A Multidisciplinary Approach to Evaluate the Presence of Hepatic and Cardiac Abnormalities in Patients with Post-Acute COVID-19 Syndrome—A Pilot Study

(1) Background: Patients suffering from the novel coronavirus 2019 (COVID-19) disease could experience several extra-pulmonary involvements, including cardiovascular complications and liver injury. This study aims to evaluate the presence of cardiac and liver alterations in patients with post-acute COVID-19 syndrome using transthoracic echocardiography (TTE) and liver elastography (LE). (2) Methods: A total of 97 subjects recovering from COVID-19, attending the hospital’s specialized outpatient clinic for persisting symptoms at 3 to 11 weeks after the acute illness, were included in this study. They all had a basal COVID-19 assessment, and subsequently, a clinical evaluation, laboratory tests, TTE, and LE. (3) Results: considering the presence of pulmonary injury during COVID-19, patients were divided into two groups. Although none of them had altered systolic function, we evidenced pulmonary hypertension, diastolic dysfunction, increased liver stiffness, viscosity, and steatosis in around one-third of the patients, with significantly higher values in subjects with pulmonary injury compared to those without. (4) Conclusion: persisting symptoms characterizing the post-acute COVID-19 syndrome could be explained by residual cardiac and hepatic lesions, which were worse in more severe COVID-19 forms. These patients may be at risk of developing liver fibrosis and cardiac alterations and should be investigated in the first 12 weeks after the onset of the infection.

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Management of Patients with Left Ventricular Assist Device during the COVID-19 Pandemic

Medicina ◽

10.3390/medicina58010116 ◽

2022 ◽

Vol 58 (1) ◽

pp. 116

Author(s):

Gassan Moady ◽

Tuvia Ben Gal ◽

Shaul Atar

Keyword(s):

Left Ventricular Assist Device ◽

Ventricular Assist Device ◽

Cardiovascular Complications ◽

Left Ventricular ◽

The Novel ◽

Assist Device ◽

Ventricular Assist ◽

Management Of Complications ◽

Left Ventricular Assist ◽

Novel Coronavirus

The novel coronavirus disease 2019 (COVID-19) is an infectious disease with multi-organ involvement, including the cardiovascular system. The disease may cause several cardiovascular complications, and may increase morbidity and mortality among patients with background cardiovascular disease. Patients with advanced heart failure are often treated with left ventricular assist device (LVAD), and represent a unique population mandating multi-disciplinary approach. Several aspects of COVID-19 should be taken into account in LVAD implants, including right ventricular involvement, hemodynamic alterations, thromboembolic and haemorrhagic complications, and the psychological effects of social isolation. Patients with VAD and suspected COVID-19 should be transferred to specialized centers for better management of complications. Here, we review the implications of COVID-19 pandemic on LVAD patients with our recommendations for appropriate management.

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Novel coronavirus infection COVID-19: extrapulmonary manifestations

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.08.000767 ◽

2020 ◽

Vol 92 (8) ◽

pp. 4-11 ◽

Cited By ~ 1

Author(s):

I. V. Maev ◽

A. V. Shpektor ◽

E. Yu. Vasilyeva ◽

V. N. Manchurov ◽

D. N. Andreev

Keyword(s):

Arterial Thrombosis ◽

Respiratory Symptoms ◽

Myocardial Damage ◽

Cardiovascular Complications ◽

Clinical Syndrome ◽

The Novel ◽

Wide Range ◽

Serum Transaminases ◽

Coronavirus Infection ◽

Novel Coronavirus

The novel coronavirus infection COVID-19 in most cases manifests with respiratory symptoms and fever, however, some patients may have cardiovascular and gastroenterological manifestations. A feature of the clinical syndrome of COVID-19 is the development of pronounced immunopathological reactions and disorders of hemostasis, leading to the development of a wide range of cardiovascular complications. The course of COVID-19 may be complicated by the development of acute myocardial infarction, venous and arterial thrombosis and thromboembolism in various vascular pools, the development of acute myocardial damage and myocarditis. Among the gastroenterological manifestations, diarrhea, nausea or vomiting, as well as abdominal pain, are most often detected. These symptoms may precede the appearance of respiratory signs of the disease, and in some cases come to the fore in the clinical picture of the disease. In addition, in some patients there are laboratory signs of liver injury (increased serum transaminases). The exact pathogenesis of the above disorders continues to be studied.

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STUDY OF CLINICAL AND PATHOGENETIC EFFECTS OF ANTI-VIRAL DRUG BASED ON FAVIPIRAVIR IN COMORBID PATIENTS WITH COVID-19 AT THE OUTPATIENT STAGE OF TREATMENT

Pharmacy & Pharmacology ◽

10.19163/2307-9266-2021-9-6-454-464 ◽

2021 ◽

Vol 9 (6) ◽

pp. 454-464

Author(s):

L. A. Balykova ◽

O. A. Radaeva ◽

K. Ya. Zaslavskaya ◽

Yu. A. Kostina ◽

M. S. Iskandyarova ◽

...

Keyword(s):

Arterial Hypertension ◽

Cardiovascular Complications ◽

Blood Levels ◽

The Novel ◽

Potential Marker ◽

Status Characteristics ◽

Essential Arterial Hypertension ◽

Prospective Comparative Study ◽

The Republic ◽

Novel Coronavirus

In many ways, arterial hypertension and obesity determine the likelihood of a severe course and lethal outcomes in COVID-19. This fact justifies the expediency of an early use of drugs with a direct antiviral action, the analysis of their efficacy not only in the acute, but also in the postcovid period.The aim of the research was to analyze the outpatient cards and case histories of the COVID-19 patients to study the effect of the early (up to the 5th day after the onset of the first symptoms of the disease) use of the drug based on favipiravir, on the frequency of patients’ hospitalizations with arterial hypertension and obesity, as well as to determine the cytokine status characteristics of this patient category in the postcovid period.Materials and methods. “An open prospective comparative study of the “Areplivir®” (favipiravir) efficacy in the debut of COVID-19 in comorbid patients” was carried out in the Republic of Mordovia (the analysis of the hospitalizations frequency and blood levels of M-CSF, EPO in 218 patients, in terms of the use of the antiviral preparation).Results. According to the results of the analysis, it was found out that, despite the presence of comorbid conditions that increase the risk of developing a severe course of COVID-19, i.e. obesity and essential arterial hypertension, in the group of patients taking favipiravir, the need for hospitalization was twice as low (p < 0.05), in relation to the comparison group. The analysis of the cytokine status revealed that in the postcovid period, in the group that took the drug based on favipiravir at the outpatient stage, the average level of M-CSF was significantly lower (p> 0.05), and EPO was higher (p> 0.05) than in the patients from the group “without antiviral drugs at the outpatient stage”. Indirectly, according to the previously obtained data, that acts as a potential marker for reducing the risk of long-term cardiovascular complications of COVID-19.Conclusion. This study showed that an early prescription of favipiravir contributes to a decrease in the rate of COVID-19 patients’ hospitalization even against the background of concomitant hypertension and obesity, due to a decrease in the likelihood of moderate and severe courses of the disease, and also leads to an earlier objective and subjective recovery. The results demonstrated a high potential benefit of an early favipiravir use in the novel coronavirus infection and in the prevention of postcovid complications.

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The Characteristics, Manifestations and Cardiopulmonary Imaging (CT/MRI) of COVID-19 in SARS-CoV-2 Infection

Journal of Interdisciplinary Medicine ◽

10.2478/jim-2020-0035 ◽

2021 ◽

Vol 6 (2) ◽

pp. 48-52

Author(s):

Abigaela Rus ◽

Nora Rat ◽

Monica Chitu ◽

Imre Benedek

Keyword(s):

Cardiovascular Complications ◽

Public Health Emergency ◽

World Health ◽

Imaging Features ◽

The Novel ◽

The World ◽

Novel Coronavirus ◽

Health Organization ◽

Cardiac Manifestations ◽

Expert Recommendations

Abstract The World Health Organization (WHO) declared the transmission of SARS-CoV-2 a Public Health Emergency of International Concern. The novel coronavirus has diverse manifestations, usually similar to a common cold or influenza. The majority of patients with coronavirus disease have typical imaging features. The typical CT characteristics of patients with COVID-19 pneumonia are ground-glass opacities and consolidative lesions with a peripheral and posterior distribution. Noninvasive imaging methods are precise and rapid means of diagnosing pneumonia and cardiovascular complications caused by COVID-19 infection. Therefore, it is important for clinicians to understand the implications of this pandemic and to be familiar with the different imaging aspects of the novel coronavirus disease. This review focuses on the most commonly reported imaging findings of COVID-19 infection in different patients from different countries, the expert recommendations, and the cardiac manifestations of SARS-CoV-2 infection.

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Targeting Endolysosomal Two-Pore Channels to Treat Cardiovascular Disorders in the Novel COronaVIrus Disease 2019

Frontiers in Physiology ◽

10.3389/fphys.2021.629119 ◽

2021 ◽

Vol 12 ◽

Author(s):

Francesco Moccia ◽

Sharon Negri ◽

Pawan Faris ◽

Angelica Perna ◽

Antonio De Luca ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Cardiovascular System ◽

Ebola Virus ◽

Cardiovascular Complications ◽

Host Cells ◽

Cardiovascular Disorders ◽

The Novel ◽

Life Threatening ◽

Novel Coronavirus

Emerging evidence hints in favor of a life-threatening link between severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and the cardiovascular system. SARS-CoV-2 may result in dramatic cardiovascular complications, whereas the severity of COronaVIrus Disease 2019 (COVID-19) and the incidence of fatalities tend to increase in patients with pre-existing cardiovascular complications. SARS-CoV-2 is internalized into the host cells by endocytosis and may then escape the endolysosomal system via endosomes. Two-pore channels drive endolysosomal trafficking through the release of endolysosomal Ca2+. Recent evidence suggested that the pharmacological inhibition of TPCs prevents Ebola virus and Middle East Respiratory Syndrome COronaVirus (MERS-CoV) entry into host cells. In this perspective, we briefly summarize the biophysical and pharmacological features of TPCs, illustrate their emerging role in the cardiovascular system, and finally present them as a reliable target to treat cardiovascular complications in COVID-19 patients.

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Extensive Exploration of Ayurvedic Herbs to Prioritize Anti-Viral Drugs Alike Phytochemicals Against SARS-CoV-2 Using Network Pharmacology

10.26434/chemrxiv.13385480 ◽

2020 ◽

Author(s):

Neha Choudhary ◽

Vikram Singh

Keyword(s):

Cardiovascular Complications ◽

Network Pharmacology ◽

The Novel ◽

Protein Targets ◽

Thlaspi Arvense ◽

Ziziphus Jujuba ◽

Regulate Protein ◽

Novel Coronavirus ◽

High Level ◽

Promising Source

<div>The novel coronavirus disease (COVID-19), which emerged in Wuhan, China, is continuously spreading worldwide, creating a huge burden on public health and economy. Currently, no specific vaccine or drug exists against SARS-CoV-2 virus, the causative agent of COVID-19. Ayurveda, the oldest healing-schema of Traditional Indian Medicinal (TIM) system, is considered as a promising CAM therapy to combat various diseases and disorders. To explore the regulatory mechanisms of 7,258 Ayurvedic herbs (AHs) against SARS-CoV-2, in this study, multi-targeting and synergistic actions of the constituent 34,472 phytochemicals (APCs) are investigated using a comprehensive approach comprising of network-pharmacology and molecular docking. By evaluating 292 APCs having high-level of similarity with anti-viral drugs in DrugBank for their binding affinity against 24 SARS-CoV-2 proteins, we develop and analyze a high confidence “Bi-regulatory network” of 115 APCs having ability to regulate protein targets in both virus and its host human-system. Immunomodulatory prospects of the antiviral drugs alike potentially effective phytochemicals (PEPs) are presented as a special case study, highlighting the importance of 6 AHs (Zea mays, Cucurbita maxima, Pisum sativum, Thlaspi arvense, Calophyllum inophyllum, Ziziphus jujuba) in eliciting the antiviral immunity at initial stages of infection. The mechanistic actions of PEPs against cardiovascular complications, diabetes mellitus and hypertension are also investigated to address the regulatory potential of Ayurvedic herbs in dealing with COVID-19 associated comorbidities. The study further reports 12 PEPs as promising source of COVID-19 comorbidity regulators.</div>

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COVID-19 and cardiovascular disease: a review of current knowledge

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2020-0052 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Aastha Pal ◽

Ashok Kumar Ahirwar ◽

Apurva Sakarde ◽

Priyanka Asia ◽

Niranjan Gopal ◽

...

Keyword(s):

Cardiovascular Disease ◽

Current Knowledge ◽

Cardiovascular Complications ◽

Cardiovascular Complication ◽

The Novel ◽

Age Group ◽

The World ◽

Deadly Disease ◽

Novel Coronavirus ◽

High Level

Abstract The uncontrolled spread of the COVID-19 pandemic which originated in China created a global turmoil. While the world is still busy figuring out a cure for the deadly disease, scientists worked out on many theories and conducted several studies to establish a relationship between the infection and other known diseases. Cardiovascular diseases (CVD) are one of the major complications of this infection after the respiratory manifestations. Individuals with cardiovascular complication are said to be more susceptible to acquiring the infection because the novel coronavirus uses the ACE2 receptor for its entry inside the cell and there is a high level of ACE2 expression in individuals with cardiovascular complications because of the enzyme’s anti-hypertrophic, anti-fibrotic and anti-hypertensive effects on the heart. Individuals who belong to the older age group are also more susceptible. Knowing the above information, it might seem that using ACE2 inhibitors would help to slow or prevent the entry of the novel coronavirus but it would also at the same time prove to have deleterious effects on the cardiovascular system as the protective functions of ACE2 would be lost. While the search for a cure still continues it has been stated many a times that the conditions might worsen with time and the only way to keep ourselves and our family safe would be to follow the appropriate social distancing methods and get a COVID test if we experience any of the major symptoms.

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Extensive Exploration of Ayurvedic Herbs to Prioritize Anti-Viral Drugs Alike Phytochemicals Against SARS-CoV-2 Using Network Pharmacology

10.26434/chemrxiv.13385480.v1 ◽

2020 ◽

Author(s):

Neha Choudhary ◽

Vikram Singh

Keyword(s):

Cardiovascular Complications ◽

Network Pharmacology ◽

The Novel ◽

Protein Targets ◽

Thlaspi Arvense ◽

Ziziphus Jujuba ◽

Regulate Protein ◽

Novel Coronavirus ◽

High Level ◽

Promising Source

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Approach to Acute Cardiovascular Complications in COVID-19 Infection

Circulation Heart Failure ◽

10.1161/circheartfailure.120.007220 ◽

2020 ◽

Vol 13 (7) ◽

Cited By ~ 11

Author(s):

Lauren S. Ranard ◽

Justin A. Fried ◽

Marwah Abdalla ◽

D. Edmund Anstey ◽

Raymond C. Givens ◽

...

Keyword(s):

Mechanical Circulatory Support ◽

Myocardial Injury ◽

Cardiovascular Complications ◽

Circulatory Support ◽

Cardiac Complications ◽

Team Approach ◽

The Novel ◽

Global Pandemic ◽

Novel Coronavirus ◽

Acute Mechanical Circulatory Support

The novel coronavirus disease 2019, otherwise known as COVID-19, is a global pandemic with primary respiratory manifestations in those who are symptomatic. It has spread to >187 countries with a rapidly growing number of affected patients. Underlying cardiovascular disease is associated with more severe manifestations of COVID-19 and higher rates of mortality. COVID-19 can have both primary (arrhythmias, myocardial infarction, and myocarditis) and secondary (myocardial injury/biomarker elevation and heart failure) cardiac involvement. In severe cases, profound circulatory failure can result. This review discusses the presentation and management of patients with severe cardiac complications of COVID-19 disease, with an emphasis on a Heart-Lung team approach in patient management. Furthermore, it focuses on the use of and indications for acute mechanical circulatory support in cardiogenic and/or mixed shock.

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Liver Elastography in Healthy Children Using Three Different Systems – How Many Measurements Are Necessary?

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1283-5906 ◽

2020 ◽

Author(s):

Anders Batman Mjelle ◽

Anesa Mulabecirovic ◽

Roald Flesland Havre ◽

Edda Jonina Olafsdottir ◽

Odd Helge Gilja ◽

...

Keyword(s):

Shear Wave ◽

Transient Elastography ◽

Intraclass Correlation ◽

Age Groups ◽

Liver Stiffness ◽

Shear Wave Elastography ◽

Healthy Children ◽

Significant Difference ◽

Pediatric Liver Disease ◽

Liver Elastography

Abstract Purpose Liver elastography is increasingly being applied in screening for and follow-up of pediatric liver disease, and has been shown to correlate well with fibrosis staging through liver biopsy. Because time is of the essence when examining children, we wanted to evaluate if a reliable result can be achieved with fewer acquisitions. Materials and Methods 243 healthy children aged 4–17 years were examined after three hours of fasting. Participants were divided into four age groups: 4–7 years; 8–11 years; 12–14 years and 15–17 years. Both two-dimensional shear wave elastography (2D-SWE; GE Logiq E9) and point shear wave elastography (pSWE; Samsung RS80A with Prestige) were performed in all participants, while transient elastography (TE, Fibroscan) was performed in a subset of 87 children aged 8–17 years. Median liver stiffness measurement (LSM) values of 3, 4, 5, 6, 7, and 8 acquisitions were compared with the median value of 10 acquisitions (reference standard). Comparison was performed for all participants together as well as within every specific age group. We investigated both the intraclass correlation coefficient (ICC) with absolute agreement and all outliers more than 10 %, 20 % or ≥ 0.5 or 1.0 kPa from the median of 10 acquisitions. Results For all three systems there was no significant difference between three and ten acquisitions, with ICCs ≥ 0.97. All systems needed 4 acquisitions to achieve no LSM deviating ≥ 1.0 kPa of a median of ten. To achieve no LSM deviating ≥ 20 % of a median of ten acquisitions, pSWE and TE needed 4 acquisitions, while 2D-SWE required 6 acquisitions. Conclusion Our results contradict recommendations of 10 acquisitions for pSWE and TE and only 3 for 2D-SWE.

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