Acute Multivessel Coronary Occlusion Revealing COVID-19 in a Young Adult

Zendjebil, Sandra; Zeitouni, Michel; Batonga, Marc; Bèze, Nathan El; Guedeney, Paul; Collet, Jean‐Philippe; Choussat, Rémi; Silvain, Johanne; Montalescot, Gilles

doi:10.1016/j.jaccas.2020.06.002

Cited by 11 publications

(10 citation statements)

References 5 publications

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“…Conversely there are also multiple reports of patients without traditional risk factors, but with COVID-19, presenting with STEMI with a high thrombus burden. [50][51][52]56,[58][59][60] This observation underlies our suggestion that in patients without, or with few, risk factors presenting with high thrombus burden STEMI, there should be a high index of suspicion for COVID-19. 63 This suspicion should remain even if initial PCR testing is negative given the high false negative rates.…”

Section: Coronary Thrombus In Covid-19supporting

confidence: 54%

Therapeutic Implications of COVID-19 for the Interventional Cardiologist

Kelham

Choudry

Hamshere

et al. 2020

J Cardiovasc Pharmacol Ther

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Although COVID-19 is viewed primarily as a respiratory disease, cardiovascular risk factors and disease are prevalent among infected patients and are associated with worse outcomes. In addition, among multiple extra-pulmonary manifestations, there has been an increasing recognition of specific cardiovascular complications of COVID-19. Despite this, in the initial stages of the pandemic there was evidence of a reduction in patients presenting to acute cardiovascular services. In this masterclass review, with the aid of 2 exemplar cases, we will focus on the important therapeutic implications of COVID-19 for interventional cardiologists. We summarize the existing evidence base regarding the varied cardiovascular presentations seen in COVID-19 positive patients and the prognostic importance and potential mechanisms of acute myocardial injury in this setting. Importantly, through the use of a systematic review of the literature, we focus our discussion on the observed higher rates of coronary thrombus burden in patients with COVID-19 and acute coronary syndromes.

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Section: Coronary Thrombus In Covid-19supporting

confidence: 54%

Therapeutic Implications of COVID-19 for the Interventional Cardiologist

Kelham

Choudry

Hamshere

et al. 2020

J Cardiovasc Pharmacol Ther

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“…COVID‐19 was confirmed with serology in 2/39 (5.1%) cases, including one patient presenting with repeated negative RT‐PCR tests despite clinical and radiological profile highly suggestive with COVID‐19 and another patient, asymptomatic but exposed to the disease. Among COVID‐19 cases confirmed with RT‐PCR, several tests were performed on 19/37 (51.3%) patients, with a median of 2 (2–3.3) tests per patient and 15.5 [5–27] days between the first and last PCR test (Fig. S1).…”

Section: Resultsmentioning

confidence: 99%

“…As of the end of October 2020, nearly 50 million people were infected, worldwide, with approximately 1.2 million deaths [1]. COVID‐19 has a wide clinical spectrum, ranging from asymptomatic infection to mild upper respiratory tract illness, acute respiratory distress syndrome and acute cardiac injury [2–5]. Although the risk of viral infection is markedly increased among solid organ transplant recipients, including heart transplant (HT) recipients, available data on clinical presentation and outcomes of COVID‐19 in this high‐risk population remain limited [6–12].…”

Section: Introductionmentioning

confidence: 99%

Clinical manifestations and outcomes of coronavirus disease‐19 in heart transplant recipients: a multicentre case series with a systematic review and meta‐analysis

et al. 2021

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Summary Available data on clinical presentation and mortality of coronavirus disease‐2019 (COVID‐19) in heart transplant (HT) recipients remain limited. We report a case series of laboratory‐confirmed COVID‐19 in 39 HT recipients from 3 French heart transplant centres (mean age 54.4 ± 14.8 years; 66.7% males). Hospital admission was required for 35 (89.7%) cases including 14/39 (35.9%) cases being admitted in intensive care unit. Immunosuppressive medications were reduced or discontinued in 74.4% of the patients. After a median follow‐up of 54 (19–80) days, death and death or need for mechanical ventilation occurred in 25.6% and 33.3% of patients, respectively. Elevated C‐reactive protein and lung involvement ≥50% on chest computed tomography (CT) at admission were associated with an increased risk of death or need for mechanical ventilation. Mortality rate from March to June in the entire 3‐centre HT recipient cohort was 56% higher in 2020 compared to the time‐matched 2019 cohort (2% vs. 1.28%, P = 0.15). In a meta‐analysis including 4 studies, pre‐existing diabetes mellitus (OR 3.60, 95% CI 1.43–9.06, I 2 = 0%, P = 0.006) and chronic kidney disease stage III or higher (OR 3.79, 95% CI 1.39–10.31, I 2 = 0%, P = 0.009) were associated with increased mortality. These findings highlight the aggressive clinical course of COVID‐19 in HT recipients.

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“…Considering the type and location of the culprit coronary lesion, delayed intervention poses a risk for associated non-reversible complications including but not limited to complete atrioventricular heart block, severe ischemic cardiomyopathy, left ventricular aneurysm formation, or apical thrombosis [ 71 ]. Additionally, there are cases of STEMI in younger patients in the setting of COVID-19 infection [ 79 ]. Although ruling out acute coronary syndrome is appropriate in the correct clinical context, we must remain aware that during the COVID-19 pandemic, ST-elevation and troponin release may be a result of several STEMI mimics.…”

Section: Cardiovascular Complications In Covid-19mentioning

confidence: 99%