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The global evolution of the SARS-CoV-2 virus is known to all. The diagnosis of SARS-CoV-2 pneumonia is expected to worsen, and mortality will be higher when combined with myocardial injury (MI). The combination of novel coronavirus infections in patients with MI can cause confusion in diagnosis and assessment, with each condition exacerbating the other, and increasing the complexity and difficulty of treatment. It would be a formidable challenge for clinical practice to deal with this situation. Therefore, this review aims to gather literature on the progress in managing MI related to SARS-CoV-2 pneumonia. This article reviews the definition, pathogenesis, clinical evaluation, management, and treatment plan for MI related to SARS-CoV-2 pneumonia based on the most recent literature, diagnosis, and treatment trial reports. Many studies have shown that early diagnosis and implementation of targeted treatment measures according to the different stages of disease can reduce the mortality rate among patients with MI related to SARS-CoV-2 pneumonia. The reviewed studies show that multiple strategies have been adopted for the management of MI related to COVID-19. Clinicians should closely monitor SARS-CoV-2 pneumonia patients with MI, as their condition can rapidly deteriorate and progress to heart failure, acute myocardial infarction, and/or cardiogenic shock. In addition, appropriate measures need to be implemented in the diagnosis and treatment to provide reasonable care to the patient.

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Background: Low-dose aspirin (LDA) is the backbone for secondary prevention of coronary artery disease, although limited by gastric toxicity. This study aimed to identify novel metabolites that could predict LDA-induced gastric toxicity using pharmacometabolomics. Methods: Pre-dosed urine samples were collected from male Sprague-Dawley rats. The rats were treated with either LDA (10 mg/kg) or 1% methylcellulose (10 mL/kg) per oral for 28 days. The rats’ stomachs were examined for gastric toxicity using a stereomicroscope. The urine samples were analyzed using a proton nuclear magnetic resonance spectroscopy. Metabolites were systematically identified by exploring established databases and multivariate analyses to determine the spectral pattern of metabolites related to LDA-induced gastric toxicity. Results: Treatment with LDA resulted in gastric toxicity in 20/32 rats (62.5%). The orthogonal projections to latent structures discriminant analysis (OPLS-DA) model displayed a goodness-of-fit (R2Y) value of 0.947, suggesting near-perfect reproducibility and a goodness-of-prediction (Q2Y) of −0.185 with perfect sensitivity, specificity and accuracy (100%). Furthermore, the area under the receiver operating characteristic (AUROC) displayed was 1. The final OPLS-DA model had an R2Y value of 0.726 and Q2Y of 0.142 with sensitivity (100%), specificity (95.0%) and accuracy (96.9%). Citrate, hippurate, methylamine, trimethylamine N-oxide and alpha-keto-glutarate were identified as the possible metabolites implicated in the LDA-induced gastric toxicity. Conclusion: The study identified metabolic signatures that correlated with the development of a low-dose Aspirin-induced gastric toxicity in rats. This pharmacometabolomic approach could further be validated to predict LDA-induced gastric toxicity in patients with coronary artery disease.

Asthma is a heterogeneous disease that inflames and narrows the airways. It is identified with respiratory symptoms such as wheezing, shortness of breath, chest tightness and cough. It has also been established that adherence to evidence-based guidelines may raise asthma control to optimal levels in both diagnosis and medical intervention. The objectives are to assess the knowledge, practice and adherence to asthma-management guidelines of general practitioners (GPs) and community pharmacists (CPs) in Pulau Pinang, Malaysia. A cross-sectional study was conducted in Pulau Pinang using a validated self-administered questionnaire. The knowledge, practice and adherence to asthmamanagement guidelines of GPs and CPs were captured using a 30-item questionnaire that prompted their responses using a mixture of closed-ended and Likert scale techniques. The questionnaires, together with a self-addressed stamped envelope for return, were mailed to 236 CPs and 300 GPs. The knowledge of both CPs and GPs on asthma was slightly above average, and there was no significant difference between the two groups (65.9% for CPs and 67.2% for GPs, p = 0.933). Overall, GPs have better practice than CPs, with a mean score of 4 or higher for most practice questions. GPs have a significantly higher tendency to follow the asthma guidelines (71.9%), whereas less than half of the CPs (46.4%) adhere to them. Only 40.6% of GPs and 3.5% of CPs mentioned the name of the guidelines they followed. Our findings show that although CPs and GPs have similar levels of knowledge, GPs have better practice and adherence to guidelines than CPs.