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Objectives: The aim of this study was to assess Jordanian physicians' awareness about venous thromboembolism (VTE) risk among COVID-19 patients and its treatment protocol. Method(s): This was a cross-sectional-based survey that was conducted in Jordan in 2020. During the study period, a convenience sample of physicians working in various Jordanian hospitals were invited to participate in this study. Physicians' knowledge was evaluated and physicians gained one point for each correct answer. Then, a knowledge score out of 23 was calculated for each. Key Findings: In this study, 102 physicians were recruited. Results from this study showed that most of the physicians realize that all COVID-19 patients need VTE risk assessment (n = 69, 67.6%). Regarding VTE prophylaxis, the majority of physicians (n = 91, 89.2%) agreed that low molecular weight heparin (LMWH) is the best prophylactic option for mild-moderate COVID-19 patients with high VTE risk. Regarding severe/critically ill COVID-19 patients, 75.5% of physicians (n = 77) recognized that LMWH is the correct prophylactic option in this case, while 80.4% of them (n = 82) knew that mechanical prevention is the preferred prophylactic option for severe/critically ill COVID-19 patients with high bleeding risk. Moreover, 77.5% of physicians (n = 79) knew that LMWH is the treatment of choice for COVID-19 patients diagnosed with VTE. Finally, linear regression analysis showed that consultants had an overall higher knowledge score about VTE prevention and treatment in COVID-19 patients compared with residents (P = 0.009). Conclusion(s): All physicians knew about VTE risk factors for COVID-19 patients. However, consultants showed better awareness of VTE prophylaxis and treatment compared with residents. We recommend educational workshops be conducted to enhance physicians' knowledge and awareness about VTE thromboprophylaxis and management in COVID-19 patients.Copyright © 2022 The Author(s). Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved.
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Introduction: The relentless COVID-19 pandemic caused a devastating sickness and loss of life at a global level. The stress related to the pandemic lockdown and near total paralysis of most human activities was associated with behavioral changes. It is largely unknown if these stresses could trigger acute cardiovascular events among non-infected individuals. Purpose: To explore the relation between COVID-19 associated stresses and acute cardiovascular events among non-infected individuals. Methods: Adult patients presented with acute myocardial infarction (AMI), stroke or out-of-hospital cardiac arrest (OHCA) at 11 hospitals in Jordan from March 2020 through February 2021 were assessed for potential exposure to stressful life events related to the COVID-19 pandemic. None of the patients was COVID-19 infected or a health care worker. Results: Of 297 patients enrolled (mean age 58.4±13.1 years, 18.5% females), 267 patients (89.8%) had AMI, 15 patients (5.1%) had stroke, and 15 patients (5.1%) had OHCA. Cigarette smoking was present in 59.6%, hypertension in 50.5%, dyslipidemia in 42.8%, diabetes in 37.4%, and 35% had prior diagnosis of cardiovascular disease. Coronary revascularization was performed in 228 (85.4%) of AMI patients. In-hospital mortality among the AMI and stroke patients was 4.3% and none of the OHCA patients survived. The most common stresses preceded these events included financial hardships (50.8%), lockdown stress (25.9%), fears from the pandemic (24.9%), anger (22.6%), loneliness (19.2%), smoking binges (19.9%), death of a significant person (6.4%), and food binges (3.4%). Conclusions: The COVID-19 pandemic and lockdown caused immense psychosocial and financial stresses that triggered life threatening acute cardiovascular events in non-infected individuals. Early recognition of stress-related symptoms during this unremitting pandemic warrants proper referral and evaluation.
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Background and Aims: The Covid-19 pandemic-related stressors are associated with behavioral and psychological problems, but no reports describe the pandemic stress triggering acute coronary events including acute myocardial infarction (AMI) and out-of-hospital cardiac arrest (OHCA) among individuals not infected with the covid-19 virus. Methods: We enrolled Covid-19 negative patients with AMI or OHCA admitted to 8 centers in Jordan during the covid-19 pandemic (March 15 through December 31, 2020). All of the patients were exposed to pandemic-related psychosocial and financial stressors. Results: We enrolled 177 patients (mean age 59.6+9.9 years, 84% men). Hypertension was present in 50%, diabetes in 45%, cigarette smoking in 71%, and 36% had history of cardiovascular disease (CVD). Of the whole group, 166 (94%) had AMI and 11 (6%) had OHCA. Patients with OHCA were younger (55.0+7.1 vs. 59.9+10.7 years, p<0.05) and had lower rate of past CVD (9% vs. 37%, p<0.001) compared with AMI patients. Of the AMI patients, 147 (83%) had coronary angiography, 119 (67%) had percutaneous angioplasty and 14 (8%) had bypass surgery. Survival rate was 0 for the OHCA patients and 98.2% for AMI patients (p<0.0001). The most common reported pandemic-related triggers the patients were exposed to included financial hardships in 82 (46%), loneliness in 77 (44%), fear to contract the virus or of lack of medical care in 55 (31%), anger in 29 (16%), and heavy physical exertion in 8 patients (5%). Conclusions: The Covid-19 pandemic-related stressors can potentially trigger life threatening acute coronary events. The minority of patients who had OHCA had a grim prognosis.