Case Report: Stemi With Covid-19

BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV‑2) causing coronavirus disease 2019 (COVID-19) has reached pandemic levels by March 2020. Patients with cardiovascular disease, particularly with cardiac injury represent a vulnerable population and increased risk of mortality and morbidity. There is still no guidelines for management of cardiovascular disease during the COVID-19 pandemic. CASE ILLUSTRATION An unconscious 52-year-old male brought to ER with complaints of abdominal discomfort and nausea. The patient had a cardiac arrest in ER and ROSC was obtained. The patient was intubated ECG showed anterior STEMI and primary PCI was performed. The endotracheal tube was changed due to blockage of excessive and thick slime. Tracheostomy was performed. Bronchoscopy was performed and found tracheal mucosal edema, hyperemic and easily bleed; mucous plug and blood clots in the tip of tracheostomy cannula. Thoracic CT-Scan showed ground-glass appearance and fibrosis of the 6th thoracic dextra segment. PCR SARS-CoV-2 showed reactive. The patient was discharged from our hospital after three weeks with clinically stable and referred to COVID-19 center hospital nearby his home for another two weeks. After PCR SARS CoV-2 was performed twice showed negative results, the patient was discharged. CONCLUSION SARS-CoV‑2 infection may lead to acute myocardial injury through viral systemic inflammation, although specific mechanism remained uncertain. A thick mucus plaque and stool cell may be a specific clinical features in COVID-19 patients. Tracheostomy has a continuing role in managing weaning from extended periods of mechanical ventilation during the COVID-19 pandemic.

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Particulate Matter as a Driven Factor Covid19 Transmission at Outdoor: Review

JURNAL KESEHATAN LINGKUNGAN ◽

10.20473/jkl.v12i3.2020.225-234 ◽

2020 ◽

Vol 12 (3) ◽

pp. 225

Author(s):

Hanien Firmansyah ◽

Azmi Nur Fadlillah ◽

Aditya Sukma Pawitra

Keyword(s):

Particulate Matter ◽

Physiological Condition ◽

The Body ◽

Mortality And Morbidity ◽

Virus Rna ◽

Risk Of Mortality ◽

Increased Risk ◽

Mucous Membranes ◽

The Face ◽

Droplet Transmission

Introduction: Coronavirus Disease 2019 (Covid19) is an infectious disease caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome-related Coronavirus) which attacks the respiratory tract, with mild to severe symptoms. The virus can infect the body through mucous membranes on the face with droplet transmission. Air pollution is thought to contribute to Covid19 events which can worsen the situation of people with Covid19. The aims of this literature review is to analyze Particulate Matter (PM) as environmental factors that contributes Covid19, so it is expected to be a study in terms of prevention and prevention in the field of environmental health. Discussion: PM is thought to have contributed to an increased risk of mortality and morbidity in Covid19 events. PM which has toxic properties can enter the lungs and affect the physiological condition of the lung organs. The findings regarding the presence of SARS-CoV-2 virus RNA strengthen the suspicion that PM plays a role in Covid19 transmission. Several studies have found that there is a relationship between PM and Covid19. PM2.5 which is smaller than PM10 has a higher ability to be a risk factor for ballast in Covid19. Conclusion: The results of this synthesis state that PM can be one of the driving factors of Covid19 transmission in air.

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Abstract P323: Cardiac Rehabilitation is Associated With Decreased Mortality in HIV Patients With Cardiovascular Disease

Circulation ◽

10.1161/circ.135.suppl_1.p323 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Justin M Bachmann ◽

Suman Kundu ◽

Kaku So-Armah ◽

Amy Justice ◽

Jason Sico ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cardiac Rehabilitation ◽

Artery Bypass ◽

Coronary Intervention ◽

Hiv Status ◽

Hiv Patients ◽

Risk Of Mortality ◽

Increased Risk ◽

Cox Proportional Hazard Models ◽

One Year

Background: Human immunodeficiency virus (HIV+) patients are at high risk for cardiovascular disease (CVD). While cardiac rehabilitation (CR) reduces mortality in uninfected (HIV-) patients with CVD, there are no specific data on CR use in CVD patients with HIV. Methods: We analyzed data on 7650 veterans (28.4% HIV+) eligible for CR from the Veterans Aging Cohort Study, an observational cohort of HIV+ and HIV- veterans. CR eligibility was defined as a hospitalization for acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, or cardiac valve surgery from 2003-2012, identified using ICD9 and CPT codes. CR use was ascertained from VA and non-VA facilities within one year of discharge from the index CVD hospitalization using CPT codes. We evaluated the association between CR and mortality after adjusting for age, eligibility diagnosis, race, sex, and comorbidities using Cox proportional hazard models. Results: CR use was low in HIV+ and HIV- veterans (9.1% vs. 9.6%, respectively, p=0.06). Among the 7650 CR eligible veterans, there were 2211 deaths over 25,715 person-years of follow-up. Mortality rates were higher among those who did not receive CR, regardless of HIV status (Figure). In adjusted models stratified by HIV status, CR was associated with a significant reduction in mortality for HIV+ (hazard ratio [HR] 0.39, 95% confidence interval [CI] 0.26-0.59) and HIV- veterans (HR 0.52, 95% CI 0.42-0.65). Among those receiving CR, HIV was not associated with an increased risk of mortality (Figure) even after adjusting for confounders (HR 1.01, 95% CI 0.63-1.61). Conclusions: CR utilization in both HIV+ and HIV- veterans is low. Participation in CR programs is associated with a significant reduction in mortality, regardless of HIV status. When CR is utilized, however, the risk of mortality is the same for HIV+ and HIV- veterans. CR may be particularly important for reducing mortality in HIV+ patients with CVD.

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Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis

Intervirology ◽

10.1159/000512592 ◽

2020 ◽

pp. 1-12

Author(s):

Mohitosh Biswas ◽

Shawonur Rahaman ◽

Tapash Kumar Biswas ◽

Zahirul Haque ◽

Baharudin Ibrahim

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Meta Analysis ◽

Statistical Significance ◽

Considerable Proportion ◽

Relative Risks ◽

Risk Of Mortality ◽

Increased Risk ◽

Male Patients ◽

Reduce Risk

Introduction: Although severe acute respiratory syndrome coronavirus-2 infection is causing mortality in considerable proportion of coronavirus disease-2019 (COVID-19) patients, however, evidence for the association of sex, age, and comorbidities on the risk of mortality is not well-aggregated yet. It was aimed to assess the association of sex, age, and comorbidities with mortality in COVID-2019 patients. Methods: Literatures were searched using different keywords in various databases. Relative risks (RRs) were calculated by RevMan software where statistical significance was set as p < 0.05. Results: COVID-19 male patients were associated with significantly increased risk of mortality compared to females (RR 1.86: 95% confidence interval [CI] 1.67–2.07; p < 0.00001). Patients with age ≥50 years were associated with 15.4-folds significantly increased risk of mortality compared to patients with age <50 years (RR 15.44: 95% CI 13.02–18.31; p < 0.00001). Comorbidities were also associated with significantly increased risk of mortality; kidney disease (RR 4.90: 95% CI 3.04–7.88; p < 0.00001), cereborovascular disease (RR 4.78; 95% CI 3.39–6.76; p < 0.00001), cardiovascular disease (RR 3.05: 95% CI 2.20–4.25; p < 0.00001), respiratory disease (RR 2.74: 95% CI 2.04–3.67; p < 0.00001), diabetes (RR 1.97: 95% CI 1.48–2.64; p < 0.00001), hypertension (RR 1.95: 95% CI 1.58–2.40; p < 0.00001), and cancer (RR 1.89; 95% CI 1.25–2.84; p = 0.002) but not liver disease (RR 1.64: 95% CI 0.82–3.28; p= 0.16). Conclusion: Implementation of adequate protection and interventions for COVID-19 patients in general and in particular male patients with age ≥50 years having comorbidities may significantly reduce risk of mortality associated with COVID-19.

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The association between atrial fibrillation and in-hospital outcomes in chronic kidney disease patients with acute coronary syndrome: findings from the improving care for cardiovascular disease in China-acute coronary syndrome (CCC-ACS) project

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02125-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lijiao Yang ◽

Nan Ye ◽

Guoqin Wang ◽

Weijing Bian ◽

Fengbo Xu ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Acute Coronary Syndrome ◽

Kidney Disease ◽

Hospital Mortality ◽

Major Adverse Cardiovascular Events ◽

Coronary Syndrome ◽

Risk Of Mortality ◽

Increased Risk

Abstract Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in patients with chronic kidney disease (CKD) and acute coronary syndrome (ACS). This study aimed to explore the frequency and impact of AF on clinical outcomes in CKD patients with ACS. Methods CKD inpatients with ACS between November 2014 and December 2018 were included based on the improving care for cardiovascular disease in China-ACS (CCC-ACS) project. Included patients were divided into an AF group and a non-AF group according to the discharge diagnosis. Multivariable logistic regression was used to adjust for potential confounders. Results A total of 16,533 CKD patients with ACS were included. A total of 1418 (8.6%) patients had clinically recognized AF during hospitalization, 654 of whom had an eGFR of 45 to < 60 ml/min/1.73 m2, and 764 had an estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73 m2. Compared with the non-AF group, the AF group had a higher risk of in-hospital mortality [OR 1.250; 95% CI (1.001–1.560), P = 0.049] and major adverse cardiovascular events (MACEs) [OR 1.361; 95% CI (1.197–1.547), P < 0.001]. We also found that compared with patients with eGFR 45 to < 60 ml/min/1.73 m2, patients with eGFR < 45 ml/min/1.73 m2 had a 1.512-fold increased risk of mortality and a 1.435-fold increased risk of MACEs. Conclusions AF was a risk factor affecting the short-term prognosis of ACS patients in the CKD population. Furthermore, the lower the eGFR, the higher the risk of in-hospital mortality and MACEs in CKD patients with ACS. Trial registry: Clinicaltrial.gov, NCT02306616. Registered 29 November 2014, https://clinicaltrials.gov/ct2/show/NCT02306616?term=NCT02306616&draw=2&rank=1

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Longitudinal change in blood pressure is associated with cardiovascular disease mortality in a Chinese cohort

Heart ◽

10.1136/heartjnl-2017-312850 ◽

2018 ◽

Vol 104 (21) ◽

pp. 1764-1771 ◽

Cited By ~ 10

Author(s):

Jin-Hu Fan ◽

Jian-Bing Wang ◽

Shao-Ming Wang ◽

Christian C Abnet ◽

You-Lin Qiao ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

General Population ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Longitudinal Change ◽

Stroke Mortality ◽

Risk Of Mortality ◽

Increased Risk ◽

All Cause Mortality

BackgroundA number of studies have demonstrated a J-shaped curve between blood pressure (BP) and all-cause mortality, but few studies have used longitudinal change in BP to study mortality in the Chinese population.MethodsWe performed a 30-year follow-up study to examine the association between BP (at baseline and longitudinal change) and risk of mortality in the Linxian General Population Trial Cohort. At baseline, a total of 29 584 healthy adults were enrolled in the Linxian General Population Trial in 1985 and followed through to the end of 2014. The final analysis was restricted to 29 439 participants (55% women) after exclusion of outliers. We also examined the potential effects of BP trajectory patterns during the period of 1985–1999 on sequent risk of mortality. Adjusted Cox proportional hazards models were used to estimate HRs and 95% CIs.ResultsCompared with participants with normal BP, patients with prehypertension, stage 1, stage 2 or stage 3 hypertension had an increased risk of all-cause mortality, with HRs of 1.09 (95% CI 1.05 to 1.14), 1.34 (95% CI 1.28 to 1.40), 1.69 (95% CI 1.60 to 1.79) and 2.14 (95% CI 2.01 to 2.28), respectively. Relative to stable BP of normotension, having a rise in BP from normotension to hypertension or from prehypertension to hypertension both conferred an increased risk of total and cardiovascular disease and stroke mortality (total: HRs 1.22 (95% CI 1.12 to 1.34) and 1.36 (95% CI 1.23 to 1.51); cardiovascular disease: HRs 1.42 (95% CI 1.17 to 1.73) and 1.55 (95% CI 1.24 to 1.93); stroke: HRs 2.29 (95% CI 1.88 to 2.80) and 2.61 (95% CI 2.11 to 3.24), respectively).ConclusionsThese findings emphasise that development of incident hypertension in middle age could increase the risk of total, cardiovascular disease and stroke mortality, and suggest that current BP targets could be revised.Trial registration numberNCT00342654;Post-results.

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Cardiac Dysfunction in Rheumatoid Arthritis: The Role of Inflammation

Cells ◽

10.3390/cells10040881 ◽

2021 ◽

Vol 10 (4) ◽

pp. 881

Author(s):

Jianmin Chen ◽

Lucy V. Norling ◽

Dianne Cooper

Keyword(s):

Rheumatoid Arthritis ◽

Heart Failure ◽

Cardiovascular Disease ◽

Heart Disease ◽

Cardiac Dysfunction ◽

Preserved Ejection Fraction ◽

Risk Of Mortality ◽

Increased Risk ◽

Systemic Inflammatory Disease

Rheumatoid arthritis is a chronic, systemic inflammatory disease that carries an increased risk of mortality due to cardiovascular disease. The link between inflammation and atherosclerotic disease is clear; however, recent evidence suggests that inflammation may also play a role in the development of nonischemic heart disease in rheumatoid arthritis (RA) patients. We consider here the link between inflammation and cardiovascular disease in the RA community with a focus on heart failure with preserved ejection fraction. The effect of current anti-inflammatory therapeutics, used to treat RA patients, on cardiovascular disease are discussed as well as whether targeting resolution of inflammation might offer an alternative strategy for tempering inflammation and subsequent inflammation-driven comorbidities in RA.

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LONELINESS, MARITAL STATUS, AND COGNITIVE IMPAIRMENT AMONG OLDER AMERICANS

Innovation in Aging ◽

10.1093/geroni/igz038.1387 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S378-S378

Author(s):

Jack Lam ◽

Anthony R Bardo ◽

Takashi Yamashita

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Marital Status ◽

Later Life ◽

Older Americans ◽

Mortality And Morbidity ◽

Never Married ◽

Risk Of Mortality ◽

Increased Risk ◽

Status Data

Abstract Loneliness has been linked to increased risk of mortality and morbidity, and emergent research has identified a negative association between loneliness and cognitive functioning. While the determinants of loneliness are wide in scope, loneliness is closely tied to marital status in later life. At the same time, research has shown that those who are married have lower risk of cognitive impairment. The aim of this study was to determine the association between loneliness and cognitive impairment, and examine whether it is moderated by marital status. Data come from 9 waves of the RAND version of the HRS (1998 - 2014). Consistent with previous research, results from random effects logit models showed that loneliness is associated with greater risk of cognitive impairment [Odds-ratio (OR) = 1.41, p < 0.01]. Additionally, those who are widowed (OR = 1.29, p < 0.01), separated/divorced (OR = 1.33, p < 0.01), or never married (OR = 1.70, p < 0.01) are also more likely to have a cognitive impairment, compared to those who are married. However, the association between loneliness and cognitive function was found to only differ among those who are widowed. Contrary to expectations, widows who report feeling lonely are 29% (p < 0.01) less likely to have a cognitive impairment. In sum, while loneliness and marital status are closely linked with one another, they are both independent determinants of cognitive impairment. The distinct theoretical mechanisms linking loneliness and marital status to cognitive function in later life are discussed.

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Recent Trials of Atrial Fibrillation Therapy

European Journal of Arrhythmia & Electrophysiology ◽

10.17925/ejae.2015.01.01.17 ◽

2015 ◽

Vol 01 (01) ◽

pp. 17

Author(s):

Baktash Morrad ◽

Bulent Gorenek ◽

◽

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

Clinical Practice ◽

Functional Status ◽

Therapeutic Intervention ◽

Healthcare Systems ◽

Mortality And Morbidity ◽

Risk Of Mortality ◽

Increased Risk

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice. It may cause significant symptoms and impair both functional status and quality of life. Without therapeutic intervention, affected patients are at increased risk of mortality and morbidity, so AF places a major burden on healthcare systems. Many trials have been published on AF therapy in recent years. In this editorial, we will briefly discuss recent trials of AF therapies.

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Studi Faktor Risiko Preeklamsi terhadap Kejadian Asfiksia Neonatorum di RSUD dr. Sayidiman Magetan Tahun 2018

Jurnal Ilmiah Kedokteran Wijaya Kusuma ◽

10.30742/jikw.v10i1.1015 ◽

2021 ◽

Vol 10 (1) ◽

pp. 11

Author(s):

Vivian Ade Wilsye Maria Mongdong ◽

Rivan Virlando Suryadinata ◽

Sawitri Boengas ◽

Siti Ariffatus Saroh

Keyword(s):

Pregnant Women ◽

Birth Process ◽

Design Data ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Neonatal Asphyxia ◽

Risk Of Mortality ◽

Increased Risk ◽

Cross Sectional Design ◽

Risk Of Preeclampsia

One of the complications of pregnancy which is quite dangerous is preeclampsia. Increased blood pressure is a major indicator for pregnant women from preeclampsia. Various complications lead to increased risk of mortality and morbidity in the mother and fetus. During the birth process, the fetus that is conceived by a mother with preeclampsia, have a higher risk of developing neonatal asphyxia. This study aims was to determine the risk of preeclampsia on the incidence of neonatal asphyxia in dr. Sayidiman Magetan Hospital in 2018. The method used was observational with a cross sectional design. Data were collected using patient medical records. The results showed there was a difference in the incidence of neonatal asphyxia in preeclampsia and non- preeclampsia pregnant women (p = 0.000). Pregnant women with preeclampsia had a higher risk of giving birth with neonatal asphyxia (OR=3,071). In this study, it can be concluded that the risk of incidence of neonatal asphyxia is 3 times higher in preeclampsia than in non-preeclampsia at dr. Sayidiman Magetan in 2018.

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Impact of Diabetes in Patients Diagnosed With COVID-19

Frontiers in Immunology ◽

10.3389/fimmu.2020.576818 ◽

2020 ◽

Vol 11 ◽

Author(s):

Mohamed Abu-Farha ◽

Fahd Al-Mulla ◽

Thangavel Alphonse Thanaraj ◽

Sina Kavalakatt ◽

Hamad Ali ◽

...

Keyword(s):

Adaptive Immune Response ◽

Low Grade ◽

Mortality And Morbidity ◽

Risk Of Death ◽

Risk Of Mortality ◽

Increased Risk ◽

Treatment Of Diabetes ◽

Low Grade Inflammation ◽

Increased Susceptibility

COVID-19 is a disease caused by the coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2), known as a highly contagious disease, currently affecting more than 200 countries worldwide. The main feature of SARS-CoV-2 that distinguishes it from other viruses is the speed of transmission combined with higher risk of mortality from acute respiratory distress syndrome (ARDS). People with diabetes mellitus (DM), severe obesity, cardiovascular disease, and hypertension are more likely to get infected and are at a higher risk of mortality from COVID-19. Among elderly patients who are at higher risk of death from COVID-19, 26.8% have DM. Although the reasons for this increased risk are yet to be determined, several factors may contribute to type-2 DM patients’ increased susceptibility to infections. A possible factor that may play a role in increasing the risk in people affected by diabetes and/or obesity is the impaired innate and adaptive immune response, characterized by a state of chronic and low-grade inflammation that can lead to abrupt systemic metabolic alteration. SARS patients previously diagnosed with diabetes or hyperglycemia had higher mortality and morbidity rates when compared with patients who were under metabolic control. Similarly, obese individuals are at higher risk of developing complications from SARS-CoV-2. In this review, we will explore the current and evolving insights pertinent to the metabolic impact of coronavirus infections with special attention to the main pathways and mechanisms that are linked to the pathophysiology and treatment of diabetes.

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