Background Infection with the novel severe acute respiratory syndrome coronavirus 2 has been associated with a hypercoagulable state. Emerging data from China and Europe have consistently shown an increased incidence of venous thromboembolism (VTE). We aimed to identify the VTE incidence and early predictors of VTE at our high-volume tertiary care center. Methods We performed a retrospective cohort study of 147 patients who had been admitted to Temple University Hospital with coronavirus disease 2019 (COVID-19) from April 1, 2020 to April 27, 2020. We first identified the VTE (pulmonary embolism [PE] and deep vein thrombosis [DVT]) incidence in our cohort. The VTE and no-VTE groups were compared by univariable analysis for demographics, comorbidities, laboratory data, and treatment outcomes. Subsequently, multivariable logistic regression analysis was performed to identify the early predictors of VTE. Results The 147 patients (20.9% of all admissions) admitted to a designated COVID-19 unit at Temple University Hospital with a high clinical suspicion of acute VTE had undergone testing for VTE using computed tomography pulmonary angiography and/or extremity venous duplex ultrasonography. The overall incidence of VTE was 17% (25 of 147). Of the 25 patients, 16 had had acute PE, 14 had had acute DVT, and 5 had had both PE and DVT. The need for invasive mechanical ventilation (adjusted odds ratio, 3.19; 95% confidence interval, 1.07-9.55) and the admission D-dimer level ≥1500 ng/mL (adjusted odds ratio, 3.55; 95% confidence interval, 1.29-9.78) were independent markers associated with VTE. The all-cause mortality in the VTE group was greater than that in the non-VTE group (48% vs 22%; P = .007). Conclusion Our study represents one of the earliest reported from the United States on the incidence rate of VTE in patients with COVID-19. Patients with a high clinical suspicion and the identified risk factors (invasive mechanical ventilation, admission D-dimer level ≥1500 ng/mL) should be considered for early VTE testing. We did not screen all patients admitted for VTE; therefore, the true incidence of VTE could have been underestimated. Our findings require confirmation in future prospective studies.

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Introduction:Smoking is an independent risk factor for ischemic heart disease and acute myocardial infarction. Smoking raise both heart rate and blood pressure, thus increasing myocardial oxygen demand, moreover it also decreases the dimension of coronary vessel and coronary blood flow. Inferior wall Myocardial Infarction is consequence of disease in usually Right coronary artery, whereas anterior wall Myocardial Infarction is usually disease in left coronary artery. The aim of the study is to evaluate whether smoking influence the incidence of inferior wall MI (Right coronary artery). Study objective was to find out whether there was an association between smoking and inferior wall Myocardial Infarction and an early association of atherosclerosis and ischemic heart disease with smoking. Material and methods: 126 patients of ST ElevationMyocardial Infarction admitted from the outdoor patient department/ emergency department/ Cardiology OPD in MMIMSR, Mullana, Ambala, considered for study. Those who are willing to participate and fulfilling the inclusion and exclusion criteria.Result: In our study there was a high proportion of smoker in patient with inferior wall MI than other location of MI. Smokers were prone to get myocardial infarction at a younger age as compared to others. Mortality was higher in anterior wall MI as compared to Inferior wall MI. Anterior wall MI presented with more complications i.e. cardiogenic shock and arrhythmias. Conclusion:Smoking enhance the risk of inferior wall MI more than other MI. Smoking thus appear to adversely affect the Right coronary artery to greater extent than left coronary arterial circulation by mechanism yet to be explored. Smoking leads to ischemic heart disease at early age.

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