scholarly journals Imaging in COVID-19-related myocardial injury

2020 ◽  
Author(s):  
Riccardo Cau ◽  
Pier Paolo Bassareo ◽  
Lorenzo Mannelli ◽  
Jasjit S. Suri ◽  
Luca Saba
Keyword(s):  
Myocardial Injury ◽  
Acute Infection ◽  
Clinical Manifestations ◽  
Public Health Issue ◽  
Upward Trend ◽  
Major Public Health Issue ◽  
Heart Injury ◽  
The Moment ◽  
Novel Coronavirus

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS- CoV-2), previously named “2019 novel coronavirus” (2019-nCoV) is an emerging disease and a major public health issue. At the moment, little is known, except that its spread is on a steady upward trend. That is the reason why it was declared pandemic since March 11th, 2020. Respiratory symptoms dominate the clinical manifestations of the virus, but in a few patients also other organs are involved, such as their heart. This review article provides an overview of the existing literature regarding imaging of heart injury during COVID-19 acute infection and follow-up.

scholarly journals Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tae Ik Chang ◽  
Haeyong Park ◽  
Dong Wook Kim ◽  
Eun Kyung Jeon ◽  
Connie M. Rhee ◽  
...  
Keyword(s):  
Public Health ◽  
Cohort Study ◽  
Prescription Drugs ◽  
Mortality Risk ◽  
Residential Area ◽  
Public Health Issue ◽  
Geriatric Population ◽  
Major Public Health Issue ◽  
Elderly Individuals

Abstract Polypharmacy is a growing and major public health issue, particularly in the geriatric population. This study aimed to examine the association between polypharmacy and the risk of hospitalization and mortality. We included 3,007,620 elderly individuals aged ≥ 65 years who had at least one routinely-prescribed medication but had no prior hospitalization within a year. The primary exposures of interest were number of daily prescribed medications (1–2, 3–4, 5–6, 7–8, 9–10, and ≥ 11) and presence of polypharmacy (≥ 5 prescription drugs per day). The corresponding comparators were the lowest number of medications (1–2) and absence of polypharmacy. The study outcomes were hospitalization and all-cause death. The median age of participants was 72 years and 39.5% were men. Approximately, 46.6% of participants experienced polypharmacy. Over a median follow-up of 5.0 years, 2,028,062 (67.4%) hospitalizations and 459,076 (15.3%) all-cause deaths were observed. An incrementally higher number of daily prescribed medications was found to be associated with increasingly higher risk for hospitalization and mortality. These associations were consistent across subgroups of age, sex, residential area, and comorbidities. Furthermore, polypharmacy was associated with greater risk of hospitalization and death: adjusted HRs (95% CIs) were 1.18 (1.18–1.19) and 1.25 (1.24–1.25) in the overall and 1.16 (1.16–1.17) and 1.25 (1.24–1.25) in the matched cohorts, respectively. Hence, polypharmacy was associated with a higher risk of hospitalization and all-cause death among elderly individuals.

scholarly journals A Physicist View of COVID-19 Airborne Infection through Convective Airflow in Indoor Spaces

2020 ◽  
Vol 2 ◽  
pp. 68-72
Author(s):  
Luis Alfredo Anchordoqui ◽  
Eugene M. Chudnovsky
Keyword(s):  
Control Measures ◽  
General Idea ◽  
Public Health Issue ◽  
The Novel ◽  
Major Public Health Issue ◽  
Airborne Infection ◽  
Confined Spaces ◽  
Infection Control Measures ◽  
Novel Coronavirus ◽  
Indoor Spaces

General Idea: Naturally produced droplets from humans (such as those produced by breathing, talking, sneezing, and coughing) include several types of cells (e.g., epithelial cells and cells of the immune system), physiological electrolytes contained in mucous and saliva (e.g. Na+, K+, Cl-), as well as, potentially, several infectious agents (e.g. bacteria, fungi, and viruses). In response to the novel coronavirus SARS-CoV-2 epidemic, which has become a major public health issue worldwide, we provide a concise overview of airborne germ transmission as seen from a physics perspective. We also study whether coronavirus aerosols can travel far from the immediate neighbourhood and get airborne with the convective currents developed within confined spaces. Methodology: Methods of fluid dynamics are utilized to analyse the behavior of various-size airborne droplets containing the virus. Study Findings: We show that existing vortices in the air can make a location far away from the source of the virus be more dangerous than a nearby (e.g., 6 feet away) location. Practical Implications: Our study reveals that it seems reasonable to adopt additional infection-control measures to the recommended 6 feet social distancing. We provide a recommendation that could help to slow down the spread of the virus.

scholarly journals Progress in Treatment of Myocardial Injury in Patients with 2019-nCoV: A Chinese Experience

2020 ◽  
Vol 23 (4) ◽  
pp. E426-E429
Author(s):  
Shixiong Wei ◽  
Lin Zhang ◽  
Huimin Cui ◽  
Shengli Jiang
Keyword(s):  
Myocardial Injury ◽  
Human Life ◽  
Clinical Manifestations ◽  
Future Research ◽  
Published Data ◽  
Research Directions ◽  
Safety And Health ◽  
Disease Condition ◽  
Future Research Directions ◽  
Novel Coronavirus

Since December 2019, the 2019 novel coronavirus (2019-nCoV) infection began to appear in Hubei Province of China and gradually spread to other provinces and other countries. The virus has the characteristics of strong transmission capacity, diverse clinical manifestations, long incubation period, and latent infection, thus posing a serious threat to human life safety and health. With the increasing number of cases and the continuous enrichment of clinical data, 2019-nCoV–infected patients have received more and more attention regarding myocardial injury related to virus infection besides typical respiratory system manifestations. According to the published data, we summarize the myocardial injury manifestations, characteristics, effects on disease condition, and prognosis of 2019-nCoV–infected patients and discuss the possible injury mechanism, treatment methods, and future research directions.

scholarly journals Urine nucleic acid test positive in an asymptomatic patient with novel coronavirus 2019 infection: a case report

2020 ◽  
Author(s):  
Yaoyong Wang ◽  
Xinjian Chang ◽  
Jianguo Ren ◽  
Dongyan Li ◽  
Changfei Wang ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Throat Swab ◽  
Asymptomatic Patient ◽  
Clinical Manifestations ◽  
Nucleic Acid Test ◽  
Asymptomatic Patients ◽  
Sources Of Infection ◽  
Novel Coronavirus ◽  
Acid Test

Abstract Background: With the emergence of coronavirus disease 2019 in many places around the world, the main medical resources currently focus on the treatment of confirmed patients and the screening of suspected cases. Asymptomatic patients are difficult to detect, but they may be contagious, which makes epidemic control more difficult. We found a case of asymptomatic patient with positive urine coronavirus nucleic acid test, and we hope to attract attention of all circles.Case presentation: An asymptomatic patient with novel coronavirus infection was found in an epidemiological investigation of patients with confirmed coronavirus disease 2019. The patient was admitted to the hospital on February 24, 2020. She had no clinical manifestations such as fever, dry cough, and fatigue, and no abnormal signs. The examination showed that her throat swab was negative for nucleic acid but the urine was positive for nucleic acid. She was given antiviral and symptomatic supportive treatment. On February 26, her throat swab was checked for nucleic acid positive. On March 3 and 5, her throat swab and urine nucleic acid were negative. On March 9 and 12, her throat swab nucleic acid were negative. The patient was discharged from the hospital on March 13 and continued to be isolated and observed outside the hospital. Follow-up was conducted on March 26, the patient did not have any discomfort, the throat swab nucleic acid test was negative, and the isolation was lifted.Conclusion: There are asymptomatic patients with coronavirus disease 2019, and their urine may be one of the sources of infection.

scholarly journals Krebs von den Lungen 6 (KL-6) as a marker for disease severity and persistent radiological abnormalities following COVID-19 infection at 12 weeks

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249607
Author(s):  
David T. Arnold ◽  
Charmaine Donald ◽  
Max Lyon ◽  
Fergus W. Hamilton ◽  
Anna J. Morley ◽  
...  
Keyword(s):  
Cell Injury ◽  
Research Question ◽  
Acute Infection ◽  
Clinical Manifestations ◽  
Clinical Severity ◽  
Future Research ◽  
Significant Difference ◽  
Pulmonary Epithelial Cell ◽  
Dysfunctional Breathing

Introduction Acute presentations of COVID-19 infection vary, ranging from asymptomatic carriage through to severe clinical manifestations including acute respiratory distress syndrome (ARDS). Longer term sequelae of COVID-19 infection includes lung fibrosis in a proportion of patients. Krebs von den Lungen 6 (KL-6) is a mucin like glycoprotein that has been proposed as a marker of pulmonary epithelial cell injury. We sought to determine whether KL-6 was a marker of 1) the severity of acute COVID-19 infection, or 2) the persistence of symptoms/radiological abnormalities at medium term follow up. Methods Prospective single centre observational study. Results Convalescent KL-6 levels were available for 93 patients (male 63%, mean age 55.8 years) who attended an 12-week follow up appointment after being admitted to hospital with COVID-19. For 67 patients a baseline KL-6 result was available for comparison. There was no significant correlations between baseline KL-6 and the admission CXR severity score or clinical severity NEWS score. Furthermore, there was no significant difference in the baseline KL-6 level and an initial requirement for oxygen on admission or the severity of acute infection as measured at 28 days. There was no significant difference in the 12-week KL-6 level and the presence or absence of subjective breathlessness but patients with abnormal CT scans at 12 weeks had significantly higher convalescent KL-6 levels compared to the remainder of the cohort (median 1101 IU/ml vs 409 IU/ml). Conclusions The association between high KL-6 levels at 12 weeks and persisting CT abnormalities (GGO/fibrosis), is a finding that requires further exploration. Whether KL-6 may help differentiate those patients with persisting dyspnoea due to complications rather than deconditioning or dysfunctional breathing alone, is an important future research question.

scholarly journals Association Between Cystatin C, Cystatin C Rangeability and Mortality of COVID-19 Patients With or Without Type 2 Diabetes Mellitus: An Opportunistic Retrospective Analysis

2020 ◽  
Author(s):  
Lei Yang ◽  
Dou Xu ◽  
Yiqing Tan ◽  
Bolin Li ◽  
Dan Zhu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cystatin C ◽  
Clinical Manifestations ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Novel Coronavirus

Abstract Background: Since December of 2019, novel coronavirus (SARS-CoV-2)-induced pneumonia (COVID-19) exploded in Wuhan, and rapidly spread throughout China. Patients with COVID-19 demonstrated quite different appearances and outcomes in clinical manifestations. We aimed to figure out whether risk factors of the cystatin C (CysC) and the CysC rangeability are influencing the prognosis of COVID-19 patients with or without type 2 diabetes mellitus (T2DM).Methods: 675 T2DM patients and 602 non-T2DM patients were divided into low CysC group, high CysC group and low CysC rangeability group, high CysC rangeability group according to the serum CysC level and the change range of CysC. Demographic characteristics, clinical data and laboratory results of the four groups were collected and analyzed.Results: Our data showed that COVID-19 patients with high CysC level and CysC rangeability had more organic damage and higher mortality rate compared to those with low level or low rangeability of CysC. Furthermore, patients with higher CysC level and CysC rangeability also demonstrated higher blood lymphocytes (lymph), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) which may greatly influence disease progression and poor prognosis of COVID-19. After adjusting for possible confounders, multivariate analysis revealed that CysC≤0.93mg/dl as a reference, CysC＞0.93mg/dl were significantly associated with the risk of heart failure (OR=2.401, 95% CI: 1.118–5.156) and all-cause death (OR=2.734, 95% CI: 1.098-6.811); referring to CysC rangeability≤0, CysC rangeability＞0 significantly associated with all-cause death (OR=4.029, 95% CI: 1.864-8.706). Further grouped by T2DM, these associations were stronger in T2DM than in non-T2DM.Conclusions: It suggests that CysC level and CysC rangeability contribute to clinical manifestations and may influence the prognosis of COVID-19. The CysC is considered as a potential risk factor of the prognosis of COVID-19. Special medical care and appropriate intervention should be performed in COVID-19 patients with elevated CysC during hospitalization and later clinical follow-up, especially for those with T2DM.

scholarly journals Severe COVID-19 is associated with sustained biochemical disturbances and prolonged symptomatology; A retrospective single-centre cohort study

2021 ◽  
Author(s):  
Marija Simjanoska ◽  
Zan Mitrev ◽  
Gianluca Villa ◽  
Daniel O. Griffin ◽  
Rodney A. Rosalia
Keyword(s):  
Clinical Presentation ◽  
Acute Infection ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Clinical Severity ◽  
Single Centre ◽  
Post Discharge ◽  
Patients Experience ◽  
Biochemical Abnormalities

AbstractIntroductionCoronavirus disease 2019 (COVID-19) is associated with significant acute clinical manifestations, and reports indicate that some patients experience prolonged symptomatology and morbidity. These late clinical manifestations have been termed Post-Acute Sequelae of COVID-19 (PASC) and hypothesised to be associated with clinical severity in the acute infection phase and biochemical abnormalities.AimEvaluate the incidence of PASC in previously hospitalised COVID-19 patients and compare the admission and follow-up levels of biochemical parameters stratified according to baseline clinical severity.MethodsN = 168 COVID-19 patients previously hospitalised at the Zan Mitrev Clinic in Skopje, North Macedonia, with matched laboratory data at baseline and follow-up clinical visit > 30 days post-discharge, were stratified according to National Institute of Health clinical severity guidelines as mild, moderate, severe or critical according to admission clinical presentation. We assessed the incidence of PASC and compared the biochemical profile.ResultsThe median hospitalisation and clinical follow-up period were 11 (9-20) and 53 (30-105) days. The overall incidence of PASC was 56.5% (95/168); most PASC cases were confined to the severe sub-group (61/101, 61.4%). Contrary to mild and moderate cases and a healthy “non-COVID-19” control cohort, we observed that severe COVID-19 cases experienced sustained biochemical disturbances, most notably elevated D-dimers and Ferritin of 600 ng/ml (283-1168) and 432 ng/ml (170-916), respectively.ConclusionsPreviously hospitalised severe COVID-19 patients are more likely to experience Post-Acute Sequelae of COVID-19 and prolonged biochemical disturbances, evident by abnormal values of D-dimers and Ferritin.

scholarly journals Case report: atypical recurrent painful ophthalmoplegic neuropathy

2020 ◽  
pp. 6
Author(s):  
Felipe Soares ◽  
Jorge Lapa ◽  
Bárbara Costa ◽  
Gabriel Kubota ◽  
Daniel Andrade ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Pulse Therapy ◽  
Sudden Onset ◽  
Clinical Aspects ◽  
Oral Steroids ◽  
Neurological Exam ◽  
Cranial Mri ◽  
The Moment ◽  
Full Relief

IntroduccionRecurrent painful ophthalmoplegic neuropathy (RPON) is a rare disorder with repeated episodes of ocular cranial nerve neuropathy associated with ipsilateral headache in which secondary causes have first been excluded.Case ReportWoman, 52 years old, no comorbidity. In 2001 she presented sudden onset intense (8-10) throbbing left-sided unilateral headache that irradiated to the ipsilateral eye. The crisis lasted for 04 days, without nausea, vomit, photophobia or phonophobia. The intensity of the pain was alleviated with 1g of dipyrone and sodium naproxen in one daily oral dose of 550 mg, without analgesics excess. About two days after the end of the crisis the patient noticed left-sided palpebral ptosis and vertical diplopy preceded by retro-orbital ipsilateral twinge pain. The neurological exam showed fixed mydriasis, left-sided hypotropia and exotropia, compatible with the compromising of the 3rd ipsilateral nerve CN III. At the occasion, the patient was submitted to laboratorial exams of the cerebrospinal fluid, CT scan of the orbit and the skull, digital cerebral angiography of the four vessels, with no abnormalities. Cranial MRI showed enhanced cisternal segment of the left side third nerve. In 2004, 2006, 2008 and 2010 the patient presented the same clinical manifestations, having been treated with 1mg/kg methylprednisolone with full relief in 15 days. However, on the last episode in june of 2019, the patient presented only leftsided oculomotor manifestation, showing residual vertical diplopy after 06 months of pulse therapy. At the moment, she is taking 5 mg of Prednisone, via oral, in protocol of weaning off and ambulatorial follow up at the specialized center of cephalalgy.CommentsA case of RPON was described, diagnosed according to the ICHD-3. However, the patient presented unusual clinical aspects and age of symptoms onset. Unlike the descripitions found in literature, the first crisis occurred at the age 33. Besides, in the last event, only ocular manifestation ocurred, without cephalalgy, with persistent vertical diplopya, after pulse therapy and treatment with via oral steroids and 06 month- follow up. A case of RPON with atypical clinical manifestations and incomplete response to the treatment with steroids must be pointed out.

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