Pathophysiology of Cardiac Injury in COVID-19 Patients with Acute Ischaemic Stroke: What Do We Know So Far?—A Review of the Current Literature

Schoene, Daniela; Schnekenberg, Luiz; Pallesen, Lars-Peder; Barlinn, Jessica; Puetz, Volker; Barlinn, Kristian; Siepmann, Timo

doi:10.3390/life12010075

Cited by 11 publications

(8 citation statements)

References 75 publications

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“…Cardiovascular damage and immune dysregulation during the acute phase of COVID‐19 may result in an increased risk of long‐term CVD. 6 , 10 , 11 Several mechanisms and pathways have been suggested. Direct damage to the myocardium may occur via angiotensin‐converting enzyme 2 receptors, which facilitate entry of SARS‐CoV‐2, a strain of coronavirus causing COVID‐19, into host cells.…”

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confidence: 99%

Risk of Cardiovascular Disease After COVID‐19 Diagnosis Among Adults With and Without Diabetes

Koyama

Imperatore

Rolka

et al. 2023

JAHA

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Background Growing evidence suggests incident cardiovascular disease (CVD) may be a long‐term outcome of COVID‐19 infection, and chronic diseases, such as diabetes, may influence CVD risk associated with COVID‐19. We evaluated the postacute risk of CVD >30 days after a COVID‐19 diagnosis by diabetes status. Methods and Results We included adults ≥20 years old with a COVID‐19 diagnosis from March 1, 2020 through December 31, 2021 in a retrospective cohort study from the IQVIA PharMetrics Plus insurance claims database. A contemporaneous control group comprised adults without recorded diagnoses for COVID‐19 or other acute respiratory infections. Two historical control groups comprised patients with or without an acute respiratory infection. Cardiovascular outcomes included cerebrovascular disorders, dysrhythmia, inflammatory heart disease, ischemic heart disease, thrombotic disorders, other cardiac disorders, major adverse cardiovascular events, and any CVD. The total sample comprised 23 824 095 adults (mean age, 48.4 years [SD, 15.7 years]; 51.9% women; mean follow‐up, 8.5 months [SD, 5.8 months]). In multivariable Cox regression models, patients with a COVID‐19 diagnosis had a significantly greater risk of all cardiovascular outcomes compared with patients without a diagnosis of COVID‐19 (hazard ratio [HR], 1.66 [1.62–1.71], with diabetes; HR, 1.75 [1.73–1.78], without diabetes). Risk was attenuated but still significant for the majority of outcomes when comparing patients with COVID‐19 to both historical control groups. Conclusions In patients with COVID‐19 infection, postacute risk of incident cardiovascular outcomes is significantly higher than among controls without COVID‐19, regardless of diabetes status. Therefore, monitoring for incident CVD may be essential beyond the first 30 days after a COVID‐19 diagnosis.

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confidence: 99%

Risk of Cardiovascular Disease After COVID‐19 Diagnosis Among Adults With and Without Diabetes

Koyama

Imperatore

Rolka

et al. 2023

JAHA

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“…In terms of cardiac examination, our data showed that the proportion of abnormal ECG (72.7 vs. 36.1, P < 0.05, Table 3) and hs-cTn level (0.80 ± 0.34 vs. 0.08 ± 0.03, P < 0.05, Table 2) in the END group were signi cantly higher than that in the Non-END group. Previous studies have con rmed that cardiac injury in patients with COVID-19 combined AIS is mainly associated with coagulation dysfunction, vascular endothelial injury, and microthrombosis induced by SARS-CoV-2 infection [13,14]. There was no signi cant difference between two groups in serum CK, CK-MB and LDH (Table 2).…”

Section: Resultsmentioning

confidence: 78%

Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic stroke

Wang,

Tao

2024

Preprint

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Background: COVID-19 contributes to dysfunction and increased mortality in patients with acute ischemic stroke (AIS). However, whether COVID-19 causes early neurological deterioration (END) in patients with AIS and its underlying influencing factors are currently unclear.To ascertain the autonomous risk factors associated with END in stroke cases related to COVID-19. Methods: This is a retrospective observational study of data collected from November 2022 to February 2023 from patients with AIS complicated with COVID-19. The patients were divided into non-END and END groups, and their demographic characteristics, laboratory and imaging data were analyzed to investigate the risk factors for END in AIS patients complicated with COVID-19. Results: A total of 83 patients were enrolled in this study, and divided in to END (n = 22) and non-END (n = 61) groups. We found that patients with high baseline NIHSS score (P = 0.044), preexisting diabetes (P < 0.01), stroke (P < 0.01) and abnormal electrocardiogram (P < 0.01) were prone to END. Compared to patients with non-END, serum hs-CRP (P < 0.01), hs-cTn (P < 0.01), PT (P < 0.01), and DD (P < 0.01) were obviously increased in patients with EDN. Furthermore, multivariate Logistic regression analysis identified preexisting diabetes, stroke, high baseline NIHSS score, abnormal electrocardiogram, prolonged PT value, increased hs-CRP and elevated DD as independent risk factors for ENG in COVID-19-associated AIS. Conclusions: Patients with preexisting diabetes, stroke, high baseline NIHSS score, abnormal electrocardiogram, prolonged serum PT value, significantly increased hs-CRP and DD are prone to END in COVID-19-associated AIS.

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“…Despite the absence of DAD in four cases, the role of SARS-CoV-2 in mortality cannot be ruled out, particularly in the cases with ACS and this issue could be viewed as a caveat in our stratification approach. This is evidenced by the previous studies linking COVID-19 with direct cardiac damage and indirect involvement through the thrombotic complications [ 55 ]. However, we are inclined to believe that the cases in the “death with SARS-CoV-2 infection” group did not pass away due to SARS-CoV-2 complications since the subjects in this group lacked co-morbidities and were younger compared to those with histopathologic evidence of death due to the infection.…”

Section: Discussionmentioning

confidence: 80%

Postmortem lung and heart examination of COVID-19 patients in a case series from Jordan

Abdaljaleel

Tawalbeh

Sallam³

et al. 2023

JPTM

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Background: Coronavirus disease 2019 (COVID-19) has emerged as a pandemic for more than 2 years. Autopsy examination is an invaluable tool to understand the pathogenesis of emerging infections and their consequent mortalities. The aim of the current study was to present the lung and heart pathological findings of COVID-19–positive autopsies performed in Jordan. Methods: The study involved medicolegal cases, where the cause of death was unclear and autopsy examination was mandated by law. We included the clinical and pathologic findings of routine gross and microscopic examination of cases that were positive for COVID-19 at time of death. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed through molecular detection by real-time polymerase chain reaction, serologic testing for IgM and electron microscope examination of lung samples. Results: Seventeen autopsies were included, with male predominance (76.5%), Jordanians (70.6%), and 50 years as the mean age at time of death. Nine out of 16 cases (56.3%) had co-morbidities, with one case lacking such data. Histologic examination of lung tissue revealed diffuse alveolar damage in 13/17 cases (76.5%), and pulmonary microthrombi in 8/17 cases (47.1%). Microscopic cardiac findings were scarcely detected. Two patients died as a direct result of acute cardiac disease with limited pulmonary findings. Conclusions: The detection of SARS-CoV-2 in postmortem examination can be an incidental or contributory finding which highlights the value of autopsy examination to determine the exact cause of death in controversial cases.

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Pathophysiology of Cardiac Injury in COVID-19 Patients with Acute Ischaemic Stroke: What Do We Know So Far?—A Review of the Current Literature

Cited by 11 publications

References 75 publications

Risk of Cardiovascular Disease After COVID‐19 Diagnosis Among Adults With and Without Diabetes

Risk of Cardiovascular Disease After COVID‐19 Diagnosis Among Adults With and Without Diabetes

Influencing factors of early neurological deterioration in COVID-19 -associated acute ischemic stroke

Postmortem lung and heart examination of COVID-19 patients in a case series from Jordan

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