Postoperative inflammation to “hyper”‐inflammation: cryptic COVID‐19 connections!

Surgical VSD closure in post-COVID cohort: A double whammy!

“…Meanwhile inflammation classifies as a pivotal contributor to postoperative PH (especially concerning in context of an enhanced pulmonary blood flow (PBF), as cited above in VSD cohort), our previous experience with a cyanotic child (preoperative decreased PBF) succumbing to a post-CPB hyperinflammatory response in background of an occult COVID-19 infection, is in itself alarming. 3 Talking specifically of COVID -19 related pulmonary vasculopathy, extensive pulmonary damage with persistent inflammation, endothelial injury with hypercoagulability, thrombotic microangiopathy, hypoxic vasoconstriction, and concomitant myocardial injury are the potential factors responsible for new-onset PH or worsening of preexisting PH. 2,4 Literature reports 13.4% incidence of PH in COVID-19 infection with high PASP predicting higher incidence of ICU admission, mechanical ventilation, extracorporeal membrane oxygenation, and higher mortality.…”

COVID-19 Positive Cohort Undergoing Cardiac Surgery: A Possible Un(3H)oly Trinity of HypoxiaHemolysis-Hyperinflammation

“…Amidst reports of poor perioperative outcomes in cardiac surgical patients ailing from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia [ 1 - 3 ] , we feel motivated to put forth a 3H (Hypoxia-Hemolysis-Hyperinflammation) trilogy explaining the possible perils of an interaction between cardiopulmonary bypass (CPB, commonly employed for cardiac surgical conduct) and coronavirus disease (COVID-19) infection.…”

An outcome study in patients with COVID-19 admitted to ICU: HAS a miss?

“…While Kukoč et al understandably portray interest in the markers of inflammation in their COVID-19 study, the absence of an account of the albumin levels is difficult to comprehend, particularly when hypoalbuminemia presents both nutritional and inflammatory prognostic potential. 1 , 3 , 4 Indeed, a systematic review and meta-analysis by Soetedjo et al across 19 studies and 6,200 patients outlined an increased mortality in background of hypoalbuminemia (OR: 6.26, 95% CI: 3.26-12.04, p value<0.001). A subgroup-analysis delineated 0.59 (95% CI: 0.46-0.70) sensitivity and 0.82 (95% CI: 0.72-0.88) specificity for hypoalbuminemia guided mortality prediction.…”