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1.
Viruses ; 14(4)2022 Mar 25.
Article in English | MEDLINE | ID: covidwho-1834919

ABSTRACT

The new betacoronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the cause of COVID-19, and has spread rapidly around the world, reaching more than 200 countries, around 364 million people and causing more than 5 million deaths according to the World Health Organization, so this paper reports a fatal case of SARS-CoV-2 infection in a young pregnant woman with heart disease, without vertical transmission. A 26 years old patient at 28th week of pregnancy with regular prenatal care, presented dry cough, high fever, and severe respiratory distress. Due to her clinical symptoms, she sought medical care at a cardiology hospital in Northern Brazil. The medical conditions she presented were heart disease, rheumatic fever history and had no recent record of national or international travel. She was hospitalized and after clinical stabilization, she was referred for an emergency cesarean intervention. The young mother and the newborn were transferred to the intensive care unit after surgery, where diagnostic tests for respiratory viral infections, including SARS-CoV-2, were performed. The mother tested positive, while her newborn was negative for SARS-CoV-2 demonstrating no vertical transmission of SARS-CoV-2 in this severe case. This study reveals that despite the mother's initially mild symptoms, she progressed to severe clinical conditions resulting in death, although no vertical transmission was observed. This report highlights the relevance of comorbidities for the unfavorable clinical course of COVID-19.


Subject(s)
COVID-19 , Heart Diseases , Pregnancy Complications, Infectious , Adult , COVID-19/diagnosis , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Pregnancy , Pregnancy Complications, Infectious/diagnosis , SARS-CoV-2
2.
Adv Rheumatol ; 62(1): 13, 2022 May 03.
Article in English | MEDLINE | ID: covidwho-1822222

ABSTRACT

BACKGROUND: Patients using immunosuppressive drugs may have unfavorable results after infections. However, there is a lack of information regarding COVID-19 in these patients, especially in patients with rheumatoid arthritis (RA). Therefore, the aim of this study was to evaluate the risk factors associated with COVID-19 hospitalizations in patients with RA. METHODS: This multicenter, prospective cohort study is within the ReumaCoV Brazil registry and included 489 patients with RA. In this context, 269 patients who tested positive for COVID-19 were compared to 220 patients who tested negative for COVID-19 (control group). All patient data were collected from the Research Electronic Data Capture database. RESULTS: The participants were predominantly female (90.6%) with a mean age of 53 ± 12 years. Of the patients with COVID-19, 54 (20.1%) required hospitalization. After multiple adjustments, the final regression model showed that heart disease (OR = 4.61, 95% CI 1.06-20.02. P < 0.001) and current use of glucocorticoids (OR = 20.66, 95% CI 3.09-138. P < 0.002) were the risk factors associated with hospitalization. In addition, anosmia was associated with a lower chance of hospitalization (OR = 0.26; 95% CI 0.10-0.67, P < 0.005). CONCLUSION: Our results demonstrated that heart disease and the use of glucocorticoids were associated with a higher number of hospital admissions for COVID-19 in patients with RA. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials - RBR-33YTQC.


Subject(s)
Arthritis, Rheumatoid , COVID-19 , Heart Diseases , Adult , Aged , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/epidemiology , Brazil/epidemiology , Female , Glucocorticoids , Hospitalization , Humans , Male , Middle Aged , Prospective Studies , Registries
3.
Ther Adv Respir Dis ; 16: 17534666221096040, 2022.
Article in English | MEDLINE | ID: covidwho-1822140

ABSTRACT

PURPOSE: We aimed to better understand the pathophysiology of SARS-CoV-2 pneumonia in non-critically ill hospitalized patients secondarily presenting with clinical deterioration and increase in oxygen requirement without any identified worsening factors. METHODS: We consecutively enrolled patients without clinical or biological evidence for superinfection, without left ventricular dysfunction and for whom a pulmonary embolism was discarded by computed tomography (CT) pulmonary angiography. We investigated lung ventilation and perfusion (LVP) by LVP scintigraphy, and, 24 h later, left and right ventricular function by Tc-99m-labeled albumin-gated blood-pool scintigraphy with late (60 mn) tomographic albumin images on the lungs to evaluate lung albumin retention that could indicate microvascular injuries with secondary edema. RESULTS: We included 20 patients with confirmed SARS-CoV-2 pneumonia. All had CT evidence of organizing pneumonia and normal left ventricular ejection fraction. No patient demonstrated preserved ventilation with perfusion defect (mismatch), which may discard a distal lung thrombosis. Patterns of ventilation and perfusion were heterogeneous in seven patients (35%) with healthy lung segments presenting a relative paradoxical hypoperfusion and hypoventilation compared with segments with organizing pneumonia presenting a relative enhancement in perfusion and preserved ventilation. Lung albumin retention in area of organizing pneumonia was observed in 12 patients (60%), indicating microvascular injuries, increase in vessel permeability, and secondary edema. CONCLUSION: In hospitalized non-critically ill patients without evidence of superinfection, pulmonary embolism, or cardiac dysfunction, various types of damage may contribute to clinical deterioration including microvascular injuries and secondary edema, inconsistencies in lung segments vascularization suggesting a dysregulation of the balance in perfusion between segments affected by COVID-19 and others. SUMMARY STATEMENT: Microvascular injuries and dysregulation of the balance in perfusion between segments affected by COVID-19 and others are present in non-critically ill patients without other known aggravating factors. KEY RESULTS: In non-critically ill patients without evidence of superinfection, pulmonary embolism, macroscopic distal thrombosis or cardiac dysfunction, various types of damage may contribute to clinical deterioration including 1/ microvascular injuries and secondary edema, 2/ inconsistencies in lung segments vascularization with hypervascularization of consolidated segments contrasting with hypoperfusion of not affected segments, suggesting a dysregulation of the balance in perfusion between segments affected by COVID-19 and others.


Subject(s)
COVID-19 , Clinical Deterioration , Heart Diseases , Pulmonary Embolism , Superinfection , Albumins , Edema/diagnostic imaging , Edema/etiology , Humans , Lung/diagnostic imaging , Neovascularization, Pathologic , SARS-CoV-2 , Stroke Volume , Ventricular Function, Left
4.
Lancet ; 398(10301): 685-697, 2021 08 21.
Article in English | MEDLINE | ID: covidwho-1815297

ABSTRACT

BACKGROUND: Associations between high and low temperatures and increases in mortality and morbidity have been previously reported, yet no comprehensive assessment of disease burden has been done. Therefore, we aimed to estimate the global and regional burden due to non-optimal temperature exposure. METHODS: In part 1 of this study, we linked deaths to daily temperature estimates from the ERA5 reanalysis dataset. We modelled the cause-specific relative risks for 176 individual causes of death along daily temperature and 23 mean temperature zones using a two-dimensional spline within a Bayesian meta-regression framework. We then calculated the cause-specific and total temperature-attributable burden for the countries for which daily mortality data were available. In part 2, we applied cause-specific relative risks from part 1 to all locations globally. We combined exposure-response curves with daily gridded temperature and calculated the cause-specific burden based on the underlying burden of disease from the Global Burden of Diseases, Injuries, and Risk Factors Study, for the years 1990-2019. Uncertainty from all components of the modelling chain, including risks, temperature exposure, and theoretical minimum risk exposure levels, defined as the temperature of minimum mortality across all included causes, was propagated using posterior simulation of 1000 draws. FINDINGS: We included 64·9 million individual International Classification of Diseases-coded deaths from nine different countries, occurring between Jan 1, 1980, and Dec 31, 2016. 17 causes of death met the inclusion criteria. Ischaemic heart disease, stroke, cardiomyopathy and myocarditis, hypertensive heart disease, diabetes, chronic kidney disease, lower respiratory infection, and chronic obstructive pulmonary disease showed J-shaped relationships with daily temperature, whereas the risk of external causes (eg, homicide, suicide, drowning, and related to disasters, mechanical, transport, and other unintentional injuries) increased monotonically with temperature. The theoretical minimum risk exposure levels varied by location and year as a function of the underlying cause of death composition. Estimates for non-optimal temperature ranged from 7·98 deaths (95% uncertainty interval 7·10-8·85) per 100 000 and a population attributable fraction (PAF) of 1·2% (1·1-1·4) in Brazil to 35·1 deaths (29·9-40·3) per 100 000 and a PAF of 4·7% (4·3-5·1) in China. In 2019, the average cold-attributable mortality exceeded heat-attributable mortality in all countries for which data were available. Cold effects were most pronounced in China with PAFs of 4·3% (3·9-4·7) and attributable rates of 32·0 deaths (27·2-36·8) per 100 000 and in New Zealand with 3·4% (2·9-3·9) and 26·4 deaths (22·1-30·2). Heat effects were most pronounced in China with PAFs of 0·4% (0·3-0·6) and attributable rates of 3·25 deaths (2·39-4·24) per 100 000 and in Brazil with 0·4% (0·3-0·5) and 2·71 deaths (2·15-3·37). When applying our framework to all countries globally, we estimated that 1·69 million (1·52-1·83) deaths were attributable to non-optimal temperature globally in 2019. The highest heat-attributable burdens were observed in south and southeast Asia, sub-Saharan Africa, and North Africa and the Middle East, and the highest cold-attributable burdens in eastern and central Europe, and central Asia. INTERPRETATION: Acute heat and cold exposure can increase or decrease the risk of mortality for a diverse set of causes of death. Although in most regions cold effects dominate, locations with high prevailing temperatures can exhibit substantial heat effects far exceeding cold-attributable burden. Particularly, a high burden of external causes of death contributed to strong heat impacts, but cardiorespiratory diseases and metabolic diseases could also be substantial contributors. Changes in both exposures and the composition of causes of death drove changes in risk over time. Steady increases in exposure to the risk of high temperature are of increasing concern for health. FUNDING: Bill & Melinda Gates Foundation.


Subject(s)
Cause of Death/trends , Cold Temperature/adverse effects , Global Burden of Disease/statistics & numerical data , Global Health/statistics & numerical data , Hot Temperature/adverse effects , Mortality/trends , Bayes Theorem , Heart Diseases/epidemiology , Humans , Metabolic Diseases/epidemiology
5.
Int J Environ Res Public Health ; 19(8)2022 04 15.
Article in English | MEDLINE | ID: covidwho-1809877

ABSTRACT

Cardiac magnetic resonance (CMR) is a second-line imaging test in cardiology. Balanced enlargement of heart chambers called athlete's heart (AH) is a part of physiological adaptation to regular physical activity. The aim of this study was to evaluate the diagnostic utility of CMR in athletes with suspected structural heart disease (SHD) and to analyse the relation between the coexistence of AH and SHD. We wanted to assess whether the presence of AH phenotype could be considered as a sign of a healthy heart less prone to development of SHD. This retrospective, single centre study included 154 consecutive athletes (57 non-amateur, all sports categories, 87% male, mean age 34 ± 12 years) referred for CMR because of suspected SHD. The suspicion was based on existing guidelines including electrocardiographic and/or echocardiographic changes suggestive of abnormality but without a formal diagnosis. CMR permitted establishment of a new diagnosis in 66 patients (42%). The main diagnoses included myocardial fibrosis typical for prior myocarditis (n = 21), hypertrophic cardiomyopathy (n = 17, including 6 apical forms), other cardiomyopathies (n = 10) and prior myocardial infarction (n = 6). Athlete's heart was diagnosed in 59 athletes (38%). The presence of pathologic late gadolinium enhancement (LGE) was found in 41 patients (27%) and was not higher in athletes without AH (32% vs. 19%, p = 0.08). Junction-point LGE was more prevalent in patients with AH phenotype (22% vs. 9%, p = 0.02). Patients without AH were not more likely to be diagnosed with SHD than those with AH (49% vs. 32%, p = 0.05). Based on the results of CMR and other tests, three patients (2%) were referred for ICD implantation for the primary prevention of sudden cardiac death with one patient experiencing adequate intervention during follow-up. The inclusion of CMR into the diagnostic process leads to a new diagnosis in many athletes with suspicion of SHD and equivocal routine tests. Athletes with AH pattern are equally likely to be diagnosed with SHD in comparison to those without AH phenotype. This shows that the development of AH and SHD can occur in parallel, which makes differential diagnosis in this group of patients more challenging.


Subject(s)
Cardiomegaly, Exercise-Induced , Cardiomyopathies , Heart Diseases , Athletes , Cardiomyopathies/diagnostic imaging , Contrast Media , Female , Gadolinium , Humans , Magnetic Resonance Spectroscopy , Male , Predictive Value of Tests , Retrospective Studies
7.
Nat Rev Cardiol ; 19(5): 302-313, 2022 05.
Article in English | MEDLINE | ID: covidwho-1805618

ABSTRACT

Patients with heart failure are at a higher risk of cardiovascular events compared with the general population, particularly during domestic or international travel. Patients with heart failure should adhere to specific recommendations during travel to lower their risk of developing heart failure symptoms. In this Review, we aim to provide clinicians with a set of guidelines for patients with heart failure embarking on national or international travel. Considerations when choosing a travel destination include travel distance and time, the season upon arrival, air pollution levels, jet lag and altitude level because all these factors can increase the risk of symptom development in patients with heart failure. In particular, volume depletion is of major concern while travelling given that it can contribute to worsening heart failure symptoms. Pre-travel risk assessment should be performed by a clinician 4-6 weeks before departure, and patients should receive advice on potential travel-related illness and on strategies to prevent volume depletion. Oxygen supplementation might be useful for patients who are very symptomatic. Upon arrival at the destination, potential drug-induced photosensitivity (particularly in tropical destinations) and risks associated with the local cuisine require consideration. Special recommendations are needed for patients with cardiac implantable electronic devices or left ventricular assist devices as well as for those who have undergone major cardiac surgery.


Subject(s)
Heart Diseases , Heart Failure , Heart-Assist Devices , Heart Failure/therapy , Humans , Risk Assessment , Travel , Travel-Related Illness
8.
Kardiologiia ; 62(3): 21-27, 2022 Mar 31.
Article in Russian, English | MEDLINE | ID: covidwho-1789754

ABSTRACT

Aim      To evaluate the incidence and features of left atrial appendage (LAA) thrombosis in patients with persistent atrial fibrillation (AF) after novel coronavirus infection (COVID-19).Material and methods  Percutaneous echocardiography (pcEchoCG) was performed for 128 patients with persistent AF prepared for cardioversion, 36 (28.1 %) of whom had had COVID-19. In 3 (8.3 %) patients, the lung lesion area was 50-75 %; in 31 (86.1 %) patients, 25-50 %; in 1 (2.8 %) patient, less than 25 %. One patient had no lung lesion. Median time from the onset of COVID-19 to the patient enrollment in the study was 76.5 days. At the time of enrollment, the polymerase chain reaction test for SARS-CoV-2 was negative in all patients.Results Patients after COVID-19 and those who had not had COVID-19 were comparable by age (62.5±9.2 and 62.4±9.1 years, respectively; р=0.956), gender (men 52.8 and 59.8 %, respectively; р=0.471), and risk of stroke (score 2.19±1.28 and score 1.95±1.35, respectively; р=0.350). Duration of the last arrhythmia episode was longer for patients after COVID-19 than for the comparison group (76.5 and 45.0 days, respectively; р=0.011). All patients received oral anticoagulants. 55.6 % of COVID-19 patients received rivaroxaban, whereas 62.0% of patients who had not had COVID-19 were treated with apixaban. Median duration of the anticoagulant treatment was longer for COVID-19 patients than for the comparison group (61.5 and 32.0 days; р=0.051). LAA thrombus was detected in 7 (19.4 %) patients after COVID-19 and in 6 (6.5 %) patients of the comparison group (р=0.030). In COVID-19 patients, the thrombus adhered to LAA wall over the entire thrombus length whereas in patients who had not have COVID-19, the thrombus had a free part that formed a sharp angle with LAA walls. In the presence of LAA thrombus, the LAA blood flow velocity was considerably higher for COVID-19 patients than for the comparison group (31.0±8.9 and 18.8±4.9 cm/sec, respectively; p=0.010). At the follow-up examination performed at 24.0 days on the average, the thrombus was found to be dissolved in 80 and 50% of patients after and without COVID-19, respectively (р=0.343).Conclusion      In patients with persistent AF after the novel coronavirus infection, LAA thrombosis was detected more frequently than in patients who had never had COVID-19; it was characterized by mural localization and was not associated with a decrease in LAA blood flow velocity.


Subject(s)
Atrial Appendage , Atrial Fibrillation , COVID-19 , Heart Diseases , Thrombosis , Aged , Anticoagulants/therapeutic use , Atrial Appendage/diagnostic imaging , Atrial Fibrillation/complications , Atrial Fibrillation/diagnosis , Atrial Fibrillation/epidemiology , COVID-19/complications , Echocardiography, Transesophageal/adverse effects , Heart Diseases/complications , Humans , Male , Middle Aged , SARS-CoV-2 , Thrombosis/diagnosis , Thrombosis/epidemiology , Thrombosis/etiology
9.
Cardiol Rev ; 30(3): 145-157, 2022.
Article in English | MEDLINE | ID: covidwho-1778952

ABSTRACT

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 and was first reported in December 2019 in Wuhan, China. Since then, it caused a global pandemic with 212,324,054 confirmed cases and 4,440,840 deaths worldwide as of August 22, 2021. The disease spectrum of COVID-19 ranges from asymptomatic subclinical infection to clinical manifestations predominantly affecting the respiratory system. However, it is now evident that COVID-19 is a multiorgan disease with a broad spectrum of manifestations leading to multiple organ injuries including the cardiovascular system. We review studies that have shown that the relationship between cardiovascular diseases and COVID-19 is indeed bidirectional, implicating that preexisting cardiovascular comorbidities increase the morbidity and mortality of COVID-19, and newly emerging cardiac injuries occur in the settings of acute COVID-19 in patients with no preexisting cardiovascular disease. We present the most up-to-date literature summary to explore the incidence of new-onset cardiac complications of coronavirus and their role in predicting the severity of COVID-19. We review the association of elevated troponin with the severity of COVID-19 disease, which includes mild compared to severe disease, in nonintensive care unit compared to intensive care unit patients and in those discharged from the hospital compared to those who die. The role of serum troponin levels in predicting prognosis are compared in survivors and non-survivors. The association between COVID-19 disease and myocarditis, heart failure and coagulopathy are reviewed. Finally, an update on beneficial treatments is discussed.


Subject(s)
COVID-19 , Cardiovascular Diseases , Heart Diseases , Myocarditis , COVID-19/complications , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Heart Diseases/epidemiology , Humans , Pandemics , Troponin
10.
Front Public Health ; 10: 833345, 2022.
Article in English | MEDLINE | ID: covidwho-1776035

ABSTRACT

To the best of our knowledge, no comprehensive estimates of the descriptive epidemiology of and trends in hypertensive heart disease (HHD) in China have been reported. In this study, the temporal trends in the prevalence of HHD in China from 1990 to 2019 were estimated using an age-period-cohort model. Data related to HHD burden were collected from the Global Burden of Disease Study 2019. From 1990 to 2019, HHD prevalence in China showed decreasing trends in both sexes combined (average annual percentage change [AAPC]: -0.2%, 95% confidence interval (CI: -0.3% to -0.2%) and in males (AAPC: -0.5%, 95% CI: -0.5% to -0.4%), but significant increases in the age groups of 15-19, 20-24, …, and 60-64 years. The age effect analysis showed an increase in HHD prevalence from 50 to 94 years in both males and females, the period effect analysis showed a slight increase in HHD prevalence from 2009 to 2019 in females, and the cohort effect analysis showed a consistent decline in HHD prevalence from earlier to later birth cohorts in both males and females.


Subject(s)
Heart Diseases , Hypertension , Adolescent , Adult , Aged , Aged, 80 and over , China/epidemiology , Cohort Studies , Female , Heart Diseases/epidemiology , Humans , Hypertension/epidemiology , Male , Middle Aged , Prevalence , Young Adult
11.
Clin Appl Thromb Hemost ; 28: 10760296221090227, 2022.
Article in English | MEDLINE | ID: covidwho-1775236

ABSTRACT

BACKGROUND: Cardiac injury has been linked to a poor prognosis during COVID-19 disease. Nevertheless, the risk factors associated are yet to be thoroughly investigated. OBJECTIVES: We sought to compare demographical characteristics and in-hospital outcomes in patients infected by the SARS-CoV-2 with and without cardiac injury, to further investigate the prevalence of acute cardiac injury as well as its impact on their outcomes in COVID-19-patients. METHODS: We included in a retrospective analysis, all COVID-19 patients admitted between October first and December first, 2020, at the University Hospital Center of Oujda (Morocco) who underwent a troponin assay which was systematically measured on admission. The study population was divided into two groups: cardiac-injured patients and those without cardiac injury. Clinical, biological data and in-hospital outcomes were compared between the two groups. RESULTS: 298 confirmed COVID-19 cases were included. Our study found that compared to non-cardiac-injured, cardiac-injured patients are older, with higher possibilities of existing comorbidities including hypertension (68 [42.2%] vs 40 [29.2%], P = 0.02), diabetes (81 [50.3%] vs 53 [38.7%] P = 0.044), the need for mechanical ventilation, ICU admission and mortality. A Cox proportional hazards regression analysis shows a significantly increased risk of death among cardiac-injured COVID-19-patients as compared to non-cardiac injured. (HR, 1.620 [CI 95%: 2.562-1.024]). CONCLUSION: Our retrospective cohort found that old age, comorbidities, a previous history of CAD, were significantly associated with acute cardiac injury. COVID-19 patients with acute cardiac injury are at a higher risk of ICU admission, and death.


Subject(s)
COVID-19 , Heart Diseases , Troponin , COVID-19/diagnosis , COVID-19/mortality , COVID-19/pathology , Heart Diseases/virology , Hospitalization , Humans , Retrospective Studies , SARS-CoV-2 , Troponin/analysis
13.
Int J Environ Res Public Health ; 19(6)2022 03 08.
Article in English | MEDLINE | ID: covidwho-1732050

ABSTRACT

This study aims to assess the impact of the COVID-19 pandemic on hospital cardiac care, as assessed by performance indicators. Scoping review methodology: performance indicators were extracted to inform on changes in care during January-June 2020. Database searches yielded 6277 articles, of which 838 met the inclusion criteria. After full-text screening, 94 articles were included and 1637 indicators were retrieved. Most of the indicators that provided information on changes in the number of admissions (n = 118, 88%) signaled a decrease in admissions; 88% (n = 15) of the indicators showed patients' delayed presentation and 40% (n = 54) showed patients in a worse clinical condition. A reduction in diagnostic and treatment procedures was signaled by 95% (n = 18) and 81% (n = 64) of the indicators, respectively. Length of stay decreased in 58% (n = 21) of the indicators, acute coronary syndromes treatment times increased in 61% (n = 65) of the indicators, and outpatient activity decreased in 94% (n = 17) of the indicators related to outpatient care. Telehealth utilization increased in 100% (n = 6). Outcomes worsened in 40% (n = 35) of the indicators, and mortality rates increased in 52% (n = 31). All phases of the pathway were affected. This information could support the planning of care during the ongoing pandemic and in future events.


Subject(s)
COVID-19 , Heart Diseases , COVID-19/epidemiology , Heart Diseases/epidemiology , Heart Diseases/therapy , Hospitalization , Hospitals , Humans , Pandemics
15.
Turk J Med Sci ; 51(SI-1): 3262-3272, 2021 12 17.
Article in English | MEDLINE | ID: covidwho-1726144

ABSTRACT

The global pandemic infectious disease that was named the new coronavirus disease (COVID 19), spread throughout the world, causing a major public health emergency. The causative virus of COVID-19, called SARS CoV-2, can infect all age groups. Various clinical signs and symptoms have been observed in neonates, children, and adolescents during the COVID-19 outbreak. The clinical manifestations of COVID-19 might be different due to the medical conditions and comorbid status in elderly and pediatric patients. The rise in cases among children has been reported during the COVID-19 pandemic. Although infected children generally appear to be asymptomatic or have only mild symptoms, COVID-19 in children may also involve a wide spectrum of clinical manifestations ranging from asymptomatic carriers to life-threatening and fatal diseases, as COVID-19 is a systemic disease that can affect multiple organs. Due to the lack of knowledge in the current literature, it is necessary to describe the atypical clinical features, including extrapulmonary manifestations, in pediatric patients with COVID-19. This review is conducted to identify knowledge gaps regarding the broad spectrum of clinical signs and symptoms of children with COVID-19.


Subject(s)
COVID-19/complications , Heart Diseases/etiology , Systemic Inflammatory Response Syndrome , Adolescent , COVID-19/diagnosis , COVID-19/epidemiology , Child , Critical Care , Critical Illness , Female , Humans , Infant, Newborn , Intensive Care Units, Pediatric , Male , Pandemics , SARS-CoV-2
16.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 14: e10517, 2022. tab
Article in English, Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1726772

ABSTRACT

Objetivo: compreender as principais complicações ocasionadas pelo vírus SARS-CoV-2 no sistema cardíaco do público idoso. Métodos: trata-se de uma revisão sistemática da literatura de abordagem qualitativa e característica descritivo-exploratória realizada no ano de 2020. Resultados: as complicações cardíacas mais prevalentes na população idosa foram miocardite, arritmias, insuficiência cardíaca, infarto agudo, choque cardiogênico, lesão miocárdica aguda e parada cardiorrespiratória. O principal biomarcador cardíaco foi a troponina, apresentando elevação superior ao percentil 99°, evidenciando a necessidade de tratamento em Unidade de Terapia Intensiva. Considerações Finais: o aparecimento desse vírus causou grande prejuízo no campo da saúde, especialmente a população idosa, que apresenta risco elevado de óbito ao contrair essa doença. Destarte, é de extrema importância se ater a mensuração da troponina sérica no público alvo e realizar monitorização longitudinal, utilizando para tal a telecardiologia, uma vez que diminuem as chances de contaminação entre infectado e profissional de saúde


Objective: to understand the main complications of SARS-CoV-2 in the elderly cardiac system. Methods: systematic literature review conducted in 2020. Results: the most prevalent cardiac complications in the elderly population were myocarditis, arrhythmias, heart failure, acute infarction, cardiogenic shock, acute myocardial injury and cardiorespiratory arrest. The main cardiac biomarker was troponin, showing an elevation above the 99th percentile, evidencing the need for treatment in the Intensive Care Unit. Final Considerations: the appearance of this virus has caused great damage in the health field, especially the elderly population, who is at high risk of death when contracting this disease. Therefore, it is important to stick to the measurement of serum troponin in the target audience and perform longitudinal monitoring, using telecardiology for this purpose, since they reduce the chances of contamination between infected and health professionals


Objetivo: comprender las principales complicaciones del SARS-CoV-2 en el sistema cardíaco anciano. Métodos: revisión sistemática de la literatura realizada en 2020. Resultados: las complicaciones cardíacas más prevalentes en la población anciana fueron miocarditis, arritmias, insuficiencia cardíaca, infarto agudo, shock cardiogénico, lesión miocárdica aguda y parada cardiorrespiratoria. El principal biomarcador cardíaco fue la troponina, mostrando una elevación por encima del percentil 99, evidenciando la necesidad de tratamiento en la Unidad de Cuidados Intensivos. Consideraciones finales: la aparición de este virus ha provocado un gran daño en el campo de la salud, especialmente en la población anciana, que se encuentra en alto riesgo de muerte al contraer esta enfermedad. Por tanto, es importante ceñirse a la medición de troponina sérica en el público objetivo y realizar un seguimiento longitudinal, utilizando para ello la telecardiología, ya que reducen las posibilidades de contaminación entre los infectados y los profesionales sanitarios


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Troponin , Health of the Elderly , COVID-19/complications , Heart Diseases/etiology , Patient Care Team , Shock, Cardiogenic , Telecardiology , Heart Arrest , Heart Failure , Intensive Care Units , Myocarditis
18.
Sch Psychol ; 37(1): 54-61, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1708356

ABSTRACT

This article presents data on Coronavirus disease (COVID-19)-related learning, health, and mental health concerns of 134 families of children with heart disease (HD), the most common birth defect, who are followed by a unique hospital-based Educational Achievement Partnership Program (EAPP) designed to serve as a liaison across the family, the child's medical team, and school. At-school, remote, and hybrid learning alternatives prompted by the COVID-19 pandemic presented families with an especially complex decision to make for children with HD due to competing complications in this population: Increased susceptibility to illness, greater risk of neuropsychological problems, and higher level of individualized education services that are not readily transferable to a home learning platform. Parents of school-aged children with HD completed a survey about COVID-19-related school support needs as part of a quality improvement project. Survey results revealed 51% of children would learn from home during the 2020-2021 school year due to concerns about the child's underlying health condition, indicating a marked change in schooling modality compared to prior years (4% in 2019). Nearly 75% of families requested medical guidance for COVID-19-related school health and education plan addendums. Seventy-three percent of families had mental health concerns about their child; severity of HD was related to families' reports about mental health concerns. Findings suggest follow-up is needed by school psychologists and medical consultative collaborative partners to support the transition back to in-person schooling after the COVID-19 pandemic concludes and to identify long-term educational consequences of disrupted learning during this period. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
COVID-19 , Heart Diseases , Child , Humans , Pandemics , SARS-CoV-2 , Schools
20.
Eur Heart J ; 43(11): 1157-1172, 2022 03 14.
Article in English | MEDLINE | ID: covidwho-1692227

ABSTRACT

Emerging as a new epidemic, long COVID or post-acute sequelae of coronavirus disease 2019 (COVID-19), a condition characterized by the persistence of COVID-19 symptoms beyond 3 months, is anticipated to substantially alter the lives of millions of people globally. Cardiopulmonary symptoms including chest pain, shortness of breath, fatigue, and autonomic manifestations such as postural orthostatic tachycardia are common and associated with significant disability, heightened anxiety, and public awareness. A range of cardiovascular (CV) abnormalities has been reported among patients beyond the acute phase and include myocardial inflammation, myocardial infarction, right ventricular dysfunction, and arrhythmias. Pathophysiological mechanisms for delayed complications are still poorly understood, with a dissociation seen between ongoing symptoms and objective measures of cardiopulmonary health. COVID-19 is anticipated to alter the long-term trajectory of many chronic cardiac diseases which are abundant in those at risk of severe disease. In this review, we discuss the definition of long COVID and its epidemiology, with an emphasis on cardiopulmonary symptoms. We further review the pathophysiological mechanisms underlying acute and chronic CV injury, the range of post-acute CV sequelae, and impact of COVID-19 on multiorgan health. We propose a possible model for referral of post-COVID-19 patients to cardiac services and discuss future directions including research priorities and clinical trials that are currently underway to evaluate the efficacy of treatment strategies for long COVID and associated CV sequelae.


Subject(s)
COVID-19 , Heart Diseases , Myocarditis , COVID-19/complications , Humans , Myocarditis/etiology , SARS-CoV-2
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