Immune Mechanisms in Cardiovascular Diseases Associated With Viral Infection

Gopal, Radha; Marinelli, Michael A.; Alcorn, John F.

doi:10.3389/fimmu.2020.570681

Cited by 39 publications

(35 citation statements)

References 219 publications

(260 reference statements)

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“…Due to the pathophysiological processes involved in SARS-CoV-2 infection, HF is an important vulnerability during respiratory viral infections [ 9 , 10 ]. These pathways tend to HF decompensation and an increased risk of arrhythmia and ischemia.…”

Section: Introductionmentioning

confidence: 99%

Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19

Citu

Cîtu

Gorun

et al. 2022

JCM

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During the COVID-19 pandemic, it was observed that patients with heart disease are more likely to be hospitalized and develop severe COVID-19. Cardiac disease takes the top position among patient comorbidities, heart failure (HF) prevalence reaching almost 5% in the general population older than 35 years in Romania. This retrospective study aimed to determine the potential use of the NYHA classification for HF in hospitalized patients with COVID-19 as prognostic tool for in-hospital mortality, length of hospitalization, and probability of rehospitalization for HF decompensation. We observed that patients with advanced HF had a history of significantly more comorbid conditions that are associated with worse disease outcomes than the rest of patients classified as NYHA I and II. However, regardless of existing diseases, NYHA III, and, especially, NYHA IV, patients were at greatest risk for mortality following SARS-CoV-2 infection. They required significantly longer durations of hospitalization, ICU admission for mechanical ventilation, and developed multiple severe complications. NYHA IV patients required a median duration of 20 days of hospitalization, and their in-hospital mortality was as high as 47.8%. Cardiac biomarkers were significantly altered in patients with SARS-CoV-2 and advanced HF. Although the study sample was small, all patients with NYHA IV who recovered from COVID-19 required a rehospitalization in the following month, and 65.2% of the patients at initial presentation died during the next six months. The most significant risk factor for mortality was the development of severe in-hospital complications (OR = 4.38), while ICU admission was the strongest predictor for rehospitalization (OR = 5.19). Our result highlights that HF patients continue to be vulnerable post SARS-CoV-2 infection. Physicians and policymakers should consider this population’s high likelihood of hospital readmissions when making discharge, hospital capacity planning, and post-discharge patient monitoring choices.

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Section: Introductionmentioning

confidence: 99%

Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19

Citu

Cîtu

Gorun

et al. 2022

JCM

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“…These effects range from abnormal electrocardiogram findings such as tachycardia, 26 atrial fibrillation, 24 , 27 or even life threatening ventricular arrhythmias 25 and adverse cardiac events. 28 Taken in combination, these findings may explain why tachycardia can be a predictor of influenza infection. Of note, one study reported that during influenza infection, electrocardiogram confirmed tachycardia resolves by Day 2 of infection, 26 hence limiting the use of this marker to early presentations only.…”

Section: Discussionmentioning

confidence: 98%

Predictors of Influenza PCR Positivity in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Chen

Yew

Abisheganaden

et al. 2022

COPD

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Purpose: Influenza infection is an important cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Clinical features predicting influenza PCR positivity are unknown. We aim to identify predictors of influenza PCR positivity in AECOPD. Patients and Methods: A retrospective study of AECOPD cases admitted between 1st January 2016 to 30 June 2017 with combined nasal/throat swabs sent for influenza PCR (Xpert Xpress Flu/RSV) within 24 hours of admission was performed. Clinical parameters and investigations within 24 hours of admission were retrieved from electronic medical records. Results: Influenza PCR were sent for 925 AECOPD cases (mean age 75 years, 87.9% male). There were 90 PCR positive cases (68 Influenza A, 22 Influenza B). Influenza PCR positive cases had higher temperatures, higher heart rates, lower white cell and lower eosinophil counts. Age, gender, COPD severity, comorbidities and smoking status were similar in both groups. There were no differences in blood pressure, oxygen status, neutrophil or lymphocyte counts, C reactive protein, procalcitonin or chest X-ray consolidation between groups. Higher temperature, higher heart rate, white cell count in the lowest quartile (Q1 < 8.1 x10 9 /L) and non-eosinophilic exacerbations predicted influenza PCR positivity on univariate logistic regression and these factors remained significant after multivariate adjustment (temperature adjusted odds ratio [adj OR] 1.324 [1.009-1.737], p = 0.043; heart rate adj OR 1.017 [1.004-1.030], p = 0.011; white cell count Q1 adj OR 3.330 [1.690-6.562], p = 0.001; eosinophilic exacerbations adj OR 0.390 [0.202-0.756], p = 0.005). Conclusion: Higher temperature, higher heart rate, low white cell count (especially when < 8.1 x10 9 /L) and non-eosinophilic exacerbations are independent predictors of influenza PCR positivity in AECOPD cases.

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“…Acute influenza‐associated cardiac events are especially prevalent in patients with pre‐existing cardiovascular disease and include heart attacks and failure [83]. Due to strong support for the role of systemic inflammation in cardiovascular disease following respiratory viral infection [84], a number of studies have modeled these effects within mice and other animal models absent direct infection of cardiac tissues.…”

Section: Cardiovascular Effects and Effectorsmentioning

confidence: 99%

Nonrespiratory sites of influenza‐associated disease: mechanisms and experimental systems for continued study

Froggatt

Heaton

2022

The FEBS Journal

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The productive replication of human influenza viruses is almost exclusively restricted to cells in the respiratory tract. However, a key aspect of the host response to viral infection is the production of inflammatory cytokines and chemokines that are not similarly tissue restricted. As such, circulating inflammatory mediators, as well as the resulting activated immune cells, can induce damage throughout the body, particularly in individuals with underlying conditions. As a result, more holistic experimental approaches are required to fully understand the pathogenesis and scope of influenza virus‐induced disease. This review summarizes what is known about some of the most well‐appreciated nonrespiratory tract sites of influenza virus‐induced disease, including neurological, cardiovascular, gastrointestinal, muscular and fetal developmental phenotypes. In the context of this discussion, we describe the in vivo experimental systems currently being used to study nonrespiratory symptoms. Finally, we highlight important future questions and potential models that can be used for a more complete understanding of influenza virus‐induced disease.

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Immune Mechanisms in Cardiovascular Diseases Associated With Viral Infection

Cited by 39 publications

References 219 publications

Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19

Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19

Predictors of Influenza PCR Positivity in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Nonrespiratory sites of influenza‐associated disease: mechanisms and experimental systems for continued study

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