Cardiogenic Shock and Hyperinflammatory Syndrome in Young Males With COVID-19

Chau, Vinh Q.; Giustino, Gennaro; Mahmood, Kiran; Oliveros, Estefanía; Neibart, Eric; Oloomi, Mehdi; Moss, Noah; Mitter, Sumeet S.; Contreras, Johanna; Croft, Lori B.; Serrao, Gregory; Parikh, Aditya; Lala, Anuradha; Trivieri, Maria Giovanna; LaRocca, Gina; Anyanwu, Anelechi C.; Pinney, Sean; Mancini, Donna

doi:10.1161/circheartfailure.120.007485

Cited by 96 publications

(113 citation statements)

References 10 publications

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“…Three published case series were identified describing adult patients with manifestations consistent with MIS-A (4-6). One series describes seven previously healthy, young adult men aged 20-42 years who experienced mixed cardiogenic and vasoplegic shock and hyperinflammation along with high SARS-CoV-2 immunoglobulin G antibody titers indicating active or previous infection (4). Two of the patients identified as African American, two as Hispanic, two as Middle Eastern, and one as White.…”

Section: Published Case Seriesmentioning

confidence: 99%

Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection — United Kingdom and United States, March–August 2020

Morris¹,

Schwartz²,

Patel³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

476

644

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On October 2, 2020, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). During the course of the coronavirus disease 2019 (COVID-19) pandemic, reports of a new multisystem inflammatory syndrome in children (MIS-C) have been increasing in Europe and the United States (1-3). Clinical features in children have varied but predominantly include shock, cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-reactive protein (CRP), ferritin, D-dimer, and interleukin-6 (1). Since June 2020, several case reports have described a similar syndrome in adults; this review describes in detail nine patients reported to CDC, seven from published case reports, and summarizes the findings in 11 patients described in three case series in peer-reviewed journals (4-6). These 27 patients had cardiovascular, gastrointestinal, dermatologic, and neurologic symptoms without severe respiratory illness and concurrently received positive test results for SARS-CoV-2, the virus that causes COVID-19, by polymerase chain reaction (PCR) or antibody assays indicating recent infection. Reports of these patients highlight the recognition of an illness referred to here as multisystem inflammatory syndrome in adults (MIS-A), the heterogeneity of clinical signs and symptoms, and the role for antibody testing in identifying similar cases among adults. Clinicians and health departments should consider MIS-A in adults with compatible signs and symptoms. These patients might not have positive SARS-CoV-2 PCR or antigen test results, and antibody testing might be needed to confirm previous SARS-CoV-2 infection. Because of the temporal association between MIS-A and SARS-CoV-2 infections interventions that prevent COVID-19 might prevent MIS-A. Further research is needed to understand the pathogenesis and long-term effects of this newly described condition. Potential MIS-A patients were identified from several sources: reports from clinicians and health departments, published case reports, and published case series. Clinicians and health departments in the United States voluntarily reported adult patients with suspected MIS-A to CDC using the case report form* developed for MIS-C after a Health Advisory was published on May 14, 2020, calling for reporting of MIS-C

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Section: Published Case Seriesmentioning

confidence: 99%

Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection — United Kingdom and United States, March–August 2020

Morris¹,

Schwartz²,

Patel³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

476

644

View full text Add to dashboard Cite

show abstract

“…Nasopharyngeal swab samples were tested for SARS-CoV-2 PCR yielded negative results, and the blood sample tested for SARS CoV-2 IgM + IgG antibody yielded positive results. There was no pathological sign on chest CT. A little amount of free liquid was detected in the pelvic region and among some parts of small intestine on abdomen CT. After obtaining blood, urine, and stool samples for cultures, Hékimian et al [12] Hékimian et al [12] Hékimian et al [12] Hékimian et al [12] Hékimian et al [12] Hékimian et al [12] Hékimian et al [12] Moghadam et al [13] Age ( [16] Ahsan et al [17] Malangu et al [18] Gulersen et al [19] Vieira et al [5] Razavi et al [20] Age ( Riollano-Cruz et al [21] Riollano-Cruz et al [21] Othenin-Girard [22] Parker [23] Parker [23] Kaushik et al [24] Kaushik et al [24] Chérif et al [25] Downing et al [26] Shan et al [27] Age empirical ceftriaxone 2 gr/day was started. On the follow up, hypotension, tachycardia, and hypoxia developed on the first day of treatment, and procalcitonin, troponin, and pro-BNP levels were found increased.…”

Section: Casementioning

confidence: 99%

Multiple system inflammatory syndrome associated with SARS-CoV-2 infection in an adult and an adolescent

et al. 2021

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Multisystem inflammatory syndrome in adults (MIS-A) is a new syndrome related with COVID-19. A case-based review was performed to present real-life experiences in terms of main findings and treatment options. We described two cases with the diagnosis of MIS and searched the literature to review all reported ≥ 18-year-old cases. The PubMed, Scopus, and Web of Science databases were searched. All relevant articles from January 2020 to February 2021 were reviewed. An adolescent and an adult patient (18 and 40 years-old, respectively) with the diagnosis of MIS were presented. Both had the consistent clinical findings with the case definition criteria. Although steroid, intravenous immunoglobulin (IVIG) and supportive care treatments have been suggested in the literature, there exists no treatment guideline for MIS-A. The clinical and laboratory findings of the patients progressively improved with the implementation of the IVIG and the pulse steroid treatments. A total of 51 cases (≥ 18 years-old) with MIS were analyzed. Mean age was 29.4 ± 10 years. Fever (80.4%), gastrointestinal (72.5%), and respiratory symptoms (54.9%) were the predominant symptoms. Cardiovascular abnormalities were the most frequent reported findings (82.4%, 42/51). The dermatological and conjunctival findings were reported in 39.2% and 35.3% of the patients, respectively. The increased level of inflammatory biomarkers was remarkable. Most of the patients were treated successfully with steroid and IVIG. Clinicians managing adult patients should keep in mind the development risk of MIS related with SARS-CoV-2 infection to perform necessary interventions properly without delay. IVIG and pulse steroid treatments are the effective options on clinical improvement.

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“…Cardiogenic shock has been reported as a late complication of COVID-19. In seven patients with confirmed COVID-19, new-onset biventricular failure and vasoplegia were noted, prior to the development of severe cardiogenic shock [ 58 ]. Tavazzi et al .…”

Section: Impact Of Covid-19 Infection On the Cardiovascular Systemmentioning

confidence: 99%

“…[ 60 ] among 226 patients admitted to an ICU for severe COVID-19, three (1.3%) patients developed cardiogenic shock. Besides, cardiogenic shock is often mixed with other types of shock following SARS-CoV-2 infection, such as vasoplegic shock [ 58 , 61 ]. Of note, circulatory and respiratory support with a combination of extracorporeal membranous oxygenation (ECMO) and percutaneous ventricular assist device should be considered in COVID-19 patients with a combined cardiogenic and vasoplegic shock.…”

Section: Impact Of Covid-19 Infection On the Cardiovascular Systemmentioning

confidence: 99%

Cardiovascular disease in patients with COVID-19: evidence from cardiovascular pathology to treatment

Luo

Zhu

Jian

et al. 2021

ABBS

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The coronavirus disease-2019 (COVID-19) caused by the novel coronavirus severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has rapidly developed into a global pneumonia pandemic. Cardiovascular disease is the major comorbidity of COVID-19 patients and is closely related to the severity of COVID-19. SARS-CoV-2 infection can directly or indirectly cause a series of cardiac complications, including acute myocardial injury and myocarditis, heart failure and cardiac arrest, arrhythmia, acute myocardial infarction, cardiogenic shock, Takotsubo cardiomyopathy, and coagulation abnormalities. Intensive research on the SARS-CoV-2-associated cardiovascular complications is urgently needed to elucidate its exact mechanism and to identify potential drug targets, which will help to formulate effective prevention and treatment strategies. Hence, this review will summarize recent progress regarding the effects of COVID-19 on the cardiovascular system and describe the underlying mechanism of cardiovascular injury caused by SARS-CoV-2.

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Cardiogenic Shock and Hyperinflammatory Syndrome in Young Males With COVID-19

Cited by 96 publications

References 10 publications

Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection — United Kingdom and United States, March–August 2020

Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection — United Kingdom and United States, March–August 2020

Multiple system inflammatory syndrome associated with SARS-CoV-2 infection in an adult and an adolescent

Cardiovascular disease in patients with COVID-19: evidence from cardiovascular pathology to treatment

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