[Sports cardiology : Which sport can be recommended for heart diseases?] / Sportkardiologie : Welcher Sport kann bei Herzerkrankungen empfohlen werden?

Within cardiology the field of sports cardiology has gradually increased in importance over the past 10 years. This is mainly due to the fact that the spectrum of issues relating to physical training in prevention and secondary prevention has expanded beyond classical cardiovascular rehabilitation. This spectrum affects above all adolescents and young adults with a manifest cardiac disease who want to continue being physically active and, in some cases strive for leisure and competitive sports. In addition, the group of patients with cardiac diseases who are still striving for top athletic performance even in old age and are looking for advice is continuously growing. In these cases, it is a matter of recommending physical training as a therapy strategy but also to protect the cardiovascular system. Dedicated recommendations for physical training must therefore also take individual aspects into consideration. In addition, the recommendation for the clearance for competitive sports is addressed in ambitious leisure and competitive sports. Patients ask about sport and training recommendations with cardiovascular risk factors, such as arterial hypertension, pathologies of the coronary arteries in the sense of a malformed outlet of coronary arteries, muscle bridges or coronary heart disease, cardiomyopathies and myocarditis as well as arrhythmia and cardiac valvular defects. This article discusses these diseases with the corresponding sport cardiological specific aspects and recommendations for physical training and competitive sports are given for each case.

Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany.

Additional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

Extracorporeal multiorgan support including CO2-removal with the ADVanced Organ Support (ADVOS) system for COVID-19: A case report.

A substantial part of COVID-19-patients suffers from multi-organ failure (MOF). We report on an 80-year old patient with pulmonary, renal, circulatory, and hepatic failure. We decided against the use of extracorporeal membrane oxygenation (ECMO) due to old age and a SOFA-score of 13. However, the patient was continuously treated with the extracorporeal multi-organ- "ADVanced Organ Support" (ADVOS) device (ADVITOS GmbH, Munich, Germany). During eight 24h-treatment-sessions blood flow (100-300 mL/min), dialysate flow (160-320 mL/min) and dialysate pH (7.6-9.0) were adapted to optimize arterial PaCO2 and pH. Effective CO2 removal and correction of acidosis could be demonstrated by mean arterial- versus post-dialyzer values of pCO2 (68.7 ± 13.8 vs. 26.9 ± 11.6 mmHg; p < 0.001). The CO2-elimination rate was 48 ± 23mL/min. The initial vasopressor requirement could be reduced in parallel to pH-normalization. Interruptions of ADVOS-treatment repeatedly resulted in reversible deteriorations of paCO2 and pH. After 95 h of continuous extracorporeal decarboxylating therapy the patient had markedly improved circulatory parameters compared to baseline. In the context of secondary pulmonary infection and progressive liver failure, the patient had a sudden cardiac arrest. In accordance with the presumed patient will, we decided against mechanical resuscitation. Irrespective of the outcome we conclude that extracorporeal CO2 removal and multiorgan-support were feasible in this COVID-19-patient. Combined and less invasive approaches such as ADVOS might be considered in old-age-COVID-19 patients with MOF.