COVID-19 started as an unknown viral illness and has been a challenging pandemic to overcome. The virus has been associated with multiple organ involvement, including the heart. Takotsubo cardiomyopathy (TSCM), a stress cardiomyopathy, is an uncommon complication in patients diagnosed with COVID-19. The pathogenesis is historically a result of stress onto the body that leads to a catecholamine surge. However, COVID-19 may cause direct damage to the cardiac myocytes via spike protein and angiotensin-converting enzyme 2 (ACE2) receptors which can further exacerbate the stressful insult on the patient and lower the threshold for developing TSCM. In this case report, we discuss a 94-year-old female who presented with signs and symptoms of acute coronary syndrome but, upon cardiac catheterization, was found to have basal hypercontraction with apical ballooning, consistent with TSCM.

Objectives As 42.4% of the United States is obese and recent estimates expect an obesity/overweight prevalence of approximately three-fourths of the population by 2030, Americans have become more invested in finding weight control solutions. Commercial weight-loss programs and diets have risen to fulfill this need. However, there continues to be a lack of clarity surrounding the longitudinal and adverse outcomes of the majority of these programs. This report discusses a likely link between the usage of a popular commercial weight loss diet and the development of impaired kidney function in a 68-year-old patient. Methods Upon routine laboratory testing, the patient was noted to have elevated creatinine levels and was referred to a hematologist-oncologist for a bone marrow biopsy for a suspected diagnosis of multiple myeloma, and to a nephrologist for a kidney biopsy. The patient had a peak creatinine level of 3.02 mg/dL (reference range 0.70–1.25 mg/dL) prior to the kidney biopsy, which showed prominent calcium oxalate deposits and tubular atrophy with interstitial fibrosis, virtually excluding multiple myeloma. This finding placed the patient at risk for loss of kidney function, if not addressed immediately. Upon further investigation, the patient admitted to using a Nutrisystem® diet, which was aiding him in his weight loss goals. Results After a trial of removing this diet from his lifestyle, the creatinine level of the patient substantially improved to 1.42 mg/dL within three months, demonstrating a gradual improvement in kidney function. Conclusions This case report shows the importance of taking commercial weight-loss interventions into consideration when generating clinical recommendations for patients and adds to the currently limited literature on the long-term outcomes of the Nutrisystem® diet. Our findings point to the need for more comprehensive research into the effects of these programs and diets. Funding Sources Not applicable.

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Coronavirus disease 2019 or COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), a virus that has impacted nations and caused a global pandemic. Although COVID-19 is known to initially manifest as a pulmonary disease, we now understand it affects many major organ systems in the body, including the heart. Case reports have been published showing evidence of right ventricular (RV) strain as a result of contracting the COVID-19. However, the overall prevalence of RV strain secondary to the virus has not been well established. In this multicenter, observational analysis, we studied the prevalence of RV strain in hospitalized patients with COVID-19. We found the prevalence of RV strain to be small, ~1.5%. The average length of stay in patients with RV strain was 7 days compared to 8.63 days in non-RV strain patients. Those with RV strain were witness to have a 50% mortality rate.