research are mandatory to portray the factual scenario of HTN in Bangladesh. Lifestyle modification and dietary changes should be adopted for HTN treatment.

15.
Russian Journal of Cardiology ; 27(8):42-48, 2022.
Article in Russian | EMBASE | ID: covidwho-2081129

ABSTRACT

Aim. To conduct a comparative analysis of clinical and functional parameters and quality of life (QoL) in patients with chronic thromboembolic pulmonary hypertension (CTEPH), depending on the presence of a depressive disorder in long-term postoperative period. Material and methods. The study included 182 patients with CTEPH in the long term after surgery. Depending on the Patient Health Questionnaire 9 (PHQ-9) data, all patients were divided into 2 groups: the 1st group - patients without depressive syndrome in the long-term postoperative period, the 2nd - patients with depressive syndrome. A comparative assessment of the initial clinical and functional characteristics, as well as QoL was carried out using the SF-36 questionnaire in both groups of patients. In patients who had a coronavirus disease 2019 (COVID-19), a comparative assessment using the Post-COVID-19 Functional Status (PCFS) scale was carried out. Results. Clinically relevant depressive syndrome in patients with CTEPH in the long term after surgery was registered in 25,3% of cases. In the 2nd group of patients, prior myocardial infarction (p=0,02), concomitant chronic cerebrovascular disease (p=0,01), as well as moderate and severe post-COVID-19 functional limitations according to the PCFS scale (p=0,004) were significantly more often recorded compared with the 1st group. In the 2nd group of patients, the level of QoL in almost all parameters was significantly lower in comparison with the 1st group (p<0,05). Decreased QoL (score <40) in the 2nd group concerned numerous parameters, including the physical and mental health components. In the 1st group of patients, reduced QoL was observed only in some physical parameters. Conclusion. The group of patients with CTEPH with depressive syndrome in the long-term postoperative period was characterized by a higher incidence of concomitant chronic cerebrovascular disease and a history of myocardial infarction compared with patients without depressive disorders. In the group of patients with depressive disorders, moderate and severe post-COVID-19 functional limitations according to the PCFS scale were more often observed. Depressive disorders in patients with CTEPH in the long-term postoperative period were accompanied by significantly reduced QoL parameters. Patients experienced the greatest difficulties both during normal daily activities and in professional activities. Copyright © 2022, Silicea-Poligraf. All rights reserved.

16.
Eur J Case Rep Intern Med ; 9(9): 003540, 2022.
Article in English | MEDLINE | ID: covidwho-2080974

ABSTRACT

Introduction: Haemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome is a leading cause of maternal mortality. The emergence of coronavirus disease 2019 (COVID-19) has led to challenges in diagnosing HELLP syndrome due to overlapping clinical and laboratory presentations. We report a case of HELLP syndrome complicated by COVID-19 infection. Case Description: An otherwise healthy pregnant 31-year-old woman presented with fever, myalgia and headache. She was found to be COVID-positive with laboratory signs of HELLP syndrome. Symptoms and laboratory findings trended toward normal after delivery confirming the diagnosis of HELLP syndrome. Discussion: A prompt diagnosis of HELLP syndrome is essential to avoid maternal and fetal complications. Clinicians should be aware of the similarities in presentation between HELLP syndrome and COVID-19 for timely diagnosis and treatment. LEARNING POINTS: SARS-CoV-2 preferentially binds to ACE2 which is expressed in extrapulmonary tissue including placental tissue.COVID-19, HELLP syndrome and preeclampsia may have similar characteristics including elevated blood pressures, liver dysfunction, cardiopulmonary complaints and hypercoagulability.The temporal relationship of symptomatic improvement with delivery and after delivery may better differentiate HELLP syndrome from COVID-19.

17.
Am J Respir Crit Care Med ; 2022 Oct 17.
Article in English | MEDLINE | ID: covidwho-2079141
18.
Medical Science ; 26(126), 2022.
Article in English | Web of Science | ID: covidwho-2072576

ABSTRACT

The clinical status, i.e. oxygen need, of adult COVID-19 infection cases were linked with the 25 Point CT severity score in this investigation. An observational case control study after institutional research review board approval (NKPSIMS & RC and LMH / IEC-RADIOLOGYY/ 06/2020) including 123 case record of symptomatic cases presented to our hospital and who were RTPCR positive for COVID-19 infection, was collected for 3 months (August 2020 to Oct 2020). All patients underwent non-contrast HRCT scan on TOSHIBA Activion 16 slice CT (computed tomography). In our study, the mean age amongst the cases was ranging from 51-60 years [69.9% males, 30.1% females]. The oxygen requirements, as well as other variables such as age and sex, were found to be strongly correlated with CT severity score. CT severity score shows positive correlation with requirement of oxygen in cases with COVID-19.

19.
Medical Science ; 26(126), 2022.
Article in English | Web of Science | ID: covidwho-2072574

ABSTRACT

Introduction: Hypertension is widely spread in Saudi Arabia, often individuals do not know they are suffering from this disease or the implications. This study aims to determine the level of awareness stemming from youth residents of Riyadh, Saudi Arabia when it comes to hypertension and preventable actions. Methods: This is a community-based, cross-sectional study conducted among high school students studying in different regions of Riyadh, Saudi Arabia. Questionnaires were distributed among students and included demographic characteristics, attitude towards hypertension and a 20-item questionnaire to measure the hypertension awareness and prevention. Results: 503 students took part (54.7% males). Overall mean awareness scores were 12.8 (SD 3.85) out of 20 points. 60% were considered having moderate awareness, 25.2% good awareness and the remaining had poor awareness levels (15.3%). Factors associated with increased awareness scores were female, attending private schools, and undergoing screening tests. While being diagnosed with hypertension was the only factor associated with decreased awareness scores. Conclusion: The awareness of the students regarding hypertension and its prevention was adequate. Female students who were studying at private schools and who had undergone screening tests demonstrated better awareness levels compared to others.

20.
Rev Panam Salud Publica ; 46: e181, 2022.
Article in Spanish | MEDLINE | ID: covidwho-2072437

ABSTRACT

Cardiovascular diseases are the leading cause of mortality and morbidity in the Region of the Americas, and hypertension is one of the main risk factors. In 2018, Argentina began implementing the HEARTS Initiative in five primary health care centers, through the National Plan for the Prevention and Control of Arterial Hypertension. This study presents the impact its implementation has had on the indicators of effective coverage, treatment, combination therapy, and control. The HEARTS Initiative has multiple components; these include training health teams, reassigning tasks based on the transfer of clinical competencies, providing automatic and clinically validated blood pressure measurement devices, and using a single standardized treatment protocol. A longitudinal data model (generalized estimating equation analysis) was used, and the information from the five health centers was grouped using weighted averages according to the size of the population under coverage. Analysis of the results was stratified into two time periods delimited by the imposition of restrictions due to COVID-19. During the first period of 18 months, significant improvement was observed in treatment (5.9%; p<0.01) and combination therapy (13.4%; p<0.01), with no significant change in coverage (8.4%; p=0.87) and with a paradoxical decrease in control (-3.3%; p=0.02). When the period of restrictions was compared to the previous period, a generalized reduction was observed in all indicators, particularly coverage (-23.6%; p<0.01) and control (-12.5%; p<0.01). However, treatment and combination therapy levels remained above baseline values (1.7%; p<0.01 and 5.4%; p<0.01, respectively).


As doenças cardiovasculares são a principal causa de morbimortalidade, e a hipertensão, seu principal fator de risco. Em 2018, a Argentina começou a implementar a Iniciativa HEARTS em 5 centros de atenção primária à saúde por meio do Plano Nacional de Prevenção e Controle da Hipertensão Arterial. Este estudo apresenta o impacto de sua implementação nos indicadores de cobertura efetiva, tratamento, tratamento combinado e controle. A Iniciativa HEARTS inclui vários componentes. Entre eles, se destacam a capacitação das equipes de saúde, a reorganização das tarefas com base na transferência de competências clínicas, a disponibilização de aparelhos automáticos e clinicamente validados para aferição da pressão arterial e a utilização de um único protocolo padronizado de tratamento. Foi utilizado um modelo de equações de estimativas generalizadas para a análise de dados longitudinais, e as informações dos 5 centros de saúde foram agrupadas por meio de médias ponderadas de acordo com o tamanho da população coberta. A análise dos resultados foi estratificada em dois períodos de tempo delimitados pela irrupção das restrições em virtude da COVID-19. Durante os primeiros 18 meses, houve melhora significativa no tratamento (5,9%; p<0,01) e no tratamento combinado (13,4%; p<0,01), sem mudança significativa na cobertura (8,4%; p=0,87) e com uma diminuição paradoxal no controle (−3,3%; p=0,02). Durante as restrições e em relação ao período anterior, verificou-se redução generalizada em todos os indicadores, principalmente na cobertura (−23,6%; p<0,01) e no controle (−12,5%; p<0,01). No entanto, os níveis de tratamento e tratamento combinado persistiram acima dos valores basais (1,7%; p<0,01 e 5,4%; p<0,01, respectivamente).

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