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1.
Open Heart ; 8(1)2021 06.
Article in English | MEDLINE | ID: covidwho-1269804

ABSTRACT

BACKGROUND: Prior diagnosis of heart failure (HF) is associated with increased length of hospital stay (LOS) and mortality from COVID-19. Associations between substance use, venous thromboembolism (VTE) or peripheral arterial disease (PAD) and its effects on LOS or mortality in patients with HF hospitalised with COVID-19 remain unknown. OBJECTIVE: This study identified risk factors associated with poor in-hospital outcomes among patients with HF hospitalised with COVID-19. METHODS: Case-control study was conducted of patients with prior diagnosis of HF hospitalised with COVID-19 at an academic tertiary care centre from 1 January 2020 to 28 February 2021. Patients with HF hospitalised with COVID-19 with risk factors were compared with those without risk factors for clinical characteristics, LOS and mortality. Multivariate regression was conducted to identify multiple predictors of increased LOS and in-hospital mortality in patients with HF hospitalised with COVID-19. RESULTS: Total of 211 patients with HF were hospitalised with COVID-19. Women had longer LOS than men (9 days vs 7 days; p<0.001). Compared with patients without PAD or ischaemic stroke, patients with PAD or ischaemic stroke had longer LOS (7 days vs 9 days; p=0.012 and 7 days vs 11 days, p<0.001, respectively). Older patients (aged 65 and above) had increased in-hospital mortality compared with younger patients (adjusted OR: 1.04; 95% CI 1.00 to 1.07; p=0.036). Prior diagnosis of VTE increased mortality more than threefold in patients with HF hospitalised with COVID-19 (adjusted OR: 3.33; 95% CI 1.29 to 8.43; p=0.011). CONCLUSION: Vascular diseases increase LOS and mortality in patients with HF hospitalised with COVID-19.


Subject(s)
COVID-19/mortality , Comorbidity/trends , Heart Failure/mortality , Vascular Diseases/complications , Aged , Aged, 80 and over , Anticoagulants/therapeutic use , COVID-19/complications , COVID-19/diagnosis , COVID-19/virology , Case-Control Studies , Female , Heart Failure/diagnosis , Heart Failure/drug therapy , Heart Failure/virology , Hospitalization/statistics & numerical data , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Ischemic Stroke/complications , Ischemic Stroke/epidemiology , Length of Stay/statistics & numerical data , Male , Middle Aged , Peripheral Arterial Disease/complications , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2/genetics , Substance-Related Disorders/complications , Venous Thromboembolism/complications
2.
Int J Mol Sci ; 22(8)2021 Apr 15.
Article in English | MEDLINE | ID: covidwho-1196033

ABSTRACT

Amyloidoses are a group of diseases associated with the formation of pathological protein fibrils with cross-ß structures. Approximately 5-10% of the cases of these diseases are determined by amyloidogenic mutations, as well as by transmission of infectious amyloids (prions) between organisms. The most common group of so-called sporadic amyloidoses is associated with abnormal aggregation of wild-type proteins. Some sporadic amyloidoses are known to be induced only against the background of certain pathologies, but in some cases the cause of amyloidosis is unclear. It is assumed that these diseases often occur by accident. Here we present facts and hypotheses about the association of sporadic amyloidoses with vascular pathologies, trauma, oxidative stress, cancer, metabolic diseases, chronic infections and COVID-19. Generalization of current data shows that all sporadic amyloidoses can be regarded as a secondary event occurring against the background of diseases provoking a cellular stress response. Various factors causing the stress response provoke protein overproduction, a local increase in the concentration or modifications, which contributes to amyloidogenesis. Progress in the treatment of vascular, metabolic and infectious diseases, as well as cancers, should lead to a significant reduction in the risk of sporadic amyloidoses.


Subject(s)
Amyloidosis/etiology , Stress, Physiological , Brain Injuries/complications , Communicable Diseases/complications , Humans , Metabolic Diseases/complications , Neoplasms/complications , Oxidative Stress , Vascular Diseases/complications
3.
Cell ; 183(5): 1354-1366.e13, 2020 11 25.
Article in English | MEDLINE | ID: covidwho-871817

ABSTRACT

The COVID-19 pandemic has led to extensive morbidity and mortality throughout the world. Clinical features that drive SARS-CoV-2 pathogenesis in humans include inflammation and thrombosis, but the mechanistic details underlying these processes remain to be determined. In this study, we demonstrate endothelial disruption and vascular thrombosis in histopathologic sections of lungs from both humans and rhesus macaques infected with SARS-CoV-2. To define key molecular pathways associated with SARS-CoV-2 pathogenesis in macaques, we performed transcriptomic analyses of bronchoalveolar lavage and peripheral blood and proteomic analyses of serum. We observed macrophage infiltrates in lung and upregulation of macrophage, complement, platelet activation, thrombosis, and proinflammatory markers, including C-reactive protein, MX1, IL-6, IL-1, IL-8, TNFα, and NF-κB. These results suggest a model in which critical interactions between inflammatory and thrombosis pathways lead to SARS-CoV-2-induced vascular disease. Our findings suggest potential therapeutic targets for COVID-19.


Subject(s)
COVID-19/complications , COVID-19/immunology , SARS-CoV-2/genetics , Thrombosis/complications , Vascular Diseases/complications , Aged, 80 and over , Animals , Bronchoalveolar Lavage , C-Reactive Protein/analysis , COVID-19/blood , COVID-19/pathology , Complement Activation , Cytokines/blood , Female , Humans , Inflammation/blood , Inflammation/immunology , Inflammation/virology , Lung/pathology , Macaca mulatta , Macrophages/immunology , Male , Platelet Activation , Thrombosis/blood , Thrombosis/pathology , Transcriptome , Vascular Diseases/blood , Vascular Diseases/pathology
4.
J Wound Care ; 29(Sup9): S6-S7, 2020 Sep 01.
Article in English | MEDLINE | ID: covidwho-761156

ABSTRACT

The uncertainty due to COVID-19 surrounding live events has remained present and persistent. Therefore, this year, the American Vein & Lymphatic Society (AVLS) Annual Congress will be a virtual-only event that will take place on 15 October 2020. It will include a live-streamed session will complement the fundamental knowledge of providing wound care for patients. On-demand content will allow attendees to participate at their own pace, watching as much or as little as they want each day, potentially earning AMA PRA Category 1 CreditsTM.


Subject(s)
Betacoronavirus , Congresses as Topic , Coronavirus Infections/therapy , Pneumonia, Viral/therapy , Triage/organization & administration , Vascular Diseases/therapy , COVID-19 , Clinical Decision-Making , Coronavirus Infections/complications , Humans , International Cooperation , Pandemics , Pneumonia, Viral/complications , SARS-CoV-2 , Societies, Medical/organization & administration , United States , Vascular Diseases/complications
7.
Ann Vasc Surg ; 67: 1-5, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-526928

ABSTRACT

BACKGROUND: The epidemic potential of coronavirus infection is now a reality. Since the first case detected in late 2019 in China, a fast worldwide expansion confirms it. The vascular patient is at a higher risk of developing a severe form of the disease because of its nature associating several comorbid states, and thus, some vascular surgery communities from many countries have tried to stratify patients into those requiring care during these uncertain times. METHODS: This is an observational study describing the current daily vascular surgery practice at one tertiary academic hospital in Madrid region, Spain-one of the most affected regions worldwide due to the COVID-19 outbreak. We analyzed our surgical practice since March 14th when the lockdown was declared up to date, May 14th (2 months). Procedural surgical practice, organizational issues, early outcomes, and all the troubles encountered during this new situation are described. RESULTS: Our department is composed of 10 vascular surgeons and 4 trainees. Surgical practice has been reduced to only urgent care, totaling 50 repairs on 45 patients during the period. Five surgeries were performed on 3 COVID-19-positive patients. Sixty percent were due to critical limb ischemia, 45% of them performed by complete endovascular approach, whereas less than 10% of repairs were aorta related. We were allocated to use a total of 5 surgical rooms in different locations, none our usual, as it was converted into an ICU room while performing 50% of those repairs with unusual nursery staff. CONCLUSIONS: The COVID-19 outbreak has dramatically changed our organization and practice in favor of urgent or semiurgent surgical care alone. The lack of in-hospital/ICU beds and changing nursery staff changed the whole availability organization at our hospital and was a key factor in surgical decision-making in some cases.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Pandemics , Pneumonia, Viral/complications , Specialties, Surgical/statistics & numerical data , Vascular Diseases/surgery , Vascular Surgical Procedures/organization & administration , COVID-19 , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Spain/epidemiology , Vascular Diseases/complications
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