Takotsubo syndrome (TTS) is caused by catecholamine surge, which is also observed in COVID-19 disease due to the cytokine storm. We performed a systematic literature search using PubMed/Medline, SCOPUS, Web of Science, and Google Scholar databases to identify COVID-19-associated TTS case reports and evaluated patient-level demographics, clinical attributes, and outcomes. There are 12 cases reported of TTS associated with COVID-19 infection with mean age of 70.8 ± 15.2 years (range 43–87 years) with elderly (66.6% > 60 years) female (66.6%) majority. The time interval from the first symptom to TTS was 8.3 ± 3.6 days (range 3–14 days). Out of 12 cases, 7 reported apical ballooning, 4 reported basal segment hypo/akinesia, and 1 reported median TTS. Out of 12 cases, during hospitalization, data on left ventricular ejection fraction (LVEF) was reported in only 9 of the cases. The mean LVEF was 40.6 ± 9.9% (male, 46.7 ± 5.7%, and female, 37.7 ± 10.6%). Troponin was measured in all 12 cases and was elevated in 11 (91.6%) without stenosis on coronary angiography except one. Out of 11 cases, 6 developed cardiac complications with 1 case each of cardiac tamponade, heart failure, myocarditis, hypertensive crisis, and cardiogenic shock in 2. Five patients required intubation, 1 patient required continuous positive airway pressure, and 1 patient required venovenous extracorporeal membrane oxygenation. The outcome was reported in terms of recovery in 11 (91.6%) out of 12 cases, and a successful recovery was noted in 10 (90.9%) cases. COVID-19-related TTS has a higher prevalence in older women. Despite a lower prevalence of cardiac comorbidities in COVID-19 patients, direct myocardial injury, inflammation, and stress may contribute to TTS with a high complication rate.

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Globally, colorectal cancer is the third most diagnosed malignancy. It causes significant mortality and morbidity, which can be reduced by early diagnosis with an effective screening test. Integrating artificial intelligence (AI) and computer-aided detection (CAD) with screening methods has shown promising colorectal cancer screening results. AI could provide a “second look” for endoscopists to decrease the rate of missed polyps during a colonoscopy. It can also improve detection and characterization of polyps by integration with colonoscopy and various advanced endoscopic modalities such as magnifying narrow-band imaging, endocytoscopy, confocal endomicroscopy, laser-induced fluorescence spectroscopy, and magnifying chromoendoscopy. This descriptive review discusses various AI and CAD applications in colorectal cancer screening, polyp detection, and characterization.

There remains a high risk of thrombosis in patients affected by the SARS-CoV-2 virus and recent reports have shown pulmonary embolism (PE) as a cause of sudden death in these patients. However, the pooled rate of this deadly and frequently underdiagnosed condition among COVID-19 patients remains largely unknown. Given the frequency with which pulmonary embolism has been reported as a fatal complication of severe coronavirus disease, we sought to ascertain the actual prevalence of this event in COVID-19 patients. Using PubMed/Medline, EMBASE, and SCOPUS, a thorough literature search was performed to identify the studies reporting rate of PE among COVID-19. Random effects models were obtained to perform a meta-analysis, and I 2 statistics were used to measure inter-study heterogeneity. Among 3066 COVID-19 patients included from 9 studies, the pooled prevalence of PE was 15.8% (95% CI (6.0–28.8%), I 2 = 98%). The pooled rate in younger cohort (age < 65 years) showed a higher prevalence of 20.5% (95% CI (17.6–24.8%)) as compared to studies including relatively older cohort (age > 65 years) showing 14.3% (95% CI (2.9–30.1%)) ( p < 0.05). Single-center studies showed a prevalence of 12.9% (95% CI 1.0–30.2%), while that of multicenter studies was 19.5% (95% CI 14.9–25.2%) ( p < 0.05). Pulmonary embolism is a common complication of severe coronavirus disease and a high degree of clinical suspicion for its diagnosis should be maintained in critically ill patients.

Background With rising trends of prediabetes in the geriatric population, we aim to assess the impact of alcohol use disorder (AUD) on the outcomes of patients with prediabetes. Methods Hospitalisations amongst the patients (≥65 years) with prediabetes were identified with a diagnosis of AUD and in‐hospital stroke using the National Inpatient Sample database (2007‐2014). We compared demographics, comorbidities, all‐cause mortality, stroke rate and resource utilisation in the elderly prediabetes patients with vs without AUD. Primary outcomes of interest were all‐cause mortality and stroke rate, whereas secondary outcomes were the length of stay (days), disposition and resource utilisation in the AUD cohort as compared to the non‐AUD cohort. Results We had a total of 1.7 million hospitalisations amongst elderly patients with prediabetes, 2.8% (n = 47 962) had AUD. The AUD cohort was more often younger (71 vs 77 years), male (74.1% vs 43.5%) and nonelectively (84.5% vs 78.3%) admitted than non‐AUD cohort. The AUD cohort more often consisted of African Americans (9.0% vs 6.6%) and Hispanics (5.3% vs 5.1%) than non‐AUD cohort. The AUD cohort showed higher rates of smoking, drug abuse, chronic obstructive pulmonary disease, coagulopathy, peripheral vascular disease and fluid‐electrolyte disorders whereas a lower rate of cardiovascular risk factors than non‐AUD cohort. All‐cause mortality (4.4% vs 3.9%) and stroke (5.5% vs 4.8%, aOR 1.33, 95% CI 1.28‐1.39) were significantly higher in the AUD cohort with prolonged stay, higher charges and frequent transfers than non‐AUD cohort. Conclusion AUD in the elderly prediabetes patients increases the stroke risk by up to 33% which can adversely influence the survival rate and healthcare infrastructure.