Characteristics and outcomes of acute COVID-19 infection in paediatric and young adult patients with underlying cardiac disease

Abstract Objective To describe outcomes of acute coronavirus disease 2019 in paediatric and young adult patients with underlying cardiac disease and evaluate the association between cardiac risk factors and hospitalisation. Study design We conducted a retrospective single-institution review of patients with known cardiac disease and positive severe acute respiratory syndrome coronavirus 2 RT-PCR from 1 March, 2020 to 30 November, 2020. Extracardiac comorbidities and cardiac risk factors were compared between those admitted for coronavirus disease 2019 illness and the rest of the cohort using univariate analysis. Results Forty-two patients with a mean age of 7.7 ± 6.7 years were identified. Six were 18 years of age or more with the oldest being 22 years of age. Seventy-six percent were Hispanic. The most common cardiac diagnoses were repaired cyanotic (n = 7, 16.6%) and palliated single ventricle (n = 7, 16.6%) congenital heart disease. Fourteen patients (33.3%) had underlying syndromes or chromosomal anomalies, nine (21%) had chronic pulmonary disease and eight (19%) were immunosuppressed. Nineteen patients (47.6%) reported no symptoms. Sixteen (38.1%) reported only mild symptoms. Six patients (14.3%) were admitted to the hospital for acute coronavirus disease 2019 illness. Noncardiac comorbidities were associated with an increased risk of hospitalisation (p = 0.02), particularly chronic pulmonary disease (p = 0.01) and baseline supplemental oxygen requirement (p = 0.007). None of the single ventricle patients who tested positive required admission. Conclusions Hospitalisations for coronavirus disease 2019 were rare among children and young adults with underlying cardiac disease. Extracardiac comorbidities like pulmonary disease were associated with increased risk of hospitalisation while cardiac risk factors were not.

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Self-Reported Cardiac Risk Factors in Emergency Department Nurses and Paramedics

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00025036 ◽

2000 ◽

Vol 15 (2) ◽

pp. 14-17 ◽

Cited By ~ 12

Author(s):

Tyler W. Barrett ◽

Valerie C. Norton ◽

Matthew Busam ◽

Julie Boyd ◽

David J. Maron ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Emergency Department ◽

High Risk ◽

Cardiac Disease ◽

Cardiac Risk ◽

Smoking History ◽

Cardiac Risk Factors ◽

History Of ◽

Very High

AbstractStudy Objective:Our objective was to assess the prevalence of cardiac risk factors in a sample of urban paramedics and emergency department (ED) nurses.Methods:We asked 175 paramedics and ED nurses working at a busy, urban ED to complete a cardiovascular risk assessment. The survey asked subjects to report smoking history, diet, exercise habits, weight, stress levels, medication use, history of hypertension or cardiac disease, family history of cardiovascular disease (CVD), and cholesterol level (if known)Results:129 of 175 surveys were returned (74% return rate) by 85 paramedics and 44 nurses. The percentages of paramedics and nurses at high or very high risk for cardiac disease were 48% and 41%, respectively. Forty-one percent of female respondents and 46% of male respondents were at high or very high risk. Cigarette smoking was reported in 19% of the paramedics and 14% of the nurses. The percentages of paramedics and nurses who reported hypertension were 13% and 11%, respectively. High cholesterol was reported in 31% of paramedics and 16% of nurses.Conclusions:Forty-eight percent of paramedics and 41% of ED nurses at this center are at high or very high risk for cardiovascular disease, by self-report. Efforts should be made to better educate and intervene in this population of health-care providers in order to reduce their cardiac risk.

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Risk factors of sudden death in young adult patients with myelomeningocele

Journal of Neurosurgery Pediatrics ◽

10.3171/2011.11.peds11269 ◽

2012 ◽

Vol 9 (2) ◽

pp. 149-155 ◽

Cited By ~ 12

Author(s):

Sarah C. Jernigan ◽

Jay G. Berry ◽

Dionne A. Graham ◽

Stuart B. Bauer ◽

Lawrence I. Karlin ◽

...

Keyword(s):

Risk Factors ◽

Sleep Apnea ◽

Young Adult ◽

Sudden Death ◽

Adult Patients ◽

Csf Shunt ◽

Study Cohort ◽

Fisher Exact Test ◽

Adult Women ◽

Increased Risk

Object Although survival for patients with myelomeningocele has dramatically improved in recent decades, the occasional occurrence of sudden, unexplained death in young adult patients with myelomeningocele has been noted by the authors. This study was undertaken to determine risk factors for sudden death in this population. Methods The authors performed a retrospective chart review of patients born between 1978 and 1990 who received care at Children's Hospital Boston. The relationship between sudden death and patient demographics, presence of CSF shunt and history of shunt revisions, midbrain length as a marker for severity of hindbrain malformation, seizures, pulmonary and ventilatory dysfunction, body mass index, scoliosis, renal dysfunction, and cardiac disease was evaluated using the t-test, Fisher exact test, and logistic regression analysis. Results The age range for 106 patients in the study cohort was 19–30 years, with 58 (54.7%) women and 48 (45.3%) men. Six patients, all of whom were young women, experienced sudden death. In multivariate analysis, female sex, sleep apnea, and midbrain elongation ≥ 15 mm on MR imaging remained significantly associated with a higher risk of sudden death. These risk factors were cumulative, and female patients with sleep apnea and midbrain length ≥ 15 mm had the greatest risk (adjusted risk ratio 24.0, 95% CI 7.3–79.0; p < 0.05). No other comorbidities were found to significantly increase the risk of sudden death. Conclusions Young adult women with myelomeningocele are at significantly increased risk of sudden death in the setting of midbrain elongation and sleep apnea. Further investigation is needed to determine the benefit of routine screening to identify at-risk patients for closer cardiopulmonary monitoring and treatment.

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Cardiovascular disease in systemic lupus erythematosus

Rheumatology and Immunology Research ◽

10.2478/rir-2021-0022 ◽

2021 ◽

Vol 2 (3) ◽

pp. 157-172

Author(s):

Maureen McMahon ◽

Richard Seto ◽

Brian J. Skaggs

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Cardiovascular Disease ◽

Lupus Erythematosus ◽

Cardiovascular Events ◽

Subclinical Atherosclerosis ◽

Cardiac Risk ◽

Systemic Lupus ◽

Cardiac Risk Factors ◽

Increased Risk

Abstract There is a well-known increased risk for cardiovascular disease that contributes to morbidity and mortality in systemic lupus erythematosus (SLE). Major adverse cardiovascular events and subclinical atherosclerosis are both increased in this patient population. While traditional cardiac risk factors do contribute to the increased risk that is seen, lupus disease-related factors, medications, and genetic factors also impact the overall risk. SLE-specific inflammation, including oxidized lipids, cytokines, and altered immune cell subtypes all are likely to play a role in the pathogenesis of atherosclerotic plaques. Research is ongoing to identify biomarkers that can help clinicians to predict which SLE patients are at the greatest risk for cardiovascular disease (CVD). While SLE-specific treatment regimens for the prevention of cardiovascular events have not been identified, current strategies include minimization of traditional cardiac risk factors and lowering of overall lupus disease activity.

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Abstract 17015: Understanding Sex Differences With Cardiac Risk Factors in the Young Adult Population

Circulation ◽

10.1161/circ.142.suppl_3.17015 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Erica Davis ◽

Kathryn A Wood ◽

Jeannie Cimiotti ◽

Melinda Higgins ◽

Rebecca Gary ◽

...

Keyword(s):

Risk Factors ◽

Young Adults ◽

Sex Differences ◽

Young Adult ◽

Cardiac Risk ◽

High Cholesterol ◽

Men And Women ◽

Heavy Alcohol ◽

Cardiac Risk Factors ◽

Cad Risk

Introduction: The prevalence of coronary artery disease (CAD) is increasing in young adults (YA) (age<40 years), and greater understanding of their cardiac risk factors is essential to create effective preventive strategies. Given the sex differences for CAD observed in older adults, understanding if sex differences exist for CAD risk factors in YAs is important. Hypothesis: There will be several risk factors associated with CAD in YAs that will differ between men and women. Methods: In this secondary analysis, 125,017 YAs between the ages of 18-44 were evaluated for health conditions and behaviors considered to be risk factors for CAD. The 2017 Behavior Risk Factor Surveillance System database from the Center for Disease Control was utilized. Frequency procedures, chi-square testing, and logistic regression modeling with odds ratios were analyzed using (SAS) 9.4 software. Results: Greater percentages of men (65.5%) than women (56.7%) were found to be overweight (BMI 25-30) or obese (BMI =>30) (p<.0001). Men reported higher rates of hypertension with 18.6% as compared to women with hypertension at 11.5% (p<.0001). High cholesterol and heavy alcohol consumption were characteristic of men in this sample with percentages at 17.8% for high cholesterol and 7.5% for heavy alcohol use. YAs between the ages of 40-44 were over 2 times as likely to develop CAD than those aged 18-24, odds ratio (OR) 2.4. YAs between the ages of 25-29 were least likely to develop CAD compared to 18-24 with the lowest OR 1.3. Overall, significant risk factors for developing CAD in this population were HTN (OR 4.1), age 35-44 (OR >2.2), high cholesterol (OR 2.2), smoking (OR 1.9), and prediabetes (OR 1.7). Physical activity (OR 0.6) and healthcare coverage (OR 0.7) were protective factors against CAD. There were 276 young adults in all who were diagnosed with CAD in this analysis. Conclusions: Greater efforts are needed to reduce the number of risk factors in YAs and prevent the development of CAD. There were significant gender differences noted in CAD risk factors within the YA population. Targeted interventions should include counseling as outlined in the American Heart Association Life’s Simple 7 Campaign in an effort to improve cardiovascular health in young adult men and women.

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Prevention: From the cradle to the grave and beyond

European Journal of Preventive Cardiology ◽

10.1177/2047487318821772 ◽

2019 ◽

Vol 26 (5) ◽

pp. 507-511 ◽

Cited By ~ 4

Author(s):

Paul Dendale ◽

Martijn Scherrenberg ◽

Oksana Sivakova ◽

Ines Frederix

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Coronary Heart Disease ◽

Heart Disease ◽

Risk Reduction ◽

Cardiac Disease ◽

Cardiac Risk ◽

Prevention Strategies ◽

Cardiac Risk Factors ◽

Development Risk

Present cardiac prevention mainly focuses on risk reduction later in life, and focuses also mainly on reducing risk factors for coronary heart disease. However, multiple studies have gathered evidence that the development risk of cardiovascular disease starts early in life and that even preconceptional influences play an important role in lifetime risk. Therefore, the importance of well-timed prevention strategies to reduce cardiovascular disease is well established. In this article, we discuss different risk factors for future cardiac disease, and how we can respond to lesser known cardiac risk factors in the different stages of life.

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NON-INVASIVE MONITORING OF BLOOD GAS PARAMETERS IN PEDIATRIC AND YOUNG ADULT PATIENTS WITH CHRONIC PULMONARY DISEASE

Pediatric Research ◽

10.1203/00006450-198404001-01874 ◽

1984 ◽

Vol 18 ◽

pp. 405A-405A

Author(s):

Marilyn E Alley ◽

Alexander Spock

Keyword(s):

Young Adult ◽

Pulmonary Disease ◽

Adult Patients ◽

Invasive Monitoring ◽

Chronic Pulmonary Disease ◽

Blood Gas ◽

Non Invasive ◽

Blood Gas Parameters

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“Get Firefighters Moving”: Marketing a Physical Fitness Intervention to Reduce Sudden Cardiac Death Risk in Full-Time Firefighters

Social Marketing Quarterly ◽

10.1080/15245000903131384 ◽

2009 ◽

Vol 15 (3) ◽

pp. 85-99 ◽

Cited By ~ 5

Author(s):

John A. Staley

Keyword(s):

Risk Factors ◽

Sudden Cardiac Death ◽

Physical Fitness ◽

Social Marketing ◽

Cardiac Death ◽

Team Sports ◽

Cardiac Risk ◽

Full Time ◽

Cardiac Risk Factors ◽

Increased Risk

Firefighters as an occupational group are at increased risk for a cardiac-related injury, with the largest proportion (44%) of firefighter on-duty mortality due to sudden cardiac death. As poor physical fitness behaviors are a contributing factor to this risk, a social marketing approach was used to design and market a competitive team-sports intervention to improve physical fitness and reduce cardiac risk factors in a group of full-time firefighters. This article describes how social marketing principles were used in the design and implementation of the “Get Firefighters Moving” physical fitness intervention. This includes strategic development of the marketing plan, with discussion of audience segmentation and the marketing mix used to implement the intervention. Preliminary findings are also presented, as they suggest improvement in cardiac risk factors including blood pressure, cardiovascular class, flexibility, and percent body fat.

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Regional Cervical Plexus Blockage for Carotid Endarterectomy in Patients with Cardiovascular Risk Factors

The Heart Surgery Forum ◽

10.1532/hsf.1385 ◽

2015 ◽

Vol 18 (4) ◽

pp. 140 ◽

Cited By ~ 2

Author(s):

Mehmet Taşar ◽

Mehmet Kalender ◽

Okay Güven Karaca ◽

Ata Niyazi Ecevit ◽

Salih Salihi ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Carotid Endarterectomy ◽

Regional Anesthesia ◽

Carotid Artery Disease ◽

Risk Groups ◽

Cardiac Risk ◽

Cervical Plexus ◽

Cardiac Risk Factors ◽

Significant Difference

Background: Carotid artery disease is not rare in cardiac patients. Patients with cardiac risk factors and carotid stenosis are prone to neurological and cardiovascular complications. With cardiac risk factors, carotid endarterectomy operation becomes challenging. Regional anesthesia is an alternative option, so we aimed to investigate the operative results of carotid endarterectomy operations under regional anesthesia in patients with cardiac risk factors. Methods: We aimed to analyze and compare outcomes of carotid endarterectomy under regional anesthesia with cardiovascular risk groups retrospectively. Between 2006 and 2014, we applied 129 carotid endarterectomy ± patch plasty to 126 patients under combined cervical plexus block anesthesia. Patients were divided into three groups (high, moderate, low) according to their cardiovascular risks. Neurological and cardiovascular events after carotid endarterectomy were compared. Results: Cerebrovascular accident was seen in 7 patients (5.55%) but there was no significant difference between groups (P > .05). Mortality rate was 4.76% (n = 6); it was higher in the high risk group and was not statistically significant (P = .180). Four patients required revision for bleeding (3.17%). We did not observe any postoperative surgical infection. Conclusion: Carotid endarterectomy can be safely performed with regional cervical anesthesia in all cardiovascular risk groups. Comprehensive studies comparing general anesthesia and regional anesthesia are needed.

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