The Utility of Handheld Cardiac and Lung Ultrasound in Predicting Outcomes of Hospitalised Patients With COVID-19
Strict isolation precautions limit formal echocardiography use in the setting of COVID-19 infection. Information on the importance of handheld focused ultrasound for cardiac evaluation in these patients is scarce. This study investigated the utility of a handheld echocardiography device in hospitalised patients with COVID-19 in diagnosing cardiac pathologies and predicting the composite end point of in-hospital death, mechanical ventilation, shock, and acute decompensated heart failure.Digital Technology Application for Improved Responses to Health Care Challenges: Lessons Learned From COVID-19
While COVID-19 is still ongoing and associated with more than 5 million deaths, the scope and speed of advances over the past year in terms of scientific discovery, data dissemination, and technology have been staggering. It is not a matter of “if” but “when” we will face the next pandemic, and how we leverage technology and data management effectively to create flexible ecosystems that facilitate collaboration, equitable care, and innovation will determine its severity and scale. The aim of this review is to address emerging challenges that came to light during the pandemic in health care and innovations that enabled us to adapt and continue to care for patients.Myocarditis and Pericarditis After COVID-19 mRNA Vaccination: Practical Considerations for Care Providers
The mRNA vaccines against COVID-19 infection have been effective in reducing the number of symptomatic cases worldwide. With widespread uptake, case series of vaccine-related myocarditis/pericarditis have been reported, particularly in adolescents and young adults. Men tend to be affected with greater frequency, and symptom onset is usually within 1 week after vaccination. Clinical course appears to be mild in most cases. On the basis of the available evidence, we highlight a clinical framework to guide providers on how to assess, investigate, diagnose, and report suspected and confirmed cases.Myocarditis After SARS-CoV-2 Vaccination: A Vaccine-Induced Reaction?
Vaccination plays an important role in the fight against SARS-CoV-2 to minimie the spread of coronavirus disease 2019 (COVID-19) and its life-threatening complications. Myocarditis has been reported as a possible and rare adverse consequence of different vaccines, and its clinical presentation can range from influenza-like symptoms to acute heart failure. We report a case of a 30-year-old man who presented progressive dyspnea and constrictive retrosternal pain after receiving SARS-CoV-2 vaccine.Long COVID-19: A Primer for Cardiovascular Health Professionals, on Behalf of the CCS Rapid Response Team
It is now widely recognized that COVID-19 illness can be associated with significant intermediate and potentially longer-term physical limitations. The term, “long COVID-19” is used to define any patient with persistent symptoms after acute COVID-19 infection (ie, after 4 weeks). It is postulated that cardiac injury might be linked to symptoms that persist after resolution of acute infection, as part of this syndrome. The Canadian Cardiovascular Society Rapid Response Team has generated this document to provide guidance to health care providers on the optimal management of patients with suspected cardiac complications of long COVID-19.Kawasaki Disease Shock Syndrome vs Classical Kawasaki Disease: A Meta-analysis and Comparison With SARS-CoV-2 Multisystem Inflammatory Syndrome
The emergence of increasing reports worldwide of a severe inflammatory process and shock in pediatric patients resembling Kawasaki disease (KD)—and, more specifically, Kawasaki disease shock syndrome (KDSS)—prompted us to explore KDSS in a preamble of a systematic comparison between the 2 conditions.Challenges and Lessons Learned From COVID-19 Trials: Should We Be Doing Clinical Trials Differently?
The COVID-19 crisis led to a flurry of clinical trials activity. The COVID-evidence database shows 2814 COVID-19 randomized trials registered as of February 16, 2021. Most were small (only 18% have a planned sample size > 500) and the rare completed ones have not provided published results promptly (only 283 trial publications as of February 2021). Small randomized trials and observational, nonrandomized analyses have not had a successful track record and have generated misleading expectations. Different large trials on the same intervention have generally been far more efficient in producing timely and consistent evidence.Influenza Vaccination in Patients With Congenital Heart Disease in the Pre-COVID-19 Era: Coverage Rate, Patient Characteristics, and Outcomes
Influenza vaccination is the most commonly recommended immune prevention strategy. However, data on influenza vaccination in patients with congenital heart disease (CHD) are scarce. In this study, our goals were to: (1) measure vaccination coverage rates (VCRs) for influenza in a large cohort of children, adolescents, and adults with CHD; (2) identify patient characteristics as predictors for vaccination; and (3) investigate the effect of influenza vaccination on hospitalization.COVID-19 Vaccination Prioritization on the Basis of Cardiovascular Risk Factors and Number Needed to Vaccinate to Prevent Death
The supply limitations of COVID-19 vaccines have led to the need to prioritize vaccine distribution. Obesity, diabetes, and hypertension have been associated with an increased risk of severe COVID-19 infection. Approximately half as many individuals with a cardiovascular risk factor need to be vaccinated against COVID-19 to prevent related death compared with individuals without a risk factor. Adults with body mass index ≥ 30, diabetes, or hypertension should be of a similar priority for COVID-19 vaccination to adults 10 years older with a body mass index of 20 to < 30, no diabetes, and no hypertension.The Global Effect of the COVID-19 Pandemic on STEMI Care: A Systematic Review and Meta-analysis
The COVID-19 pandemic has affected patients with ST-segment elevation myocardial infarction (STEMI) requiring primary percutaneous coronary intervention (PCI) worldwide. In this review we examine the global effect of the COVID-19 pandemic on incidence of STEMI admissions, and relationship between the pandemic and door to balloon time (D2B), all-cause mortality, and other secondary STEMI outcomes.Use of Simulation-Based Medical Education for Advanced Resuscitation of In-Hospital Cardiac Arrest Patients With Suspected or Confirmed COVID-19
Cardiac arrest is common in critically ill patients with coronavirus disease 2019 (COVID-19) and is associated with poor survival. Simulation is frequently used to evaluate and train code teams with the goal of improving outcomes. All participants engaged in training on donning and doffing of personal protective equipment for suspected or confirmed COVID-19 cases. Thereafter, simulations of in-hospital cardiac arrest of patients with COVID-19, so-called protected code blue, were conducted at a quaternary academic centre.The Transformation of Cardiology Training in Response to the COVID-19 Pandemic: Enhancing Current and Future Standards to Deliver Optimal Patient Care
The COVID-19 pandemic has had an unprecedented impact on cardiology training. Novel opportunities have been identified in several domains: patient exposure, procedural experience, didactic education, research and development, advocacy and well-being, and career advancement. Lessons learned from COVID-19 should be used to further improve fellowship training such as, for example, through the development of a competency-based training and evaluation system. Multimodality teaching that incorporates telelearning provides creative solutions for trainee and continuing medical education.A Multiprofessional Face-to-Face and Remote Real-Time Hybrid Mode of Exercise-Based Cardiac Rehabilitation: An Innovative Proposal During the COVID-19 Pandemic
Exercise-based cardiac rehabilitation is largely recognized as a cost-effective therapeutic strategy for several clinical conditions and formally recommended and endorsed by a number of institutional guidelines.1 Since 1994, in our medically supervised exercise program, more than 2500 patients have completed over 450,000 patient-hours in exercise sessions. However, during the COVID-19 pandemic, as happened worldwide, our on-site exercise sessions were suspended, and we had to quickly implement alternative options of home-based programs, using recent advances in telecommunications and health-monitoring technology.Reply to Čulić et al—COVID-19 Pandemic and Possible Rebound Phenomenon in Incidence of Acute Myocardial Infarction
We agree with Čulić et al1 regarding to the fact that the observed ST-segment elevation myocardial infarction (STEMI) hospitalisation rebound phenomenon is not entirely unexpected. Nonetheless, our report2 is indeed the first description of this worrisome trend. Israel saw its first confirmed COVID-19 patient on February 21. The first documented in-state transmission of the virus subsequently occurred on February 22. New government regulations calling for social distancing; limiting gatherings; and restrictions on public transportation, schools, universities, and businesses were announced on March 10.Cardiovascular Care Delivery During the Second Wave of COVID-19 in Canada
Hospitals and ambulatory facilities significantly reduced cardiac care delivery in response to the first wave of the COVID-19 pandemic. The deferral of elective cardiovascular procedures led to a marked reduction in health care delivery with a significant impact on optimal cardiovascular care. International and Canadian data have reported dramatically increased wait times for diagnostic tests and cardiovascular procedures, as well as associated increased cardiovascular morbidity and mortality. In the wake of the demonstrated ability to rapidly create critical care and hospital ward capacity, we advocate a different approach during the second and possible subsequent COVID-19 pandemic waves.COVID-19–Myocarditis and Return to Play: Reflections and Recommendations From a Canadian Working Group
The COVID-19–related pandemic has resulted in profound health, financial, and societal impacts. Organized sporting events, from recreational to the Olympic level, have been cancelled to both mitigate the spread of COVID-19 and protect athletes and highly active individuals from potential acute and long-term infection-associated harms. COVID-19 infection has been associated with increased cardiac morbidity and mortality. Myocarditis and late gadolinium enhancement as a result of COVID-19 infection have been confirmed.Implications of the COVID-19 Pandemic for Cardiovascular Disease and Risk-Factor Management
COVID-19 and our public health responses to the pandemic may have far-reaching implications for cardiovascular (CV) risk, affecting the general population and not only survivors of COVID-19. In this narrative review, we discuss how the pandemic may affect general CV risk for years to come and explore the mitigating potential of telehealth interventions. From a health care perspective, the shift away from in-person office visits may have led many to defer routine risk- factor management and may have had unforeseen effects on continuity of care and adherence.Bioprosthetic Valve Thrombosis and Obstruction Secondary to COVID-19
Patients with COVID-19 may present a hypercoagulable state, with an important impact on morbidity and mortality. Because of this situation pulmonary embolism is a frequent complication during the course of infection. We present the case of a patient recently discharged, after admission with confirmed COVID-19, who developed a pulmonary embolism and thrombosis of a biological mitral valve prosthesis, producing valve obstruction and stenosis. After 15 days of anticoagulant treatment, resolution of the thrombus and normalisation of prosthetic valve function was observed.Post COVID-19 Acute Myocardial Infarction Rebound
As the first wave of COVID-19 came to a relative trough during May 2020 in parts of Europe and some states in the United States, for example Vermont, New York, and New Jersey, we are now beginning to observe a resurgence in acute myocardial infarction (AMI) admissions in Israel.1A Novel Protocol for Very Early Hospital Discharge After STEMI
Although the incidence of ST-elevation myocardial infarction (STEMI) is on the decline, management of patients who present with STEMI continues to require significant health care resources. Earlier hospital discharge in low-risk patients who present with STEMI has been an area of focus in an attempt to reduce health care costs. As a result, discharge within 48-72 hours after successful primary percutaneous coronary intervention has increasingly become routine practice. Moreover, the current COVID-19 pandemic has led to enormous pressure on health care systems to find ways to increase bed capacity, preserve resources, and reduce the risk of exposure to patients and health care workers.The Multiple Effects of SGLT2 Inhibitors Suggest Potential Benefit in COVID-19 Patients
Recent evidence has shown that inflammation is a potential contributor to the progression and exacerbation of COVID-19.1 Indeed, SARS-CoV-2 often induces a robust immune response and releases cytokines, which might contribute to multiorgan dysfunction and mortality.1 Growing evidence suggests that COVID-19 is not solely a respiratory illness, and that the infection can directly or indirectly infect organs or vascular endothelial cells causing endotheliitis. Because of the urgent need for additional therapies and because COVID-19 disproportionately affects individuals with cardiovascular/cardiometabolic comorbidities, herein we discuss the rationale for using the antidiabetic sodium-glucose cotransporter 2 (SGLT2) inhibitors, namely dapagliflozin and empagliflozin, as a unique approach to potentially treat severe COVID-19 symptoms.The Basics of ARDS Mechanical Ventilatory Care for Cardiovascular Specialists
The ongoing COVID-19 pandemic has placed pressure on health care systems and intensive care unit capacity worldwide. Respiratory insufficiency is the most common reason for hospital admission in patients with COVID-19. The most severe form of respiratory failure is acute respiratory distress syndrome (ARDS), which is associated with significant morbidity and mortality. Patients with ARDS are often treated with invasive mechanical ventilation according to established evidence-based and guideline recommended management strategies.Reduced Rate of Hospital Presentations for Heart Failure During the COVID-19 Pandemic in Toronto, Canada
Coronavirus disease 2019 (COVID-19) has resulted in public health measures and health care reconfigurations likely to have impact on chronic disease care. We aimed to assess the volume and characteristics of patients presenting to hospitals with acute decompensated heart failure (ADHF) during the 2020 COVID-19 pandemic compared with a time-matched 2019 cohort. Patients presenting to hospitals with ADHF from March 1, to April 19, 2020 and 2019 in an urban hospital were examined. Multivariable logistic-regression models were used to evaluate the difference in probability of ADHF-related hospitalization between the 2 years.Transfusion Thresholds for Adult Respiratory Extracorporeal Life Support: An Expert Consensus Document
Severe acute respiratory distress syndrome (ARDS) can complicate novel pandemic coronavirus disease (COVID-19). Extracorporeal life support (ECLS) represents the final possible rescue strategy. Variations in practice, combined with a paucity of rigourous guidelines, may complicate blood-product resource availability and allocation during a pandemic. We conducted a literature review around venovenous extracorporeal membrane oxygenation (VV-ECMO) transfusion practices for platelets, packed red blood cells, fresh frozen plasma, prothrombin complex concentrate, and antithrombin.Biventricular Thrombi Associated With Myocardial Infarction in a Patient With COVID-19
A wide spectrum of cardiovascular manifestations has been documented in patients suffering from coronavirus disease-2019 (COVID-19). Usually associated with a poor prognoses, these manifestations include thromboembolic events, acute coronary syndrome, heart failure, and cardiogenic shock. We describe a patient with COVID-19 who presented with subacute myocardial infarction, biventricular thrombi, and bilateral pulmonary emboli. Biventricular thrombi are rare, and their presence raises concern for an underlying prothrombotic condition.
Copyright © 2023 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.
