Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

Zhu, Han; Rhee, June‐Wha; Cheng, Paul; Waliany, Sarah; Chang, Amy; Witteles, Ronald; Maecker, Holden T.; Davis, Mark M.; Nguyen, Patricia K.; Wu, Sean M.

doi:10.1007/s11886-020-01292-3

Cited by 178 publications

(205 citation statements)

References 82 publications

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“…This entry mechanism is con rmed by the fact that TMPRSS2 inhibition or TMPRSS2-KO mice show both decreased, though not abolished, S protein priming, and reduced viral entry, spread, as well as, in ammatory chemokine and cytokine release [19]. Second, there may be an imbalance between Th1 and Th2 responses in COVID-19 patients, and the cytokine storm triggered by this imbalance may be another mechanism of myocardial injury [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

A nomogramic model based on clinical and laboratory parameters at admission for predicting the survival of COVID-19 patients

Wang

Huang

et al. 2020

Preprint

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Background and AimCOVID-19 has become a major global threat. The present study aimed to develop a nomogram model to predict the survival of COVID-19 patients based on their clinical and laboratory data at admission.Methods COVID-19 patients who were admitted at Hankou Hospital and Huoshenshan Hospital in Wuhan, China from January 12, 2020 to March 20, 2020, whose outcome during the hospitalization was known, were retrospectively reviewed. The categorical variables were compared using Pearson’s χ2-test or Fisher’s exact test, and continuous variables were analyzed using Student’s t-test or Mann Whitney U-test, as appropriate. Then, variables with a P-value of ≤0.1 were included in the log-binomial model, and merely these independent risk factors were used to establish the nomogram model. The discrimination of the nomogram was evaluated using the area under the receiver operating characteristic curve (AUC), and internally verified using the Bootstrap method.Results A total of 262 patients (134 surviving and 128 non-surviving patients) were included in the analysis. Seven variables, which included age (relative risk [RR]: 0.905, 95% confidence interval [CI]: 0.868-0.944; P<0.001), chronic heart disease (CHD, RR: 0.045, 95% CI: 0.0097-0.205; P<0.001, the percentage of lymphocytes (Lym%, RR: 1.125, 95% CI: 1.041-1.216; P=0.0029), platelets (RR: 1.008, 95% CI: 1.003-1.012; P=0.001), C-reaction protein (RR: 0.982, 95% CI: 0.973-0.991; P<0.001), lactate dehydrogenase (LDH, RR: 0.993, 95% CI: 0.990-0.997; P<0.001) and D-dimer (RR: 0.734, 95% CI: 0.617-0.879; P<0.001), were identified as the independent risk factors. The nomogram model based on these factors exhibited a good discrimination, with an AUC of 0.948 (95% CI: 0.923-0.973). ConclusionA nomogram based on age, CHD, Lym%, platelets, C-reaction protein, LDH and D-dimer was established to accurately predict the prognosis of COVID-19 patients. This can be used as an alerting tool for clinicians to take early intervention measures, when necessary.

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Section: Discussionmentioning

confidence: 99%

A nomogramic model based on clinical and laboratory parameters at admission for predicting the survival of COVID-19 patients

Wang

Huang

et al. 2020

Preprint

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“…It is an enveloped virus with single stranded positive sense Ribo Nucleic Acid (RNA) as a genetic material. COVID-19 infection predominantly causes respiratory illness with asymptomatic or mildly symptomatic fever, cough, fatigue and diarrhea and severe acute respiratory distress syndrome (ARDS) along with fatal multi organ collapse in certain cases [14]. COVID-19 incorporates spike protein which first binds itself to the Angiotensin Converting Enzyme 2 (ACE 2) receptor on the host cell surface.…”

Section: Fundamental Mechanism For Covid-19 Infectionmentioning

confidence: 99%

The role of Yoga in working from home during the COVID-19 global lockdown

Sharma

Anand

Kumar

2020

WOR

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BACKGROUND: The COVID-19 pandemic has become a major cause of stress and anxiety worldwide. Due to the global lockdown, work, employment, businesses and the economic climate have been severely affected. It has generated stress among people from all sections of society, especially to workers who have been assigned to cater to healthcare service or those constrained to secure daily essential items. It is widely perceived that elderly or those affected by diabetes, hypertension and other cardiovascular diseases (CVD’s) are prone to COVID-19. As per an ongoing survey, the initial data shows that the above-mentioned anxiety and stress cause insomnia, and has the considerable potential to weaken the immune system, the sole protection against the virus. OBJECTIVE: This study focuses on the need of Yoga practice at work places and at home during the global lockdown due to the COVID-19 pandemic. METHODS: Literature was searched using PubMed and Google Scholar for COVID-19-related stress and anxiety at work and society due to the worldwide lockdown. The predisposing comorbidities, viral mechanism of action and treatment regimen were also searched. Yoga-based intervention studies and online programs were also searched. RESULTS: As the lockdown cannot last forever and workplaces will have to be functional soon, there is an increased possibility of recurrent infection. Therefore, Yoga can provide the necessary tool for risk reduction, amelioration of stress and anxiety and strengthening of the immune function. The online platforms provide a good media for Yoga training at work places and homes. CONCLUSION: Due to social distancing norms, the availability of Yoga trainers has become restricted. Yoga practice is actively sought to achieve reduced anxiety and stress so that improved sleep may positively impact immunity. As a consequence, there is a spurt in social media, catering to daily online Yoga sessions which apparently prove useful in providing accessible means to achieve mental as well as physical well-being.

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“…Tachycardia may result from high cytokine levels, which activate cardiac pacemaker cells in the state of infection, or from direct myocardial invasion, as multiple studies have suggested (35,36). Since tachycardia is one of the initial manifestations of acute heart failure, patients presenting tachycardia may need evaluation for acute cardiac injury, a fatal complication of COVID-19.…”

Section: Symptomsmentioning

confidence: 99%

Clinical, laboratory, and radiologic findings associated with mortality in COVID-19: A systematic review and meta-analysis

Rhim

Park

Lee

et al. 2020

Preprint

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Abstract Although there has been a surge in reports on coronavirus disease 2019 (COVID-19), the clinical signs and findings associated with fatal outcomes have rarely been studied. This systematic review and meta-analysis aimed to investigate the clinical, laboratory, and radiologic features associated with mortality in COVID-19. A comprehensive search was performed using PubMed, Embase, Web of Science, and other databases including government sources, for articles and reports published until May 1, 2020. We extracted the number of events (mortality and non-mortality) from case series and case-control and cross-sectional studies. Hazard ratios (HR) of each finding were extracted from studies with time-to-outcome analysis. In total, 23 studies met the inclusion criteria. Of them, 18 studies were case-control, cross-sectional, and case series study. Whereas, only 5 studies included time-to-outcome analysis. Male sex, age over 80 years, dyspnea, cardiovascular disease, chronic kidney disease, increased troponin I level, acute respiratory distress syndrome, acute kidney injury, and need of invasive mechanical ventilation were significantly associated with mortality. The identification of patients at higher risk of mortality has an utmost importance to achieve better treatment outcomes. The findings from our study may aid the prioritization in times of severe shortages of medical resources. Further studies analyzing diverse demographic and geographic populations are needed to generalize the findings from this study.

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Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

Cited by 178 publications

References 82 publications

A nomogramic model based on clinical and laboratory parameters at admission for predicting the survival of COVID-19 patients

A nomogramic model based on clinical and laboratory parameters at admission for predicting the survival of COVID-19 patients

The role of Yoga in working from home during the COVID-19 global lockdown

Clinical, laboratory, and radiologic findings associated with mortality in COVID-19: A systematic review and meta-analysis

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