Abnormal echocardiographic findings after COVID-19 infection: a multicenter registry.

The Coronavirus Disease 2019 (COVID-19) pandemic has transformed health systems worldwide. There is conflicting data regarding the degree of cardiovascular involvement following infection. A registry was designed to evaluate the prevalence of echocardiographic abnormalities in adults recovered from COVID-19. We prospectively evaluated 595 participants (mean age 45.5 ± 14.9 years; 50.8% female) from 10 institutions in Argentina and Brazil. Median time between infection and evaluation was two months, and 82.5% of participants were not hospitalized for their infection. Echocardiographic studies were conducted with General Electric equipment; 2DE imaging and global longitudinal strain (GLS) of both ventricles were performed. A total of 61.7% of the participants denied relevant cardiovascular history and 41.8% had prolonged symptoms after resolution of COVID-19 infection. Mean left ventricular ejection fraction (LVEF) was 61.0 ± 5.5% overall. In patients without prior comorbidities, 8.2% had some echocardiographic abnormality: 5.7% had reduced GLS, 3.0% had a LVEF below normal range, and 1.1% had wall motion abnormalities. The right ventricle (RV) was dilated in 1.6% of participants, 3.1% had a reduced GLS, and 0.27% had reduced RV function. Mild pericardial effusion was observed in 0.82% of participants. Male patients were more likely to have new echocardiographic abnormalities (OR 2.82, p = 0.002). Time elapsed since infection resolution (p = 0.245), presence of symptoms (p = 0.927), or history of hospitalization during infection (p = 0.671) did not have any correlation with echocardiographic abnormalities. Cardiovascular abnormalities after COVID-19 infection are rare and usually mild, especially following mild infection, being a low GLS of left and right ventricle, the most common ones in our registry. Post COVID cardiac abnormalities may be more frequent among males.

Abnormal echocardiographic findings after COVID-19 infection: a multicenter registry

The Coronavirus Disease 2019 (COVID-19) pandemic has transformed health systems worldwide. There is conflicting data regarding the degree of cardiovascular involvement following infection. A registry was designed to evaluate the prevalence of echocardiographic abnormalities in adults recovered from COVID-19. We prospectively evaluated 595 participants (mean age 45.5 ± 14.9 years;50.8% female) from 10 institutions in Argentina and Brazil. Median time between infection and evaluation was two months, and 82.5% of participants were not hospitalized for their infection. Echocardiographic studies were conducted with General Electric equipment;2DE imaging and global longitudinal strain (GLS) of both ventricles were performed. A total of 61.7% of the participants denied relevant cardiovascular history and 41.8% had prolonged symptoms after resolution of COVID-19 infection. Mean left ventricular ejection fraction (LVEF) was 61.0 ± 5.5% overall. In patients without prior comorbidities, 8.2% had some echocardiographic abnormality: 5.7% had reduced GLS, 3.0% had a LVEF below normal range, and 1.1% had wall motion abnormalities. The right ventricle (RV) was dilated in 1.6% of participants, 3.1% had a reduced GLS, and 0.27% had reduced RV function. Mild pericardial effusion was observed in 0.82% of participants. Male patients were more likely to have new echocardiographic abnormalities (OR 2.82, p = 0.002). Time elapsed since infection resolution (p = 0.245), presence of symptoms (p = 0.927), or history of hospitalization during infection (p = 0.671) did not have any correlation with echocardiographic abnormalities. Cardiovascular abnormalities after COVID-19 infection are rare and usually mild, especially following mild infection, being a low GLS of left and right ventricle, the most common ones in our registry. Post COVID cardiac abnormalities may be more frequent among males. Supplementary Information The online version contains supplementary material available at 10.1007/s10554-022-02706-9.

Vascular Implications of COVID-19: Role of Radiological Imaging, Artificial Intelligence, and Tissue Characterization: A Special Report.

The SARS-CoV-2 virus has caused a pandemic, infecting nearly 80 million people worldwide, with mortality exceeding six million. The average survival span is just 14 days from the time the symptoms become aggressive. The present study delineates the deep-driven vascular damage in the pulmonary, renal, coronary, and carotid vessels due to SARS-CoV-2. This special report addresses an important gap in the literature in understanding (i) the pathophysiology of vascular damage and the role of medical imaging in the visualization of the damage caused by SARS-CoV-2, and (ii) further understanding the severity of COVID-19 using artificial intelligence (AI)-based tissue characterization (TC). PRISMA was used to select 296 studies for AI-based TC. Radiological imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound were selected for imaging of the vasculature infected by COVID-19. Four kinds of hypotheses are presented for showing the vascular damage in radiological images due to COVID-19. Three kinds of AI models, namely, machine learning, deep learning, and transfer learning, are used for TC. Further, the study presents recommendations for improving AI-based architectures for vascular studies. We conclude that the process of vascular damage due to COVID-19 has similarities across vessel types, even though it results in multi-organ dysfunction. Although the mortality rate is ~2% of those infected, the long-term effect of COVID-19 needs monitoring to avoid deaths. AI seems to be penetrating the health care industry at warp speed, and we expect to see an emerging role in patient care, reduce the mortality and morbidity rate.

Aggression, Micro-aggression, and Abuse Against Health Care Providers During the COVID-19 Pandemic. A Latin American Survey.

The COVID-19 pandemic has had tremendous consequences globally. Notably, increasing complaints of verbal and physical violence against health care providers have been reported. A cross-sectional electronic survey was conducted between January 11 and February 28, 2022 to delineate the violent behavior against front-line health professionals in Latin America. A total of 3544 participants from 19 countries were included. There were 58.5% women, 70.8% were physicians, 16% were nurses, and 13.2% were other health team members. About 54.8% reported acts of abuse: 95.6% verbal abuse, 11.1% physical abuse, and 19.9% other types. Nearly half of those who reported abuse experienced psychosomatic symptoms after the event, 56.2% considered changing their care tasks, and 33.6% considered quitting their profession. In a logistic regression model, nurses (odds ratio (OR) 1.90, P < 0.001), doctors (OR 2.11, P < 0.001), and administrative staff (OR 3.53, P = 0.005) experienced more abuse than other health workers. Women more frequently reported abuse (OR 1.56, P < 0.001), as well as those who worked directly with COVID-19 patients (OR 3.66, P < 0.001). A lower probability of abuse was observed at older ages (OR 0.95, P < 0.001). There has been a high prevalence of abuse against health personnel in Latin America during the COVID-19 pandemic. Those caring for COVID-19 patients, younger staff, and women were found to be at elevated risk. It is imperative to develop strategies to mitigate these acts and their repercussions on the patient-provider relationship and outcomes.

Gender-related Differences in the Impact of COVID-19 Pandemic in Cardiometabolic Patients in Latin America: The CorCOVID LATAM Gender Sub-study.

COVID-19 pandemic and lockdown measures have disrupted lifestyle habits and self-care. Gender differences in health behavior during the pandemic have not yet been fully elucidated. The aim of this study was to evaluate gender related differences in the impact of COVID-19 pandemic on patients with cardiometabolic diseases. A cross-sectional survey was administered to cardiometabolic patients in 13 Latin American countries between June 15th and July 15th, 2020. The study included 4216 participants, of which 2147 (50.9%) were women. Women reported healthier eating habits as well as lower tobacco and alcohol consumption than men but exercised less and reported increased symptoms of depression. Low income and symptoms of depression were associated with sedentarism in women. The interplay between psychological factors and sedentarism could increase the risk of cardiovascular events in this population.

Virtual versus in-person suture training: an evaluation of synchronous and asynchronous teaching paradigms

Background: Many components of the undergraduate medical education curriculum (UGME) have been delivered virtually because of COVID-19. Evaluation of the impact of these changes on learning outcomes is limited, especially the impact on teaching procedural skills. To date, asynchronous and synchronous virtual teaching have not been compared to in-person procedural skills training in undergraduate medical education. Our study aims to investigate whether virtual synchronous or asynchronous teaching differ from in-person teaching with respect to novice-learner suturing performance or learner anxiety. Although procedural skills in the UGME curriculum are being taught online, there has been limited evaluation of the effectiveness of these teaching methods. Methods: Sixty medical students will be randomly assigned to either in-person synchronous, virtual synchronous, or virtual asynchronous teaching of simple-interrupted suturing. Pre- and post-teaching assessments of suturing performance and anxiety regarding suturing will be compared between groups. Performance will be measured using a previously validated objective structured assessment of technical skills (OSATS) tool. Results: Enrolment is ongoing and the trial will take place from August 23-27, 2021. We anticipate having preliminary results by the date of the conference. Conclusion: We plan to use our results to optimize suturing training for novice medical learners, and to inform educators, provide guidelines for additional virtual procedural skills program evaluation, and assist in the broad integration of virtual learning initiatives.

Impact of COVID-19 on procedural skills training and career preparation of medical students

Background: The COVID-19 pandemic has significantly disrupted clinical/procedural skills training of Canadian medical students. Pandemic-related restrictions on in-person learning have affected academic/professional preparedness and emotional coping skills of medical students. We aimed to delineate these effects on medical students exposure to clinical/procedural skills training and to determine whether reductions in practical experiences affected career indecision and anxiety. Methods: All medical students (n = 400) were invited to anonymously complete an online survey. The survey consisted of 27 questions divided into 5 subsections: demographics, clinical/procedural skills exposure, informal career advising, level of career indecision, and level of career anxiety. Results: Recruitment is ongoing. To date, the survey has been completed by 37 students. Early data show that 22 respondents participated in 0-2 in-person sessions and 29 participated in 0-2 virtual events since March 2020. Of the 19 students who reported participating in 1 or more virtual curriculum-related procedural skills sessions, 12 rated them as either somewhat or extremely ineffective for building knowledge/skills. Although 16 of 37 respondents indicated they are either somewhat more or much more decisive regarding their career path than before the pandemic, 12 indicated they are either somewhat less or much less decisive, comparatively. Finally, 22 students indicated that they are either somewhat more or much more anxious regarding their career path than before the pandemic. Conclusion: Early results suggest that the pandemic has decreased exposure and quality of procedural skills training according to medical students. Levels of career indecision have been less affected;however, there has been an increase in career-related anxiety levels.

Chapter 10 - COVID-19 & Heart

In December 2019, a new single-stranded ribonucleic acid betacoronavirus (SARS-CoV-2) was observed in the People's Republic of China causing coronavirus disease 2019 (COVID-19) characterized by an acute respiratory distress syndrome (ARDS) (World Health Organization (WHO);Gonzalez Carta et al., 2021;The European Society for Cardiology;Nishiga et al., 2020). Subsequently, COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11th of 2020 (World Health Organization (WHO)). COVID-19 has had devastating global consequences for public health, the economy, and society (World Health Organization (WHO);Gonzalez Carta et al., 2021;The European Society for Cardiology;Nishiga et al., 2020;Mendoza et al., 2020). The predominant impact of COVID-19 is on the respiratory system, followed by Physiopathology of cardiovascular (CV) involvement which has significant prognostic implications. Individuals with underlying CV disease are at highest risk, including those with arterial hypertension and diabetes (Gonzalez Carta et al., 2021;The European Society for Cardiology;Nishiga et al., 2020;Mendoza et al., 2020). The global prevalence of reported CV complications in COVID-19 ranges between 12 and 78% of cases (Gonzalez Carta et al., 2021;The European Society for Cardiology;Nishiga et al., 2020;Mendoza et al., 2020). The mortality rate reported in patients with COVID-19 and previous CV diseases is significant (10.5%), and it is related to the presence of factors that alter the regulation of the immune system, such as older age or CV risk factors (Gonzalez Carta et al., 2021;The European Society for Cardiology;Nishiga et al., 2020;Mendoza et al., 2020).