Resilience with the crisis: cardiology department experience to cope with the corona virus disease 2019 pandemic

Samir, Ahmad; Fahim, M. M.; Mohsen, Ahmed A.; Mahrous, Hossam; Mahmoud, Kareem; Elamragy, Ahmed; Meshaal, Marwa Sayed; Yehia, Hesham; Ammar, Waleed; Said, Karim; Baghdady, Yasser; Salah, Hesham; Abdelhamid, Magdy; Abdel‐Ghany, Mohamed

doi:10.4103/kamj.kamj_35_20

Cited by 2 publications

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“…This is probably attributed to the selective recruitment, with several exclusion criteria mentioned in the study protocol. Also, the partial overlap of the study recruitment period with COVID-19 peaking (last 3-months of recruitment period), could have impacted STEMI presentations, with declining numbers and potentially affecting patients’ profiles [ 26 ]. The exclusion of patients with coma, cardiogenic shock, or severe renal impairment would hamper generalization of the study results to these subgroups, however, there is established evidence that these subgroups have characteristic course and outcomes different from the general cohort, requiring to be assessed in dedicated studies.…”

Section: Discussionmentioning

confidence: 99%

Characterization of features and outcomes of young patients (< 45 years) presenting with ST-segment elevation myocardial infarction

et al. 2023

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Background Coronary artery disease (CAD) is the commonest cause of death worldwide. ST-segment elevation myocardial infarction (STEMI) and its consequences can be devastating particularly at younger age for a bigger impact on the patient’s psychology and ability to work. Little is known about the differential features and outcomes of young STEMI patients in Egypt. This study characterized young STEMI patients (≤ 45 years) compared to patients > 45 years and evaluated 1-year outcomes. Results A total of 492 eligible STEMI patients who presented to the National Heart Institute and Cairo University Hospitals were recruited. Young STEMI patients (< 45 years old) represented 20% of all STEMI comers. Male gender was predominant in both groups, yet with a significantly higher proportion in the younger compared to older patients (87% vs. 73%, p = 0.004). Compared to older patients, young STEMI patients had characteristically higher rates of smoking (72.4% vs. 49.7%, p < 0.001) and family history (13.3% vs. 4.8%, p = 0.002), while significantly lower rate of other conventional CAD risk factors as diabetes, hypertension, and dyslipidemia (20.4% vs. 44.7%, 20.4% vs. 44.9% and 12.7% vs. 21.8%, respectively, p < 0.05 for all). Follow-up was continued for at least 12 months after the index event. Younger STEMI patients had fewer major adverse cardiovascular events and fewer heart failure hospitalizations compared to the older controls (10.2 vs. 23.9% and 18.4% vs. 34.8%, respectively, p < 0.005 for both), however, 1-year mortality was similar (3.1% vs. 4.1%, p = 0.64). Conclusions Younger STEMI patients (≤ 45 years) show peculiar characteristics, with significantly higher rates of smoking and family history of premature CAD, while less prevalence of other conventional CAD risk factors. Overall MACE occurred less in younger STEMI patients; however, the mortality rate was similar to the older controls.

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Section: Discussionmentioning

confidence: 99%

Characterization of features and outcomes of young patients (< 45 years) presenting with ST-segment elevation myocardial infarction

et al. 2023

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“…Lockdowns, curfews, healthcare resources reallocation, and other similar approaches were proposed as bailout solutions for the pressing situation 3 . During the peaking waves of the pandemic, all aspects of medical practice were substantially undermined, including cancellation of elective visits and procedures, and deferral of all ''judged as non-emergency'' medical services in order to limit the spread of the virus 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Infective endocarditis presentations during the COVID-19 pandemic: Have they paid an untold toll?

Elamragy,

Samir,

Maher

et al. 2024

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Background: COVID-19 caused restrictions and re-allocation of medical resources among all healthcare services. During the peak of the pandemic, several unrelated–yet critical–conditions had silently taken their toll. Infective endocarditis (IE), owing to its non-specific clinical presentation, may have been largely mislabeled as COVID-19 in a number of cases. Results: This retrospective observational study reviewed all IE presentations at an IE unit in a university hospital during the peak of COVID-19. Patient characteristics, courses, and outcomes were compared with historical controls from our IE database published before the COVID era. We identified 30 IE cases [Group A] during the COVID-19 peak in our region (June 2021 to June 2022), with a 25% decrease compared to the usual annual rate. This is in contrast to the expected surge during the pandemic. Compared with group B (398 published IE cases from our database), group A had significantly longer symptoms-to-presentation intervals (60 [31–92] vs. 28 [14–72] days, p = 0.01). Male sex dominated both groups, but group A had significantly less pre-existing structural heart disease. Despite the more liberal use of empirical antibiotics in the COVID-era, group-A had lower rates of culture-negative IE. Compared to group B, group A demonstrated a better response to medical therapy, fewer arterial embolizations, fewer indications for surgery, and fewer overall complications, except for increased acute kidney injury. This can be explained by the abundant use of non-steroidal anti-inflammatory drugs. The data analysis strongly suggests that there might have been a natural selection or selection bias of IE patients with favorable profiles to survive the pandemic to the appropriate diagnosis. Conclusions: The diagnosis of IE and commencing the appropriate workup were significantly undermined during the COVID-19 pandemic. The inexplicable decline in IE referral rate and the favorable outcomes witnessed during the pandemic strongly suggest a referral bias and natural selection of those who survived the pandemic to the appropriate IE diagnosis.

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Resilience with the crisis: cardiology department experience to cope with the corona virus disease 2019 pandemic

Cited by 2 publications

References 1 publication

Characterization of features and outcomes of young patients (< 45 years) presenting with ST-segment elevation myocardial infarction

Characterization of features and outcomes of young patients (< 45 years) presenting with ST-segment elevation myocardial infarction

Infective endocarditis presentations during the COVID-19 pandemic: Have they paid an untold toll?

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