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1.
Journal of Cardiothoracic and Vascular Anesthesia ; JOUR
Article in English | ScienceDirect | ID: covidwho-2106551

ABSTRACT

This special article is the fifteenth in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the editorial board for the opportunity to continue this series, namely the research highlights of the past year in the specialty of cardiothoracic and vascular anesthesiology.1 The major themes selected for 2022 are outlined in this introduction, and each highlight is reviewed in detail in the main body of the article. The literature highlights in the specialty for 2022 begin with an update on COVID-19 therapies, with a focus on the temporal updates in a wide range of therapies progressing from medical, to the utilization of extracorporeal membrane oxygenation (ECMO), and ultimately with lung transplantation in this high-risk group. The second major theme is focused on medical cardiology, with the authors discussing new insights into the life cycle of coronary disease, heart failure treatments, and outcomes related to novel statin therapy. The third theme is focused on mechanical circulatory support, with discussions focusing on both right and left-sided temporary support outcomes and optimal timing of deployment. The fourth, and final theme is an update on cardiac surgery, with discussion of diverse aspects of concomitant valvular surgery and optimal approach to procedural treatment for coronary arterial disease. The themes selected for this fifteenth special article are only a few of the diverse advances in the specialty during 2022. These highlights will inform the reader of key updates on a variety of topics, leading to improvement of perioperative outcomes for patients with cardiothoracic and vascular disease.

3.
Cardiovascular Disease in Racial and Ethnic Minority Populations, 2 Edition ; CHAP: 1-11,
Article in English | Web of Science | ID: covidwho-2102083
4.
Vestnik Transplantologii I Iskusstvennyh Organov ; JOUR(2):58-64, 24.
Article in Russian | Web of Science | ID: covidwho-2100535

ABSTRACT

Hypertrophic cardiomyopathy (HCM) is a disease that is usually unresponsive to conservative pathogenetic therapy. It does not have clearly developed surgical correction algorithms. Heart transplantation (HTx) is the sole therapeutic option when drug therapy is ineffective and surgical reduction of hypertrophic myocardium is not feasible. There are only sporadic reports in the literature about HTx for HCM. The novel coronavirus disease 2019 (COVID-19) pandemic has significantly affected the work of cardiac surgical units and, in particular, organ transplantation activities. This paper presents a clinical case of an HCM patient who underwent HTx, complicated by COVID-19 infection in the early postoperative period.

5.
Turk J Med Sci ; 52(2): 445-455, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-2101116

ABSTRACT

BACKGROUND: Infective endocarditis (IE) is still a significant cause of morbidity and mortality among cardiovascular diseases. ENDOCARDITIS-TR study aims to evaluate the compliance of the diagnostic and therapeutic methods being used in Turkey with current guidelines. METHODS: The ENDOCARDITIS-TR trial is a multicentre, prospective, observational study consisting of patients admitted to tertiary centres with a definite diagnose of IE. In addition to the demographic, clinical, microbiological, and echocardiographic findings of the patients, adverse events, indications for surgery, and in-hospital mortality were recorded during a 2-year time interval. RESULTS: A total of 208 IE patients from 7 tertiary centres in Turkey were enrolled in the study. The study population included 125 (60.1%) native valve IE (NVE), 65 (31.3%) prosthetic IE (PVIE), and 18 (8.7%) intracardiac device-related IE (CDRIE). One hundred thirty-five patients (64.9%) were culture positive, and the most frequent pathogenic agent was methicillin-susceptible Staphylococcus aureus (MSSA) (18.3%). Among 155 (74.5%) patients with an indication for surgery, only 87 (56.1%) patients underwent surgery. The all-cause mortality rate was 29.3% in-hospital follow-up. Multivariable Cox regression analysis revealed that absence of surgery when indicated (HR: 3.29 95% CI: 0.93-11.64 p = 0.05), albumin level at admission (HR: 0.46 95% CI: 0.29-0.73 P < 0.01), abscess formation (HR: 2.11 95% CI: 1.01-4.38 p = 0.04) and systemic embolism (HR: 1.78 95% CI: 1.05-3.02 p = 0.03) were ascertained independent predictors of in-hospital all-cause mortality. DISCUSSION: The short-term results of the ENDOCARDITIS-TR trial showed the high frequency of staphylococcal IE, relatively high in-hospital mortality rates, shortage of surgical treatment despite guideline-based surgical indications and low usage of novel imaging techniques. The results of this study will provide a better insight to physicians in respect to their adherence to clinical practice guidelines.


Subject(s)
Endocarditis, Bacterial , Endocarditis , Albumins , Endocarditis/diagnosis , Endocarditis/microbiology , Endocarditis/therapy , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/microbiology , Endocarditis, Bacterial/therapy , Hospital Mortality , Humans , Methicillin , Prognosis , Prospective Studies , Retrospective Studies , Turkey/epidemiology
6.
Front Cardiovasc Med ; 9: 998842, 2022.
Article in English | MEDLINE | ID: covidwho-2099116

ABSTRACT

Background: Heart failure (HF) patients are at higher risk of severe coronavirus disease 2019 (COVID-19). The Omicron variant has many novel mutations including those in the spike protein, leading to questions about vaccine effectiveness. The aim of this analysis was to evaluate the effectiveness of the COVID-19 vaccine with or without a booster (i.e., after the third dose) during the Omicron variant wave. Methods: Chronic heart failure patients in the Czech Republic were included in the analysis. COVID-19 infection was monitored from January 1st 2022 to March 31st 2022. The analysis was conducted on data collected in the National Health Information System. Vaccine effectiveness of vaccinated (with or without booster) vs. unvaccinated patients was analyzed for incidence of COVID-19, COVID-19-related hospitalizations, COVID-19 related intensive care unit admissions, and COVID-19 related mechanical ventilation/extracorporeal membrane oxygenation treatment. Findings: From a total 165,453 HF patients in the Czech Republic, 9,728 contracted COVID-19 (22.9% of them not vaccinated, 23.2% vaccinated and 53.8% vaccinated and boosted). Risk of intensive care unit (ICU) hospitalization was 7.6% in the unvaccinated group, 4.8% in the vaccinated group and 2.9% in the boosted group. The calculated effectiveness of the COVID-19 vaccine in prevention of ICU hospitalization in the vaccinated group was 41.9 and 76.6% in the boosted group. Interpretation: The results demonstrated moderate vaccine effectiveness in the prevention of severe COVID-19 in vaccinated but not boosted HF patients. Much stronger effectiveness was found in those who were vaccinated and boosted.

7.
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
8.
Pediatr Int ; 64(1): e15329, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-2097855

ABSTRACT

BACKGROUND: Although widely reported to affect older adults more, coronavirus disease 2019 (COVID-19) also affects adolescents, especially those with co-morbidities, including heart diseases. The safety and efficacy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines has been established in healthy adolescents, yet there are few data for humoral and cellular immunogenicity in adolescents with cardiac diseases. METHODS: We evaluated anti-spike antibodies, neutralizing activities, and interferon-gamma production prior to and after SARS-CoV-2 vaccination in adolescents with cardiac diseases and healthy controls. RESULTS: Five healthy adolescents and 26 patients with cardiac diseases, including congenital heart disease (CHD, n = 10), dilated cardiomyopathy (DCM, n = 4), idiopathic pulmonary arterial hypertension (IPAH, n = 4), and those post-heart transplantation (post-HTx, n = 8) were enrolled. No severe adverse events, including myocarditis and pericarditis, were noted, even in patients with severe heart failure. Febrile events were noted after 21 of 62 injections (34%). All the healthy adolescents and 21 of the 26 patients (81%) showed sufficient elevation of neutralizing antibodies after the second dose of vaccination. Neutralizing antibodies and cellular immunity were absent in four of the eight post-HTx patients and one with single ventricle CHD. There was no correlation between the anti-spike and neutralizing antibody titers and interferon-gamma levels. When comparing the clinical characteristics of the patients post-HTx who did or did not acquire antibodies, there was no significant difference in the immunosuppressant types and trough levels. CONCLUSIONS: SARS-CoV-2 mRNA vaccine has efficient immunogenicity for adolescents with CHD, IPAH, and DCM. Half of post-HTx patients could not acquire sufficient humoral immunity.


Subject(s)
COVID-19 , Heart Diseases , Viral Vaccines , Adolescent , Humans , Aged , COVID-19 Vaccines , SARS-CoV-2 , COVID-19/prevention & control , Interferon-gamma , Antibodies, Viral , Viral Vaccines/adverse effects , Antibodies, Neutralizing , Vaccination , Heart Diseases/chemically induced
9.
Lancet Reg Health West Pac ; : 100630, 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2095737

ABSTRACT

Background: COVID-19 vaccines are important for patients with heart failure (HF) to prevent severe outcomes but the safety concerns could lead to vaccine hesitancy. This study aimed to investigate the safety of two COVID-19 vaccines, BNT162b2 and CoronaVac, in patients with HF. Methods: We conducted a self-controlled case series analysis using the data from the Hong Kong Hospital Authority and the Department of Health. The primary outcome was hospitalization for HF and the secondary outcomes were major adverse cardiovascular events (MACE) and all hospitalization. We identified patients with a history of HF before February 23, 2021 and developed the outcome event between February 23, 2021 and March 31, 2022 in Hong Kong. Incidence rate ratios (IRR) were estimated using conditional Poisson regression to evaluate the risks following the first three doses of BNT162b2 or CoronaVac. Findings: We identified 32,490 patients with HF, of which 3035 were vaccinated and had a hospitalization for HF during the observation period (BNT162b2 = 755; CoronaVac = 2280). There were no increased risks during the 0-13 days (IRR 0.64 [95% confidence interval 0.33-1.26]; 0.94 [0.50-1.78]; 0.82 [0.17-3.98]) and 14-27 days (0.73 [0.35-1.52]; 0.95 [0.49-1.84]; 0.60 [0.06-5.76]) after the first, second and third doses of BNT162b2. No increased risks were observed for CoronaVac during the 0-13 days (IRR 0.60 [0.41-0.88]; 0.71 [0.45-1.12]; 1.64 [0.40-6.77]) and 14-27 days (0.91 [0.63-1.32]; 0.79 [0.46-1.35]; 1.71 [0.44-6.62]) after the first, second and third doses. We also found no increased risk of MACE or all hospitalization after vaccination. Interpretation: Our results showed no increased risk of hospitalization for HF, MACE or all hospitalization after receiving BNT162b2 or CoronaVac vaccines in patients with HF. Funding: The project was funded by a Research Grant from the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region (Ref. No. COVID19F01). F.T.T.L. (Francisco T.T. Lai) and I.C.K.W. (Ian C.K. Wong)'s posts were partly funded by the D24H; hence this work was partly supported by AIR@InnoHK administered by Innovation and Technology Commission.

10.
Front Cardiovasc Med ; 9: 1001780, 2022.
Article in English | MEDLINE | ID: covidwho-2089824

ABSTRACT

Objective: To analyze the clinical characteristics and prognostic factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infections in children with congenital heart disease (CHD). Methods: A retrospective analysis was performed on SARS-CoV-2 Omicron-infected children with CHD who were admitted to Shanghai Children's Medical Center from April 1, 2022 to May 31, 2022. The clinical, laboratory and imaging data, and the nucleic acid conversion time of the children in this group were collected and analyzed. Results: Thirteen patients were included in this study and had an average age of 1.1 (0.16-14) years. Among the patients, 3 patients were preoperatively treated, and 10 were postoperatively treated. According to the severity of the disease, 1 patient was diagnosed with the moderate type, and the remaining 12 patients were diagnosed with the mild type. The clinical symptoms were mostly associated with upper respiratory tract infections, including 13 with fever (100%), 8 with cough (61.8%), 5 with sputum production (38.5%), 1 of shortness of breath (7.7%), etc. All patients were successfully discharged from the hospital, with 16.4 ± 2.9 days needed to obtain cycle threshold (CT) values ≥35 in nucleic acid testing and 17.5 ± 3.6 days of hospitalization. Conclusions: For vulnerable patients such as children with CHD, SARS-CoV-2 Omicron variant infections mostly present with mild upper respiratory tract symptoms with negative or mildly changed chest imaging. Through appropriate treatment of the underlying disease in the quarantine ward, patients might obtain good outcomes, even after long periods of hospitalization.

11.
Heart ; 2022 Oct 24.
Article in English | MEDLINE | ID: covidwho-2088827
12.
J Nurs Scholarsh ; 2022 Oct 25.
Article in English | MEDLINE | ID: covidwho-2088271

ABSTRACT

INTRODUCTION: A diagnosis of chronic illness posed a serious threat to people during the recent COVID-19 pandemic. People with chronic illnesses were faced with increased mortality and reduced access to healthcare. Self-care is the process of maintaining health and managing a chronic illness. Nurses working in specialist services provide healthcare education to people with chronic illnesses. Access to these nurses was decreased during periods of the COVID-19 virus escalation due to the reconfiguration of services and redeployment of nurses. The purpose of the research was to learn from the experiences of people with a chronic illnesses in self-care behaviors and accessing altered healthcare services to inform future practices. DESIGN: A population survey design. METHODS: A mixed methods survey was designed, combining validated questionnaires and scales with open-ended questions. A convenience sample was utilized via using social media platforms. Data analysis included descriptive and inferential statistics. Content analysis was used to analyze open-ended responses. RESULTS: There were 147 responses, with approximately half reporting no changes in face-to-face healthcare contact, 41% reporting decreased contacts and 12% increased contacts. Non-face-to-face contacts were reduced by almost 9%, did not change by almost 60%, while 33% indicated an increase. Participants reported mixed perceptions in contact with healthcare providers during restrictions. In the Patient Assessment of Chronic Illness Care and the Self-Care of Chronic Illness scales, participants scored statistically lower scores than in previous studies. Participants indicated that public health restrictions negatively impacted their confidence, created challenges with re-engaging and that access to care was more difficult. CONCLUSION: This research highlights the importance of providing continued support to people with chronic illness irrespective of other challenges to healthcare services. A structured approach to virtual self-care education is required. CLINICAL RELEVANCE: This research concluded that the experience of access to one healthcare professional as opposed to diverse multidisciplinary input was similar for a number of chronic illnesses groups of people during the COVID-19 pandemic. There was an altered dynamic of virtual contacts with healthcare providers and a lack of confidence interpreting what monitoring was required by people with a chronic illnesses due to a lack of preparedness for virtual healthcare delivery.

13.
Int J Cardiol Heart Vasc ; 43: 101144, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2086280

ABSTRACT

Background: Coronavirus-2019 (COVID-19) is known to affect the heart and is associated with a pro-inflammatory state. Most studies to date have focused on clinically sick subjects. Here, we report cardiac and proinflammatory biomarkers levels in ambulatory young adults with asymptomatic or mild COVID-19 infection compared to those without infection 4-8 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) testing. Methods: 131 asymptomatic or mildly symptomatic subjects were enrolled following testing for SARS-COV-2. Fifty subjects tested negative, and 81 subjects tested positive. Serum samples were collected for measurement of C-reactive protein, ferritin, interleukin-6, NT-pro-B-type natriuretic peptide, and cardiac troponin 28-55 days after SARS-COV-2 RT-PCR testing. Results: Biomarker levels trended higher in SARS-COV-2-positive vs negative subjects, but differences in biomarker levels or proportion of subjects with elevated biomarkers were not statistically significant with respect to SARS-COV-2 status. Among individuals with ≥ 1 comorbidity, odds of elevated CRP were greater compared to individuals without any comorbidities (odds ratio [OR] = 2.90); this effect size was increased 1.4-fold among SARS-COV-2-positive subjects (OR = 4.03). Similarly, NT-pro-BNP was associated with CVD, with the strongest association in COVID-positive individuals (OR = 16.9). Conclusions: In a relatively young, healthy adult population, mild COVID-19 infection was associated with mild elevations in cardiac and proinflammatory biomarkers within 4-8 weeks of mild or asymptomatic COVID-19 infection in individuals with preexisting comorbidities, but not among individuals without comorbidities. For the general population of young adults, we did not find evidence of elevation of cardiac or proinflammatory biomarkers 4-8 weeks after COVID-19 infection.Clinical Perspective: This is a characterization of cardiac and proinflammatory biomarkers in ambulatory subjects following asymptomatic or mild COVID-19 infection. Young, ambulatory individuals did not have cardiac and proinflammatory biomarker elevation 4-8 weeks after mild COVID-19 infection. However, COVID-19 infection was associated with biomarker elevations in select individuals with comorbidities.Clinical study number: H-47423.

14.
Heart Lung ; 57: 130-139, 2022 Sep 28.
Article in English | MEDLINE | ID: covidwho-2086275

ABSTRACT

BACKGROUND: Little is known about the mental health burden or the factors that contribute to mental health variables in parents of children with congenital heart defects (CHD) during the COVID-19 pandemic. OBJECTIVE: The purpose of this study was to examine risk and protective factors associated with anxiety symptoms, depression symptoms, and perceived stress in parents of young children with CHD during the COVID-19 pandemic. METHODS: A nonexperimental design was used in this study of 127 parents of children aged newborn to five years with CHD during the COVID-19 pandemic. Regression analyses were conducted to examine associations between COVID-19 stressors, CHD care-related factors, parental resilience, external support, and mental health variables. RESULTS: Parental resilience, emotional support, and informational support were key protective factors for anxiety, depression, and stress. However, resilience was remarkably low in CHD parents. Increased levels of anxiety symptoms, depression symptoms, and perceived stress were associated with 1) Exposure to a greater number of COVID-19-related stressors, 2) Distress from family visitation restrictions during healthcare encounters, 3) Worry related to the perceived risk of their CHD child's exposure to COVID-19 during healthcare encounters, and 4) Worry about their CHD child's risk of death or serious illness from COVID-19. CONCLUSIONS: The additive impact of the COVID-19 pandemic plus CHD care-related worries on this parent population's mental health is significant. Interventions that promote resilience, address the effect of healthcare system changes, and support the needs of parents of young children with CHD during this and future pandemics are needed.

15.
Ann Cardiol Angeiol (Paris) ; 2022 Oct 20.
Article in French | MEDLINE | ID: covidwho-2085907

ABSTRACT

Technological advances over the past two decades have paved the way for the prehospital use of ultrasound. This practice was first developed in traumatology and then in a multitude of other indications, including cardiology. The development of pulmonary ultrasound is certainly the most visible illustration of this. Firstly, because it is an extra-cardiac examination that provides the answer to a cardiac question. Secondly because from a theoretical point of view this ultrasound indication was a bad indication for the use of ultrasound due to the air contained in the thorax. Thirdly, because this indication has become a 'standard of care' when caring for a patient with dyspnea - a practice that has become widespread during the COVID epidemic. In patients with heart failure, ultrasound has a high diagnostic power (including for alternative diagnoses) which is all the more precise since the technique is non-invasive, the response is obtained quickly, the examination can be repeated at desire to follow the evolution of the patient. The main other indications for prehospital ultrasound are cardiac arrest to search for a curable cause, identification of residual mechanical cardiac activity, monitoring of cerebral perfusion; chest pain, for both positive and negative diagnoses; shock for the search for an etiology and therapeutic follow-up or even pulmonary embolism or ultrasound for the search for dilation of the right ventricle which is now at the forefront of the recommendation algorithm.

16.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; JOUR(12-B):No Pagination Specified, 83.
Article in English | APA PsycInfo | ID: covidwho-2083522

ABSTRACT

Data indicated that work-related stress could cost organizations financially, with losses associated with decreased productivity, healthcare costs and organizational dysfunction. Excessive stress in the workplace can cause significant costs to the employee as measured by declines in psychological and physiological health. Stress induced health symptoms and corresponding costs to the organization may be exacerbated by the COVID-19 Pandemic. These disruptions can affect organizational functioning as well the system's ability to dynamically respond to opportunities, challenges and organizational goals all of which can further increase employee stress and associated health outcomes. Human resource development professionals are in a position to offer interventions to help employees and organizational systems adjust to these new demands. Heart rate variability (HRV) training as a workplace wellness intervention to reduce stress for impacted employees has emerged as a promising line of research and applied work, with data supporting improved physical/mental health, learning and development and organizational outcomes.The purpose of this study was to investigate the effects of a HRV training intervention on measures of employee health and organizational outcomes during the COVID-19 pandemic. Empirical data collection for this inquiry was operationalized with a quantitative, between-groups, experimental research design to test the effects of a HRV self-regulation training on participants who were randomly assigned to active treatment groups and non-participant groups (wait-list control). Participants were assessed on psychological and physiological health and organizational outcomes by analyzing results of the POQA-R4 survey. The study population (N = 147) consisted of employees at a large, multi-national, independent public company in the multi-utilities industry. Data analyses concluded that three of this study's five hypotheses were upheld. Hypotheses related to emotional stress (moderate effect size), physical stress (moderate effect size) and emotional vitality (borderline moderate effect size) were upheld. The findings associated with mental and physical stress were consistent with previous literature, while organizational results were more ambiguous. Based on these findings, recommendations for future research, application, theory building and implications for HRD were offered. Specific recommendations included further refinement of conceptual/theoretical frames, measurement variables and assessment tools. Recommendations for practice focused on providing evidenced based wellness interventions (such as HRV self-regulation training), and reinforcing the organizational culture to support a range of wellness needs and to strengthen social systems, which serve as protective and mediating factors in times of stress. These recommendations may position HRD professionals as agile and dynamic leaders who implement organizational wellness to both support business objectives while reinforcing a culture of care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

17.
Pol Merkur Lekarski ; 50(299): 312-317, 2022 Oct 21.
Article in English | MEDLINE | ID: covidwho-2083590

ABSTRACT

Native heart valve thrombosis (NHVT) is a rare valvular pathology, usually associated with prothrombotic state or disturbed intracardiac blood flow related to structural valve abnormalities. While different venous and arterial thromboembolic complications of COVID-19 have been widely described, so far NHVT has not been reported in the context of the disease. The authors describe 4 cases of NHVT associated with COVID-19, revealed on aortic, mitral (2 patients) and tricuspid valve. In a 29-yearold male with mild pneumonia, large thrombus developed on bicuspid aortic valve (BAV), which resulted in fatal brain emboli. In a 76-yearold male with a history of rheumatoid arthritis (RA) being in a recovery period after COVID-19, central retinal artery occlusion (CRAO) was the first sign of mitral valve thrombus, which disappeared after 3 weeks, during apixaban use. Such therapy was also successful in a 46-yearold female with multiple cardiovascular risk factors in whom mitral valve thrombus was found in a routine echocardiography after she got COVID-19 the third time. In a 75-year-old man with moderate COVID-19 pneumonia and bacterial coinfection, coexistent transient focal LV dysfunction and tricuspid valve thrombus were observed. The patient was treated with apixaban as well; however, in this case only reduction in the thrombus size was seen after 4 months therapy. The authors indicate that in patients with COVID-19 and NHVT, other prothrombotic conditions can usually be found. This complication may involve different valves and occur irrespective of COVID-19 severity. Interdisciplinary evaluation of such patients is necessary.


Subject(s)
COVID-19 , Coronary Thrombosis , Heart Diseases , Humans , Male , Female , Middle Aged , Aged , Adult , COVID-19/complications , Mitral Valve , Tricuspid Valve
18.
European Review for Medical and Pharmacological Sciences ; JOUR(15):5587-5595, 26.
Article in English | Web of Science | ID: covidwho-2081698

ABSTRACT

- OBJECTIVE: The Coronavirus dis-ease 2019 (COVID-19) infection is associated with autonomic dysfunction. Data on the long-term re-lationship between COVID-19 infection, heart rate recovery (HRR), and exaggerated blood pressure response to exercise (EBPR) are very limited. In our study, we aimed at investigating the long-term association between COVID-19, HRR, EBPR, metabolic, and echocardiographic parameters.PATIENTS AND METHODS: The study includ-ed 65 patients in the study group (33 female, median age 46) and 57 in the control group (30 female, 39 median age) between 1 April 2020 and 1 January 2021. Office blood pressure mea-surement, 24-hour ambulatory blood pressure monitoring, treadmill test, echocardiography, and metabolic parameters were evaluated.RESULTS: The frequency of blunted HRR (25 subjects, 38.5%, p < 0.001) and EBPR (7 subjects, 10.8%, p = 0.014) were significantly higher in study group. The study group had higher levels of white blood cell (p = 0.002), neutrophil, c -reac-tive protein, and uric acid (p < 0.001). Diameters of left atrium, aortic root, and ascending aorta were significantly higher in study group (p < 0.05). Age adjusted multiple logistic regression analysis showed that neutrophil levels (odds ra-tio (OR), 9.21;95% confidence interval (CI), 1.52-55.75, p = 0.016), glomerular filtration rate (OR, 1.34;95% CI, 1.13-1.59, p = 0.001), basal heart rate (OR, 1.58;95% CI, 1.17-2.12, p = 0.003), and mean heart rate (OR, 1.22;95% CI, 1.03-1.45, p = 0.0021) were independently associated with COVID-19 infection.CONCLUSIONS: The frequency of blunted HRR and EBPR, and uric acid levels were significant-ly higher in the study group compared to the control group, suggesting autonomic dysfunc-tion as the possible sequelae of the COVID-19 infection and increased risk of cardiovascular events in the future.

19.
European Review for Medical and Pharmacological Sciences ; JOUR(15):5596-5600, 26.
Article in English | Web of Science | ID: covidwho-2081693

ABSTRACT

- OBJECTIVE: SARS-CoV-2 infection is associated with a higher risk of acute right heart failure (RHF) due to primary right ventricle (RV) dilation and systemic inflammatory response, which in turn lead to microvascular and cardiomyocytes dysfunction, local hypoxia and multi-organ failure. In this clinical setting, levosimendan could be a viable therapy thanks to its right-heart tropism and its additional pleiotropic properties. CASE REPORT: We present the case of a 72 years-old man with positive nasopharyngeal swab for SARS-CoV-2 infection, mild pulmonary involvement and clinical signs of new-onset RHF. We started a 12-hour levosimendan cycle to improve RV performance and reduce cardiac filling pressures. RESULTS: We obtained a net clinical benefit in terms of acute RHF-related signs and symptoms, progressive renal and liver function improvement and concomitant reduction of high-sensitivity C-Reactive Protein and Interleukin-6 (IL-6) levels. CONCLUSIONS: Acute RHF during SARSCoV-2 infection could be related to a convergent widespread systemic inflammatory response. Thanks to its anti-inflammatory and anti-remodsponse.

20.
Vis Inform ; 2022 Oct 24.
Article in English | MEDLINE | ID: covidwho-2082800

ABSTRACT

Digital learning is becoming increasingly important in the crisis COVID-19 and is widespread in most countries. The proliferation of smart devices and 5G telecommunications systems are contributing to the development of digital learning systems as an alternative to traditional learning systems. Digital learning includes blended learning, online learning, and personalized learning which mainly depends on the use of new technologies and strategies, so digital learning is widely developed to improve education and combat emerging disasters such as COVID-19 diseases. Despite the tremendous benefits of digital learning, there are many obstacles related to the lack of digitized curriculum and collaboration between teachers and students. Therefore, many attempts have been made to improve the learning outcomes through the following strategies: collaboration, teacher convenience, personalized learning, cost and time savings through professional development, and modeling. In this study, facial expressions and heart rate are used to measure the effectiveness of digital learning systems and the level of learners' engagement in learning environments. The results showed that the proposed approach outperformed the known related works in terms of learning effectiveness. The results of this research can be used to develop a digital learning environment.

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