|
1
|
Maghaminejad F, Varaei S, Dehghan‐Nayeri N. The Process of Inefficient Self-Management in Patients With Myocardial Infarction in Prehospital: A Grounded Theory. Health Sci Rep 2025; 8:e70720. [PMID: 40303905 PMCID: PMC12037699 DOI: 10.1002/hsr2.70720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2024] [Revised: 03/29/2025] [Accepted: 04/04/2025] [Indexed: 05/02/2025] Open
Abstract
Introduction Myocardial infarction (MI) is a cardiovascular emergency that needs immediate diagnosis and treatment. utilizing incorrect strategies during a MI may lead to adverse consequences and complications. This study was conducted to explore the process of prehospital management of patients with MI. Methods This study was conducted using the grounded theory design. fifteen patients with MI and six family members were purposefully and theoretically selected from a leading hospital in Kashan, Iran. Data were collected using unstructured and semi-structured interviews and were analyzed through the constant comparison method proposed by Corbin and Strauss (2015). The length of the interviews was 40-60 min and data collection were kept on to reach data saturation. Results The patients' mean age was 70.06 years, and 53.3% of them were male. The findings were categorized into three major categories and nine subcategories. The three major categories of "fighting between awareness and preference," "taking problematic arbitrary measures," and "consulting lay people" emerged from the participants' experiences, along with the theme of "inefficient self-management." Conclusion Complex situation, unfamiliarity with MI and its management makes MI management very difficult for patients and family members. Therefore, MI-specific educations are needed to improve patients' self-management abilities.
Collapse
Affiliation(s)
| | - Shokoh Varaei
- Department of Nursing and Midwifery, Bab.CIslamic Azad UniversityBabolIran
| | - Nahid Dehghan‐Nayeri
- Department of Medical Surgical Nursing, School of Nursing & MidwiferyTehran University of Medical ScienceTehranIran
| |
Collapse
|
|
2
|
Zhong C, Mao S, Tang S, Zheng P, Peng J. Impact of COVID-19 on door-to-wire time in ST-segment elevation myocardial infarction treatment: the role of digital communication. BMC Cardiovasc Disord 2025; 25:173. [PMID: 40075270 PMCID: PMC11899889 DOI: 10.1186/s12872-025-04618-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2024] [Accepted: 03/03/2025] [Indexed: 03/14/2025] Open
Abstract
INTRODUCTION ST-segment elevation myocardial infarction (STEMI) is a life-threatening cardiovascular emergency necessitating rapid reperfusion. During the COVID-19 pandemic, healthcare providers faced the challenge of ensuring timely STEMI interventions while managing the risk of viral transmission in hospitals. This study aims to analyze changes in the door-to-wire (D-to-W) time for STEMI treatment across three pandemic phases-early pre-epidemic phase (Group C), initial lockdown phase (Group A), and intermediate normalization phase (Group B). It also examines the impact of digital communication tools, collectively referred to as "InterNet+" (e.g., Twitter, WeChat), on treatment processes. METHODS Based on data of 630 STEMI patients treated in Chest Pain Center in a particular hospital in China from 2019 to 2020, changes in D-to-W time in different groups are measured. Time intervals in STEMI treatment process are also predicted by Bayesian statistics approach. The study investigated the influence of InterNet+ utilization before and after the pandemic through a questionnaire-based assessment. RESULTS For transfer-non-emergency- treatment, the time from first-electrocardiogram to preliminary-diagnosis in Group-A is significantly longer than that in Groups-B and -C (p = 0.004, p = 0.004); the time from decision-on-intervention to catheterization-room-activation in Group-A and -B is significantly longer than that in Group-C (p = 0.003, p < 0.001). For transfer-emergency- treatment, the time from first-medical-contact to arterial-puncture in Group-A and -B is remarkably shorter than that in Group-C (p = 0.006). Meanwhile, Bayesian method performs well in forecasting time intervals, so it can provide effective assistance for STEMI treatment. The findings from the questionnaire indicated that physicians perceived a significant association between the optimal management of STEMI and an increased frequency of InterNet+ tool usage following the pandemic (p = 0.019). CONCLUSIONS The treatment and management of STEMI patients have been in dilemmas and various time intervals of D-to-W are inevitably prolonged during the COVID-19 pandemic. The implementation of InterNet + tools proved essential for minimizing delays in D-to-W and FMC-to-W times, offering a valuable strategy for enhancing STEMI care amid ongoing pandemic challenges. CLINICAL TRIAL NUMBER Not applicable.
Collapse
Affiliation(s)
- Changqing Zhong
- Department of Cardiovascular Medicine, Hunan Provincial People's Hospital, Changsha, Hunan, China
- Department of Cardiovascular Medicine, First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
- Clinical Research Center for Heart Failure in Hunan Province, Changsha, Hunan, 410006, China
| | - Shanjun Mao
- Department of Statistics, Hunan University, Changsha, Hunan, 410006, China.
| | - Shan Tang
- Department of Statistics, Hunan University, Changsha, Hunan, 410006, China
| | - Pengfei Zheng
- Department of Cardiovascular Medicine, Hunan Provincial People's Hospital, Changsha, Hunan, China
- Department of Cardiovascular Medicine, First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Jianqiang Peng
- Department of Cardiovascular Medicine, Hunan Provincial People's Hospital, Changsha, Hunan, China
- Department of Cardiovascular Medicine, First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| |
Collapse
|
|
3
|
Zhang L, Li MY, Zhi C, Zhu M, Ma H. Identification of Early Warning Signals of Infectious Diseases in Hospitals by Integrating Clinical Treatment and Disease Prevention. Curr Med Sci 2024; 44:273-280. [PMID: 38632143 DOI: 10.1007/s11596-024-2850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/19/2024] [Indexed: 04/19/2024]
Abstract
The global incidence of infectious diseases has increased in recent years, posing a significant threat to human health. Hospitals typically serve as frontline institutions for detecting infectious diseases. However, accurately identifying warning signals of infectious diseases in a timely manner, especially emerging infectious diseases, can be challenging. Consequently, there is a pressing need to integrate treatment and disease prevention data to conduct comprehensive analyses aimed at preventing and controlling infectious diseases within hospitals. This paper examines the role of medical data in the early identification of infectious diseases, explores early warning technologies for infectious disease recognition, and assesses monitoring and early warning mechanisms for infectious diseases. We propose that hospitals adopt novel multidimensional early warning technologies to mine and analyze medical data from various systems, in compliance with national strategies to integrate clinical treatment and disease prevention. Furthermore, hospitals should establish institution-specific, clinical-based early warning models for infectious diseases to actively monitor early signals and enhance preparedness for infectious disease prevention and control.
Collapse
Affiliation(s)
- Lei Zhang
- Sixth Medical Center, Chinese PLA General Hospital, Beijing, 100048, China
| | - Min-Ye Li
- The Nursing Department, Chinese PLA General Hospital, Beijing, 100853, China
| | - Chen Zhi
- The Nursing Department, Chinese PLA General Hospital, Beijing, 100853, China
| | - Min Zhu
- Sixth Medical Center, Chinese PLA General Hospital, Beijing, 100048, China
| | - Hui Ma
- The Nursing Department, Chinese PLA General Hospital, Beijing, 100853, China.
| |
Collapse
|
|
4
|
Emamzadehashemi YR, Emamzadehashemi KR, Khanghah AG, Paryad E, Sayad Noveiri MJ. Signs and symptoms of covid - 19 in patients with a history of coronary artery bypass grafting surgery. BMC Infect Dis 2024; 24:241. [PMID: 38388892 PMCID: PMC10885614 DOI: 10.1186/s12879-024-09090-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND People who have coronary artery disease are more likely to develop signs and symptoms of COVID-19 due to their special circumstances. Coronary artery bypass grafting surgery (CABG)does not cure the disease but reduces the signs and symptoms, therefore, there is a possibility of severe complications of Covid-19 after it. MATERIALS AND METHODS This study is a descriptive and cross-sectional study conducted from June to July 2020 on 200 patients who underwent CABG from February 2018 to February 2020. The instrument consisted of socio-demographic variables and COVID's signs and symptoms checklist. Data were collected by census method by telephone. Data were analyzed using descriptive statistics, Fisher's exact test, Mann Whitney U test, and logistic regression model. RESULTS The results showed that the majority of the samples were male (67%). The mean age of them was 62.02 ± 9.06 years and 10% of the m had signs and symptoms of Covid 19. Having the symptoms of COVID-19 is significant in terms of the variables of decreased sense of smell (p < 0.002), decreased sense of taste (p < 0.002), and home quarantine (p < 0.01). The logistic regression model showed decreased sense of taste (OR = 6.071, CI95%: 1.621-29.984, p < 0.009) and non-compliance with home quarantine (OR = 0.061, CI95%: 0.005-0.741, p < 0.028) were the related variables to signs and symptoms of Covid 19. CONCLUSION The results did not indicate the frequency of COVID signs and symptoms among people with a history of Coronary artery bypass grafting surgery more than healthy people in the Iranian community. Extensive studies are suggested in this regard.
Collapse
Affiliation(s)
| | | | - Atefeh Ghanbari Khanghah
- Social Determinants of Health Research Center (SDHRC), Department of Nursing, Guilan University of Medical Sciences, Rasht, Iran
| | - Ezzat Paryad
- Department of Nursing, GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Marzieh Jahani Sayad Noveiri
- Department of Medical Surgery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
| |
Collapse
|
|
5
|
Eftekhar Z, Haybar H, Mohebbi A, Saki N. Cardiac Complications and COVID-19: A Review of Life-threatening Co-morbidities. Curr Cardiol Rev 2024; 20:1-12. [PMID: 38415433 PMCID: PMC11284692 DOI: 10.2174/011573403x279782240206091322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/23/2023] [Accepted: 01/19/2024] [Indexed: 02/29/2024] Open
Abstract
The novel 2019 coronavirus disease (COVID-19) was first reported in the last days of December 2019 in Wuhan, China. The presence of certain co-morbidities, including cardiovascular diseases (CVDs), are the basis for worse outcomes in patients with COVID-19. Relevant English-language literature was searched and retrieved from the Google Scholar search engine and PubMed database up to 2023 using COVID-19, SARS-CoV-2, Heart failure, Myocardial infarction, and Arrhythmia and Cardiac complication as keywords. Increased hemodynamic load, ischemia-related dysfunction, ventricular remodeling, excessive neurohumoral stimulation, abnormal myocyte calcium cycling, and excessive or insufficient extracellular matrix proliferation are associated with heart failure (HF) in COVID-19 patients. Inflammatory reaction due to the excessive release of inflammatory cytokines, leads to myocardial infarction (MI) in these patients. The virus can induce heart arrhythmia through cardiac complications, hypoxia, decreased heart hemodynamics, and remarkable inflammatory markers. Moreover, studies have linked cardiac complications in COVID-19 with poor outcomes, extended hospitalization time, and increased mortality rate. Patients with COVID-19 and CVDs are at higher mortality risk and they should be given high priority when receiving the treatment and intensive care during hospitalization.
Collapse
Affiliation(s)
- Zeinab Eftekhar
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Haybar
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Mohebbi
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Najmaldin Saki
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
|
6
|
Agrawal RS, Yusuf J, Mahajan B, Mehta V, Mandal S, Mukhopadhyay S. Effect of prasugrel versus ticagrelor on coronary microcirculation in patients undergoing pharmacoinvasive strategy - acute and short-term results. Coron Artery Dis 2023; 34:381-388. [PMID: 37471285 DOI: 10.1097/mca.0000000000001265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Both ticagrelor and prasugrel are class I recommendations for treatment of ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) [ 1 ]. But clinical outcomes with the two drugs are conflicting which might be due to differential effects on coronary microcirculation. No study to date had compared the effects of prasugrel or ticagrelor on coronary microcirculation in patients undergoing pharmacoinvasive PCI (pPCI). AIM AND OBJECTIVE To compare the effects of prasugrel and ticagrelor on coronary microcirculation in STEMI patients undergoing pPCI as assessed by Myocardial Blush Grade (MBG). The secondary aim was to assess flow in the infarct-related artery by corrected thrombolysis in myocardial infarction (TIMI) frame count (cTFC) and whether a differential effect if detected on coronary microcirculation translated in improvement in left ventricular ejection fraction assessed at 6 months. MATERIAL AND METHODS A total of 240 patients with STEMI were evaluated in this open-label randomized control trial who initially underwent thrombolysis and later PCI (from 24 to 48 h) post-successful thrombolysis. The study subjects were randomized to receive either ticagrelor ( n = 120) or prasugrel ( n = 120) in 1 : 1 ratio 2 h prior to elective PCI. Patients underwent PCI according to standard protocol and post-procedure cTFC and MBG were compared. Patients were also followed up for 6 months to compare ejection fractions in both groups. We also assessed the effect of the two drugs on bleeding complications during hospitalization and over 6-month follow-up period. RESULTS There were no significant differences between the two groups with respect to baseline characteristics. Prasugrel administration resulted in higher MBG Grade 3 (50.86% vs 33.89%, P = 0.012) and lower cTFC (17.14 ± 4.08 vs 19.3 ± 4.06, P < 0.01). Improvement in ejection fraction was significantly higher with prasugrel compared to ticagrelor (10.29% ± 15.2 vs 4.66% ± 13.5, P = 0.003). Bleeding events at 6 months follow-up according to TIMI classification were similar in both the groups (11.86% vs 6.9%, P = 0.39). CONCLUSION Prasugrel produces greater improvement in coronary microcirculation than Ticagrelor resulting in improved myocardial salvage in patients of STEMI undergoing pPCI.
Collapse
Affiliation(s)
| | | | - Bhawna Mahajan
- Department of Biochemistry, GB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | | | - Sunil Mandal
- Department of Cardiology
- Department of Biochemistry, GB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | | |
Collapse
|
|
7
|
Khedr A, Hennawi HA, Khan MK, Elbanna M, Jama AB, Proskuriakova E, Mushtaq H, Mir M, Boike S, Rauf I, Eissa A, Urtecho M, Koritala T, Jain N, Goyal L, Surani S, Khan SA. Effect of fibrinolytic therapy on ST-elevation myocardial infarction clinical outcomes during the COVID-19 pandemic: A systematic review and meta-analysis. World J Cardiol 2023; 15:309-323. [PMID: 37397830 PMCID: PMC10308269 DOI: 10.4330/wjc.v15.i6.309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/30/2023] [Accepted: 05/19/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND ST-elevation myocardial infarction (STEMI) is the result of transmural ischemia of the myocardium and is associated with a high mortality rate. Primary percutaneous coronary intervention (PPCI) is the recommended first-line treatment strategy for patients with STEMI. The timely delivery of PPCI became extremely challenging for STEMI patients during the coronavirus disease 2019 (COVID-19) pandemic, leading to a projected steep rise in mortality. These delays were overcome by the shift from first-line therapy and the development of modern fibrinolytic-based reperfusion. It is unclear whether fibrinolytic-based reperfusion therapy is effective in improving STEMI endpoints. AIM To determine the incidence of fibrinolytic therapy during the COVID-19 pandemic and its effects on STEMI clinical outcomes. METHODS PubMed, Google Scholar, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were queried from January 2020 up to February 2022 to identify studies investigating the effect of fibrinolytic therapy on the prognostic outcome of STEMI patients during the pandemic. Primary outcomes were the incidence of fibrinolysis and the risk of all-cause mortality. Data were meta-analyzed using the random effects model to derive odds ratios (OR) and 95% confidence intervals. Quality assessment was carried out using the Newcastle-Ottawa scale. RESULTS Fourteen studies including 50136 STEMI patients (n = 15142 in the pandemic arm; n = 34994 in the pre-pandemic arm) were included. The mean age was 61 years; 79% were male, 27% had type 2 diabetes, and 47% were smokers. Compared with the pre-pandemic period, there was a significantly increased overall incidence of fibrinolysis during the pandemic period [OR: 1.80 (1.18 to 2.75); I2= 78%; P = 0.00; GRADE: Very low]. The incidence of fibrinolysis was not associated with the risk of all-cause mortality in any setting. The countries with a low-and middle-income status reported a higher incidence of fibrinolysis [OR: 5.16 (2.18 to 12.22); I2 = 81%; P = 0.00; GRADE: Very low] and an increased risk of all-cause mortality in STEMI patients [OR: 1.16 (1.03 to 1.30); I2 = 0%; P = 0.01; GRADE: Very low]. Meta-regression analysis showed a positive correlation of hyperlipidemia (P = 0.001) and hypertension (P < 0.001) with all-cause mortality. CONCLUSION There is an increased incidence of fibrinolysis during the pandemic period, but it has no effect on the risk of all-cause mortality. The low- and middle-income status has a significant impact on the all-cause mortality rate and the incidence of fibrinolysis.
Collapse
Affiliation(s)
- Anwar Khedr
- Department of Internal Medicine, BronxCare Health System, Bronx, NY 10457, United States
| | - Hussam Al Hennawi
- Department of Internal Medicine, Jefferson Abington Hospital, Abington, PA 19001, United States
| | - Muhammed Khuzzaim Khan
- Department of Internal Medicine, Dow University of Health Science, Karachi 74200, Pakistan
| | - Mostafa Elbanna
- Department of Internal Medicine, Rochester Regional Health, Rochester, NY 14621, United States
| | - Abbas B Jama
- Department of Critical Care, Mayo Clinic Health System, Mankato, MN 56001, United States
| | | | - Hisham Mushtaq
- Department of Internal Medicine, St. Vincent's Medical Center, Bridgeport, CT 06606, United States
| | - Mikael Mir
- Department of Medicine, University of Minnesota, Minneapolis, MN 55455, United States
| | - Sydney Boike
- Department of Medicine, University of Minnesota, Minneapolis, MN 55455, United States
| | - Ibtisam Rauf
- Department of Medicine, St. George's University, School of Medicine, St George SW17 0RE, Grenada
| | - Aalaa Eissa
- Department of Medicine, KFS University, KFS 33511, Egypt
| | - Meritxell Urtecho
- Department of Medicine, Robert D and Patricia E. Kern Center of Health Care Delivery, Mayo Clinic, Rochester, MN 55905, United States
| | - Thoyaja Koritala
- Department of Hospital Medicine, Mayo Clinic Health System, Mankato, MN 56001, United States
| | - Nitesh Jain
- Department of Medicine, Mayo Clinic Health System, Mankato, MN 56001, United States
| | - Lokesh Goyal
- Department of Hospital Medicine, Christus Sphon Hospital-shoreline, Corpus Christo, TX 78404, United States
| | - Salim Surani
- Department of Pulmonary, Critical Care & Sleep Medicine, Texas A&M University, College Station, TX 77843, United States.
| | - Syed A Khan
- Department of Critical Care Medicine, Mayo Clinic Health System, Mankato, MN 56001, United States
| |
Collapse
|
|
8
|
López-Palop R, Lozano Í, Carrillo P. COVID-19 pandemic: National outbreak and acute coronary syndrome. Collateral damages? Int J Cardiol 2023; 375:144-146. [PMID: 36493929 DOI: 10.1016/j.ijcard.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Ramón López-Palop
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.
| | - Íñigo Lozano
- Servicio de Cardiología, Hospital Universitario de Cabueñes, Gijón, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain; Universidad de Oviedo, Spain
| | - Pilar Carrillo
- Sección de Cardiología, Hospital Universitario San Juan de Alicante, Spain
| |
Collapse
|
|
9
|
Kyriakoulis KG, Trontzas IP, Kyriakoulis IG, Terentes-Printzios D, Papageorgiou NG, Fyta E, Kotteas E, Kollias A. ST-Segment Elevation Myocardial Infarction (STEMI) Management in the Era of COVID-19: A Systematic and Critical Review of Published Guidance Reports. Rev Cardiovasc Med 2023; 24:54. [PMID: 39077423 PMCID: PMC11273141 DOI: 10.31083/j.rcm2402054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 07/31/2024] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) had a major impact on healthcare systems worldwide. During the early phase of the pandemic many elective procedures were postponed. At the same time, the safe and effective management of medical emergencies such as ST-segment elevation myocardial infarction (STEMI) has been a challenge. Methods A systematic literature search was conducted aiming to identify published guidance reports by national or international societies regarding the management of patients suffering STEMI in the era of COVID-19. Results Among 1681 articles initially retrieved, six fulfilled the inclusion criteria and were included in the systematic review. Two reports were international consensus documents, while four reports were national guidance statements from Asian countries (Taiwan, India, Iran, and China). Most documents were drafted during the early phase of the pandemic. According to the international consensus documents, percutaneous coronary intervention (PCI) should be regarded as the reperfusion method of choice. On the other hand, in three out of four national consensus statements (Taiwan, Iran and China) fibrinolysis was considered as the reperfusion method of choice for STEMI in suspected/confirmed patients with COVID-19, unless contraindicated or in the presence of high cardiovascular risk clinical features. Authors of all documents underlined the need for early COVID-19 testing in patients with STEMI to better determine the next therapeutical steps. Conclusions National and international consensus statements for STEMI management in the era of COVID-19 have been published mainly during the early peak phase of the pandemic. Authors recognise that these recommendations are mainly based on expert opinions and observational data. As global immunization rates increase and methods for rapid COVID-19 detection are widely available, the implementation of traditional evidence-based practices used before the pandemic is becoming more feasible.
Collapse
Affiliation(s)
- Konstantinos G Kyriakoulis
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | - Ioannis P Trontzas
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | - Ioannis G Kyriakoulis
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | - Dimitrios Terentes-Printzios
- 1st Department of Cardiology, Athens Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Nikolaos-Georgios Papageorgiou
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | - Eleni Fyta
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | - Elias Kotteas
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | - Anastasios Kollias
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece
| |
Collapse
|
|
10
|
Kapusta J, Chudzik M, Kałuzińska-Kołat Ż, Kołat D, Burzyńska M, Jankowski P, Babicki M. Do selected lifestyle parameters affect the severity and symptoms of COVID-19 among elderly patients? The retrospective evaluation of individuals from the STOP-COVID registry of the PoLoCOV study. J Infect Public Health 2023; 16:143-153. [PMID: 36521330 PMCID: PMC9743693 DOI: 10.1016/j.jiph.2022.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/30/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Older individuals tend to include less physical activity in their routine and are more prone to chronic diseases and severe medical complications, making them the most burdened group that is losing years of life due to pandemic-related premature mortality. This research aimed to assess the lifestyle factors that affect the COVID-19 course among patients ≥ 65 years old. METHODS The study included 568 convalescents (64.1% women and 35.9% men) with persistent clinical symptoms after isolation. The mean age was 70.41 ± 4.64 years (minimum: 65 years; maximum: 89 years). The patients completed the questionnaire during their in-person visit to the medical center. The survey included questions regarding their health status when suffering from COVID-19, basic sociodemographic data, and medical history concerning chronic conditions and lifestyle. RESULTS Physical inactivity (p < 0.001) and feeling nervous (p = 0.026) increased the risk of having a severe disease course. Coronary artery disease raised both the risk of a severe disease course (p = 0.002) and the number of present symptoms up to 4 weeks (p = 0.039). Sleep disturbances increased the number of symptoms during infection (p = 0.001). The occurrence of any symptoms was also associated with the female sex (p = 0.004). The severity of the course was associated with longer persistent symptoms (p < 0.001) and a greater number of symptoms (p = 0.004); those with a more severe course were also at a greater risk of persistent symptoms for up to 4 weeks (p = 0.006). Senior citizens in the third pandemic wave suffered with more severe disease (p = 0.004), while illness during the fourth (p = 0.001) and fifth (p < 0.001) waves was associated with a lower risk of persistent symptoms for up to 4 weeks. The disease duration was significantly shorter among vaccinated patients (p = 0.042). CONCLUSIONS Elderly COVID-19 patients should re-think their lifestyle habits to consider a physical activity level that is adjusted to their abilities, in order to decrease the risk of a severe disease course and to further limit both the number and duration of symptoms. The research was carried out in accordance with the Declaration of Helsinki, and approval from the Bioethics Committee of Lodz Regional Medical Chamber to conduct the study was obtained (approval number 0115/2021). The PoLoCOV-Study ClinicalTrials.gov identifier is NCT05018052.
Collapse
Affiliation(s)
- Joanna Kapusta
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 70-445 Lodz, Poland.
| | - Michał Chudzik
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre for Postgraduate Education, 01-813 Warsaw, Poland; Boruta Medical Center, 95-100 Zgierz, Poland.
| | - Żaneta Kałuzińska-Kołat
- Boruta Medical Center, 95-100 Zgierz, Poland; Department of Experimental Surgery, Medical University of Lodz, 90-136 Lodz, Poland
| | - Damian Kołat
- Boruta Medical Center, 95-100 Zgierz, Poland; Department of Experimental Surgery, Medical University of Lodz, 90-136 Lodz, Poland
| | - Monika Burzyńska
- Department of Epidemiology and Biostatistics, Social and Preventive Medicine of the Medical University of Lodz, 90-752 Lodz, Poland
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre for Postgraduate Education, 01-813 Warsaw, Poland
| | - Mateusz Babicki
- Department of Family Medicine, Wroclaw Medical University, 51-141 Wroclaw, Poland
| |
Collapse
|
|
11
|
Cesaro A, De Michele G, Gragnano F, Calabrò P. How has COVID-19 impacted the care of patients with acute coronary syndromes? Expert Rev Cardiovasc Ther 2023; 21:1-4. [PMID: 36534926 DOI: 10.1080/14779072.2023.2159809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Arturo Cesaro
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,Division of Cardiology, A.O.R.N. "Sant'Anna E San Sebastiano", Caserta, Italy
| | - Gianantonio De Michele
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,Division of Cardiology, A.O.R.N. "Sant'Anna E San Sebastiano", Caserta, Italy
| | - Felice Gragnano
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,Division of Cardiology, A.O.R.N. "Sant'Anna E San Sebastiano", Caserta, Italy
| | - Paolo Calabrò
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,Division of Cardiology, A.O.R.N. "Sant'Anna E San Sebastiano", Caserta, Italy
| |
Collapse
|
|
12
|
Aguirre-Milachay E, León-Figueroa DA, Chumán-Sánchez M, Romani L, Runzer-Colmenares FM. Factors associated with mortality in patients hospitalized for COVID-19 admitted to a tertiary hospital in Lambayeque, Peru, during the first wave of the pandemic. PLoS One 2023; 18:e0285133. [PMID: 37167338 PMCID: PMC10174592 DOI: 10.1371/journal.pone.0285133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/15/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread worldwide, becoming a long-term pandemic. OBJECTIVES To analyze the factors associated with mortality in patients hospitalized for COVID-19 in a tertiary hospital in the Lambayeque region of Peru. METHODS A retrospective cohort study of patients with a diagnosis of COVID-19, hospitalized in a hospital in northern Peru, was conducted from March to September 2020. RESULTS Of the 297 patients studied, 69% were women, the mean age was 63.99 years (SD = ±15.33 years). Hypertension was the most frequent comorbidity (36.67%), followed by diabetes mellitus (24.67%) and obesity (8.33%). The probability of survival at 3 days of ICU stay was 65.3%, at 7 days 24.2%, and 0% on day 14. Risk factors associated with mortality in patients hospitalized for COVID-19 are age, male sex, tachypnea, low systolic blood pressure, low peripheral oxygen saturation, impaired renal function, elevated IL-6 and elevated D-dimer. CONCLUSIONS Mortality in hospitalized patients with COVID-19 was 51.18 per 100 persons, Mortality was found to be associated with hypertension, type of infiltrating, and sepsis.
Collapse
Affiliation(s)
- Edwin Aguirre-Milachay
- Servicio de Geriatría, Departamento de Medicina, Hospital Nacional Almanzor Aguinaga Asenjo, Chiclayo, Peru
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
| | - Darwin A León-Figueroa
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
- Emerge, Unidad de Investigación en Enfermedades Emergentes y Cambio Climático, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Marisella Chumán-Sánchez
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
- Sociedad Científica de Estudiantes de Medicina Veritas (SCIEMVE), Chiclayo, Perú
| | - Luccio Romani
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
- Emerge, Unidad de Investigación en Enfermedades Emergentes y Cambio Climático, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | |
Collapse
|
|
13
|
Ma J, Zhou S, Li N, Dong X, Maimaitiming M, Yue D, Jin Y, Zheng ZJ. Quality of healthcare and admission rates for acute cardiac events during COVID-19 pandemic: a retrospective cohort study on ST-segment-elevation myocardial infarction in China. BMJ Open 2022; 12:e059720. [PMID: 36357000 PMCID: PMC9659714 DOI: 10.1136/bmjopen-2021-059720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To evaluate changes in admission rates for and quality of healthcare of ST-segment-elevation myocardial infarction (STEMI) during the period of the COVID-19 outbreak and postoutbreak. METHODS We conducted a retrospective study among patients with STEMI in the outbreak time and the postoutbreak time. DESIGN To examine the changes in the admission rates and in quality of healthcare, by comparison between periods of the postoutbreak and the outbreak, and between the postoutbreak and the corresponding periods. SETTING Data for this analysis were included from patients discharge diagnosed with STEMI from all the hospitals of Suzhou in each month of the year until the end of July 2020. PARTICIPANTS 1965 STEMI admissions. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the number of moecondary outcomnthly STEMI admissions, and the secondary outcomes were the quality metrics of STEMI healthcare. RESULTS There were a 53% and 38% fall in daily admissions at the phase of outbreak and postoutbreak, compared with the 2019 corresponding. There remained a gap in actual number of postoutbreak admissions at 306 and the predicted number at 497, an estimated 26 deaths due to STEMI would have been caused by not seeking healthcare. Postoutbreak period of 2020 compared with corresponding period of 2019, the percentage of cases transferred by ambulance decreased from 9.3% to 4.2% (p=0.013), the door-to-balloon median time increased from 17.5 to 34.0 min (p=0.001) and the rate of percutaneous coronary intervention (PCI) therapy declined from 71.3% to 60.1% (p=0.002). CONCLUSIONS The impact of public health restrictions may lead to unexpected out-of-hospital deaths and compromised quality of healthcare for acute cardiac events. Delay or absence in patients should be continuously considered avoiding the secondary disaster of the pandemic. System delay should be modifiable for reversing the worst clinical outcomes from the COVID-19 outbreak, by coordination measures with focus on the balance between timely PCI procedure and minimising contamination of cardiac catheterisation rooms.
Collapse
Affiliation(s)
- Junxiong Ma
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Shuduo Zhou
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Na Li
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Xuejie Dong
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Mailikezhati Maimaitiming
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Dahai Yue
- Department of Health Policy and Management, University of Maryland at College Park, College Park, Maryland, USA
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
- Bill & Melinda Gates Foundation China Office, Beijing, China
| |
Collapse
|
|
14
|
Nappi F, Nappi P, Gambardella I, Avtaar Singh SS. Thromboembolic Disease and Cardiac Thrombotic Complication in COVID-19: A Systematic Review. Metabolites 2022; 12:889. [PMID: 36295791 PMCID: PMC9611930 DOI: 10.3390/metabo12100889] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/10/2022] [Accepted: 09/16/2022] [Indexed: 01/08/2023] Open
Abstract
The coronavirus 2019 pandemic has affected many healthcare systems worldwide. While acute respiratory distress syndrome (ARDS) has been well-documented in COVID-19, there are several cardiovascular complications, such as myocardial infarction, ischaemic stroke, and pulmonary embolism, leading to disability and death. The link between COVID-19 and increasing thrombogenicity potentially occurs due to numerous different metabolic mechanisms, ranging from endothelial damage for direct virus infection, associated excessive formation of neutrophil extracellular traps (NETs), pathogenic activation of the renin-angiotensin-aldosterone system (RAAS), direct myocardial injury, and ischemia induced by respiratory failure, all of which have measurable biomarkers. A search was performed by interrogating three databases (MEDLINE; MEDLINE In-Process and Other Non-Indexed Citations, and EMBASE). Evidence from randomized controlled trials (RCT), prospective series, meta-analyses, and unmatched observational studies were evaluated for the processing of the algorithm and treatment of thromboembolic disease and cardiac thrombotic complications related to COVID-19 during SARS-CoV-2 infection. Studies out with the SARS-Cov-2 infection period and case reports were excluded. A total of 58 studies were included in this analysis. The role of the acute inflammatory response in the propagation of the systemic inflammatory sequelae of the disease plays a major part in determining thromboembolic disease and cardiac thrombotic complication in COVID-19. Some of the mechanisms of activation of these pathways, alongside the involved biomarkers noted in previous studies, are highlighted. Inflammatory response led to thromboembolic disease and cardiac thrombotic complications in COVID-19. NETs play a pivotal role in the pathogenesis of the inflammatory response. Despite moving into the endemic phase of the disease in most countries, thromboembolic complications in COVID-19 remain an entity that substantially impacts the health care system, with long-term effects that remain uncertain. Continuous monitoring and research are required.
Collapse
Affiliation(s)
- Francesco Nappi
- Department of Cardiac Surgery, Centre Cardiologique du Nord, 93200 Saint-Denis, France
| | - Pierluigi Nappi
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Ivancarmine Gambardella
- Department of Cardiothoracic Surgery, Weill Cornell Medicine–New York Presbyterian Medical Center, New York, NY 10065, USA
| | | |
Collapse
|
|
15
|
Akkaif MA, Bitar AN, Al-Kaif LAIK, Daud NAA, Sha’aban A, Noor DAM, Abd Aziz F, Cesaro A, SK Abdul Kader MA, Abdul Wahab MJ, Khaw CS, Ibrahim B. The Management of Myocardial Injury Related to SARS-CoV-2 Pneumonia. J Cardiovasc Dev Dis 2022; 9:307. [PMID: 36135452 PMCID: PMC9503627 DOI: 10.3390/jcdd9090307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 02/07/2023] Open
Abstract
The global evolution of the SARS-CoV-2 virus is known to all. The diagnosis of SARS-CoV-2 pneumonia is expected to worsen, and mortality will be higher when combined with myocardial injury (MI). The combination of novel coronavirus infections in patients with MI can cause confusion in diagnosis and assessment, with each condition exacerbating the other, and increasing the complexity and difficulty of treatment. It would be a formidable challenge for clinical practice to deal with this situation. Therefore, this review aims to gather literature on the progress in managing MI related to SARS-CoV-2 pneumonia. This article reviews the definition, pathogenesis, clinical evaluation, management, and treatment plan for MI related to SARS-CoV-2 pneumonia based on the most recent literature, diagnosis, and treatment trial reports. Many studies have shown that early diagnosis and implementation of targeted treatment measures according to the different stages of disease can reduce the mortality rate among patients with MI related to SARS-CoV-2 pneumonia. The reviewed studies show that multiple strategies have been adopted for the management of MI related to COVID-19. Clinicians should closely monitor SARS-CoV-2 pneumonia patients with MI, as their condition can rapidly deteriorate and progress to heart failure, acute myocardial infarction, and/or cardiogenic shock. In addition, appropriate measures need to be implemented in the diagnosis and treatment to provide reasonable care to the patient.
Collapse
Affiliation(s)
- Mohammed Ahmed Akkaif
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Malaysia
| | - Ahmad Naoras Bitar
- Department of Clinical Pharmacy, Michel Sayegh College of Pharmacy, Aqaba University of Technology, South of Aqaba, South Beach Road, Opposite Aqaba Development Corporation Stores, Aqaba 910122, Jordan
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Malaysian Allied Health Sciences Academy, Jalan SP 2, Bandar Saujana Putra, Jenjarom 42610, Malaysia
| | - Laith A. I. K. Al-Kaif
- Department of Medical Laboratory Techniques, Al Mustaqbal University College, Hillah 51001, Babylon, Iraq
| | | | - Abubakar Sha’aban
- School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4YS, UK
| | | | | | - Arturo Cesaro
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | | | | | - Chee Sin Khaw
- Department of Cardiology, Penang General Hospital, George Town 10990, Malaysia
| | - Baharudin Ibrahim
- Faculty of Pharmacy, University of Malaya, Kuala Lumpur 50603, Malaysia
| |
Collapse
|
|
16
|
Idowu O, Oshola H, Idowu J, Omosuyi A. A tropical tertiary neurosurgical centre response to COVID-19 pandemic and its effect on neurosurgical practices. Afr Health Sci 2022; 22:512-519. [PMID: 36910393 PMCID: PMC9993300 DOI: 10.4314/ahs.v22i3.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background COVID-19 pandemic may decrease the quantum of care for patients with neurosurgical conditions. Objectives To determine outpatient clinic (OPC) patient load, neurosurgical procedures volume and disease spectrum following the institution of a new care protocol during the ongoing COVID-19 pandemic and compare with previous practice data in our institution. Methods A monocentric retrospective analysis of all patients requiring neurosurgical care over a 2-year period. Results There was a 42.4% reduction in OPC attendance and 41.8% reduction in surgical procedures in 2020 compared to 2019. There was >60 percent reduction in the volume of surgery that was done at the onset and peak of the pandemic but this has normalized in November 2020 despite the resurgence of COVID-19, after the institution of a new care protocol. Neurotrauma procedures (29.6%) were the most common neurosurgical operation in 2020 while congenital malformation surgery (37.3%) was the most common procedure performed in 2019. Conclusions The ongoing COVID-19 pandemic initially led to significant decrease in quantum and spectra of patients who presented at the OPC and for neurosurgical procedures. Instituted local protocol and Teleclinics, if added to clinical care armamentarium, may help to improve on the low patient attendance during pandemics.
Collapse
Affiliation(s)
- Olufemi Idowu
- Lagos State University College of Medicine, Surgery (Neurosurgery Unit).,Lagos State University Teaching Hospital, Surgery (Neurological Surgery Unity)
| | - Hammed Oshola
- Lagos State University Teaching Hospital, Surgery (Neurological Surgery Unity)
| | - Jeuel Idowu
- Lagos State University Teaching Hospital, Surgery (Neurological Surgery Unity)
| | - Ademola Omosuyi
- Lagos State University Teaching Hospital, Surgery (Neurological Surgery Unity)
| |
Collapse
|
|
17
|
Kovalevskaiia L, Pakhlevanzade A, Ivanchenko S, Kupriianova L, Volianska V, Plakida A, Panigrahi P. Cardiovascular Disorders as a Result of COVID-19. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Based on the literature data, we present current literature information about frequency, main spectrum, and prognostic value of cardiovascular complications of the SARS-CoV-2 infection. We have highlighted in detail the variants of cardiovascular disorders in the case of patients with SARS-CoV-2 infection caused by concomitant diseases of hypertension, acute coronary syndrome, myocardial infarction, arrhythmias, virus-associated myocarditis, and heart failure. We have described the adverse cardiovascular effects of medicines of different groups used to treat COVID-19 disease and possible medical interactions. We have summarized some current recommendations on cardiotonic and cardioprotective therapy in the case of patients with cardiovascular complications.
Collapse
|
|
18
|
Huang K, Zhang Y, Yang F, Luo X, Long W, Hou X. Effect of Enalapril Combined with Bisoprolol on Cardiac Function and Inflammatory Indexes in Patients with Acute Myocardial Infarction. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:6062450. [PMID: 36034944 PMCID: PMC9410778 DOI: 10.1155/2022/6062450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 11/20/2022]
Abstract
Objective The use of enalapril in combination with bisoprolol in patients with acute myocardial infarction (AMI) was studied for its effect on cardiac function and inflammatory parameters. Methods Sixty-two cases of AMI patients admitted to our clinic from November 2019 to November 2021 were selected for the study and grouped according to the random number table method, those enrolled were given conventional treatment such as oxygenation, absolute bed rest, and sedation, and administered low molecular heparin, aspirin, atorvastatin calcium tablets, clopidogrel, and nitrates. The control group (31 cases) was treated with enalapril maleate folic acid tablets, and the treatment group (31 cases) was treated with bisoprolol fumarate tablets on top of the control group, and the efficacy, adverse effects, cardiac function, inflammatory indexes, and oxidative stress indexes of the two arms were contrasted. Results The incidence of adverse reactions in the therapy cohort was 12.90% higher than that in the controlled arm, but the discrepancy was not medically relevant (P < 0.05). The SOD level was larger than the concentration in the corresponding drug therapy group, and the MDA level was lower than the concentration in the respective test cases (P < 0.05); the incidence of 12.90% adverse reactions in the treatment period was lower than that of 16.13% in the specific drug therapy group, but the variance was not scientifically evident (P > 0.05). Conclusion Enalapril application combined with bisoprolol in AMI patients is beneficial to boost the efficacy, promote the improvement of cardiac function, reduce the inflammatory response, and improve the oxidative stress with fewer adverse effects, which can ensure the therapeutic security.
Collapse
Affiliation(s)
- Kaiyue Huang
- Internal Medicine-Cardiovascular Department, The People's Hospital of Yue Chi, No. 22, Jianshe Road East, Yuechi County, Sichuan Province, China
| | - Yubin Zhang
- Internal Medicine-Cardiovascular Department, The People's Hospital of Yue Chi, No. 22, Jianshe Road East, Yuechi County, Sichuan Province, China
| | - Fulin Yang
- Internal Medicine-Cardiovascular Department, The People's Hospital of Yue Chi, No. 22, Jianshe Road East, Yuechi County, Sichuan Province, China
| | - Xue Luo
- Internal Medicine-Cardiovascular Department, The People's Hospital of Yue Chi, No. 22, Jianshe Road East, Yuechi County, Sichuan Province, China
| | - Weiying Long
- Internal Medicine-Cardiovascular Department, The People's Hospital of Yue Chi, No. 22, Jianshe Road East, Yuechi County, Sichuan Province, China
| | - Xingzhi Hou
- Internal Medicine-Cardiovascular Department, The People's Hospital of Yue Chi, No. 22, Jianshe Road East, Yuechi County, Sichuan Province, China
| |
Collapse
|
|
19
|
Zuo M, Xiang S, Bhattacharyya S, Chen Q, Zeng J, Li C, Deng Y, Siu C, Yin L. Management strategies and outcomes of acute coronary syndrome (ACS) during Covid-19 pandemic. BMC Cardiovasc Disord 2022; 22:242. [PMID: 35614403 PMCID: PMC9130978 DOI: 10.1186/s12872-022-02680-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 05/13/2022] [Indexed: 02/08/2023] Open
Abstract
Background The COVID-19 outbreak represents a significant challenge to international health. Several studies have reported a substantial decrease in the number of patients attending emergency departments with acute coronary syndromes (ACS) and there has been a concomitant rise in early mortality or complications during the COVID-19 pandemic. A modified management system that emphasizes nearby treatment, safety, and protection, alongside a closer and more effective multiple discipline collaborative team was developed by our Chest Pain Center at an early stage of the pandemic. It was therefore necessary to evaluate whether the newly adopted management strategies improved the clinical outcomes of ACS patients in the early stages of the COVID-19 pandemic. Methods Patients admitted to our Chest Pain Center from January 25th to April 30th, 2020 based on electronic data in the hospitals ACS registry, were included in the COVID-19 group. Patients admitted during the same period (25 January to 30 April) in 2019 were included in the pre-COVID-19 group. The characteristics and clinical outcomes of the ACS patients in the COVID-19 period group were compared with those of the ACS patients in the pre-COVID-19 group. Multivariate logistic regression analyses were used to identify the risk factors associated with clinical outcomes.
Results The number of patients presenting to the Chest Pain Center was reduced by 45% (p = 0.01) in the COVID-19 group, a total of 223 ACS patients were included in the analysis. There was a longer average delay from the onset of symptom to first medical contact (FMC) (1176.9 min vs. 625.2 min, p = 0.001) in the COVID-19 period group compared to the pre-COVID-19 group. Moreover, immediate percutaneous coronary intervention (PCI) (80.1% vs. 92.3%, p = 0.008) was performed less frequently on ACS patients in the COVID-19 group compared to the pre-COVID-19 group. However, more ACS patients received thrombolytic therapy (5.8% vs. 0.6%, p = 0.0052) in the COVID-19 group than observed in the pre-COVID-19 group. Interestingly, clinical outcome did not worsen in the COVID-19 group when cardiogenic shock, sustained ventricular tachycardia, ventricular fibrillation or use of mechanical circulatory support (MCS) were compared against the pre-COVID-19 group (13.5% vs. 11.6%, p = 0.55). Only age was independently associated with composite clinical outcomes (HR = 1.3; 95% CI 1.12–1.50, p = 0.003). Conclusion This retrospective study showed that the adverse outcomes were not different during the COVID-19 pandemic compared to historical control data, suggesting that newly adopted management strategies might provide optimal care for ACS patients. Larger sample sizes and longer follow-up periods on this issue are needed in the future.
Collapse
Affiliation(s)
- Mingliang Zuo
- Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Shoubo Xiang
- West China Hospital, Sichuan University, Chengdu, China
| | - Sanjib Bhattacharyya
- College of Pharmaceutical Sciences, Southwest University, Beibei, Chongqing, China
| | - Qiuyi Chen
- Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Jie Zeng
- Department of Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Chunmei Li
- Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Yan Deng
- Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Chungwah Siu
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Room 1929, Block K, 102 Pokfulam Road, Hong Kong SAR, China.
| | - Lixue Yin
- Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
| |
Collapse
|
|
20
|
Sakamoto A, Yanishi K, Shoji K, Kawamata H, Hori Y, Fujioka A, Kodama N, Kohno Y, Kitamura M, Furukawa K, Nakamura T, Matoba S. Impact of Door-to-Balloon Time Reduction Depending on the Killip Classification in Patients with ST-Segment Elevation Myocardial Infarction Transported by Emergency Medical Services. Int Heart J 2022; 63:226-234. [PMID: 35354744 DOI: 10.1536/ihj.21-583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The coronavirus disease 2019 pandemic occurred in several countries, making the conventional medical system difficult to maintain. Recent recommendations aim to prevent nosocomial infections and infections among health care workers. Therefore, establishing a cardiovascular medical system under an emergency for patients with ST-segment elevation myocardial infarction (STEMI) is desired. This study aimed to determine the relationship between prognosis and door-to-balloon time (DBT) shortening based on the severity on arrival.This retrospective, multi-center, observational study included 1,127 consecutive patients with STEMI. These patients were transported by emergency medical services and underwent primary percutaneous coronary intervention. Patients were stratified according to the Killip classification: Killip 1 (n = 738) and Killip ≥ 2 (n = 389) groups.Patients in the Killip ≥ 2 group were older, with more females, and more severity on arrival than those in the Killip 1 group. The 30-day mortality rate in the Killip 1 and Killip ≥ 2 groups was 2.2% and 18.0%, respectively. The Killip ≥ 2 group had a significant difference in the 30-day mortality between patients with DBT ≤ 90 minutes and those with DBT > 90 minutes; however, this did not occur in the Killip 1 group. Furthermore, multivariate analysis revealed that DBT ≤ 90 minutes was not a significant predictive factor in the Killip 1 group; however, it was an independent predictive factor in the Killip ≥ 2 group.DBT shortening affected the 30-day mortality in STEMI patients with Killip ≥ 2, although not those with Killip 1.
Collapse
Affiliation(s)
- Akira Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Kenji Yanishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Keisuke Shoji
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Hirofumi Kawamata
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Yusuke Hori
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Ayumu Fujioka
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Naotoshi Kodama
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Yoshio Kohno
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | | | - Takeshi Nakamura
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | | |
Collapse
|
|
21
|
Olabi V, Wilberforce T, Elsaid K, Sayed ET, Abdelkareem MA. Impact of COVID-19 on the Renewable Energy Sector and Mitigation Strategies. Chem Eng Technol 2022; 45:558-571. [PMID: 35465220 PMCID: PMC9015258 DOI: 10.1002/ceat.202100504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 01/14/2022] [Accepted: 02/02/2022] [Indexed: 12/01/2022]
Abstract
This review explores the impact of the COVID-19 pandemic on the renewable energy (RE) sector, especially in countries with the highest RE capacities, e.g., the USA, China, India, and the EU. It highlights stimulus packages put in place by governments worldwide and their sustainability to cushion the RE sector. Commissioning of RE projects has stalled due to lack of funding allocation and interruptions in the supply of equipment and components due to lockdown measures. Despite the need to fund COVID-19 vaccination programs and other related health services, the world must not neglect other sectors of the economy, creating more problems, such as worsening the climate change situation in the long run. This review aims to present the information needed to sustain future energy during the COVID-19 global pandemic.
Collapse
Affiliation(s)
| | - Tabbi Wilberforce
- Aston UniversityMechanical Engineering and DesignSchool of Engineering and Applied ScienceAston TriangleB4 7ETBirminghamUK
| | - Khaled Elsaid
- Texas A&M University at QatarChemical Engineering ProgramP.O. 23874DohaQatar
| | - Enas Taha Sayed
- University of SharjahCentre for Advanced Materials ResearchP.O. Box 27272SharjahUnited Arab Emirates
- Minia UniversityChemical Engineering Department, Faculty of EngineeringEgypt
| | - Mohammad Ali Abdelkareem
- University of SharjahCentre for Advanced Materials ResearchP.O. Box 27272SharjahUnited Arab Emirates
- Minia UniversityChemical Engineering Department, Faculty of EngineeringEgypt
- University of SharjahDepartment of Sustainable and Renewable Energy EngineeringP.O. Box 27272SharjahUnited Arab Emirates
| |
Collapse
|
|
22
|
Matteucci A, Bonanni M, Versaci F, Frati G, Peruzzi M, Sangiorgi G, Biondi-Zoccai G, Massaro G. Cardiovascular medicine: a year in review. Minerva Cardiol Angiol 2022; 70:40-55. [PMID: 34713681 DOI: 10.23736/s2724-5683.21.05816-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cardiovascular medicine is facing several challenges in the current era, dominated by the rapid spread of a previously unknown virus around the world. Indeed, the 2020 COVID-19 pandemic set the course of cardiovascular science and education in an extraordinary way, hogging the attention of the medical community. Notably, while COVID-19 impacted research progress, there has been considerable effort in exploring topics of great interest, from the management of acute coronary syndromes to new horizons in the treatment of heart failure, from novelties in the surgical treatment of cardiovascular disease to new data on implantable cardiac devices, and from new diagnostic applications of multimodal imaging techniques to relevant basic science findings. Minerva Cardiology and Angiology, formerly Minerva Cardioangiologica, has strived to inform its readers on these topics and novelties, aiming for a succinct yet poignant melding of timeliness and accuracy. Accordingly, the purpose of this narrative review is to highlight and summarize the major research and review articles published during 2020. In particular, we provide a broad overview of the novelties identifying six major areas of interest in the field of cardiovascular sciences in which new evidences have contributed to improving prevention, diagnosis and treatment of heart and vessels diseases.
Collapse
Affiliation(s)
- Andrea Matteucci
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy -
| | - Michela Bonanni
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy
| | - Francesco Versaci
- Unit of Intensive Care, Hemodynamics, and Cardiology, S. Maria Goretti Hospital, Latina, Italy
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome
- IRCCS NEUROMED, Pozzilli, Italy
| | - Mariangela Peruzzi
- Mediterranea Cardiocentro, Napoli, Italy
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - Giuseppe Sangiorgi
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Giuseppe Biondi-Zoccai
- IRCCS NEUROMED, Pozzilli, Italy
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | | |
Collapse
|
|
23
|
Toscano O, Cosentino N, Campodonico J, Bartorelli AL, Marenzi G. Acute Myocardial Infarction During the COVID-19 Pandemic: An Update on Clinical Characteristics and Outcomes. Front Cardiovasc Med 2022; 8:648290. [PMID: 35004867 PMCID: PMC8733166 DOI: 10.3389/fcvm.2021.648290] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 11/26/2021] [Indexed: 12/12/2022] Open
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) has rapidly become a worldwide pandemic. On top of respiratory complications, COVID-19 is associated with major direct and indirect cardiovascular consequences, with the latter probably being even more relevant, especially in the setting of time-dependent cardiovascular emergencies. A growing amount of data suggests a dramatic decline in hospital admissions for acute myocardial infarction (AMI) worldwide during the COVID-19 pandemic, mostly since patients did not activate emergency medical systems because hospitals were perceived as dangerous places regarding the infection risk. Moreover, during the COVID-19 pandemic, patients with AMI had a significantly higher in-hospital mortality compared to those admitted before COVID-19, potentially due to late arrival to the hospital. Finally, no consensus has been reached regarding the most adequate healthcare management pathway for AMI and shared guidance on how to handle patients with AMI during the pandemic is still needed. In this review, we will provide an update on epidemiology, clinical characteristics, and outcomes of patients with AMI during the COVID-19 pandemic, with a special focus on its collateral cardiac impact.
Collapse
Affiliation(s)
- Olga Toscano
- Centro Cardiologico Monzino, I.R.C.C.S., Milan, Italy
| | - Nicola Cosentino
- Centro Cardiologico Monzino, I.R.C.C.S., Milan, Italy.,Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | | | - Antonio L Bartorelli
- Centro Cardiologico Monzino, I.R.C.C.S., Milan, Italy.,Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy
| | | |
Collapse
|
|
24
|
boudihi A, Derar C, Mazouzi M, ismaili N, el ouafi N. Association of pulmonary embolism and acute coronary syndrome during COVID-19 infection: Case report and a brief review. Ann Med Surg (Lond) 2022; 73:103152. [PMID: 34900243 PMCID: PMC8642827 DOI: 10.1016/j.amsu.2021.103152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE COVID 19 infection is considered a potentially serious disease since it is responsible for important respiratory and cardiovascular complications with a high morbid-mortality. CASE PRESENTATION We report the case of a 54-year-old diabetic patient with hypertension who was admitted for heart failure with a reduced LVEF of 23% triggered by a pulmonary embolism and an acute coronary syndrome in the context of COVID-19 infection. CLINICAL DISCUSSION Indeed, these complications may be secondary to a prothrombotic and hypercoagulable state as well as endothelial dysfunction caused by the vascular and systemic inflammation and cytokine storm induced by SARS-CoV-2. Although the clinical polymorphism of COVID 19 infection is recognized, the association of myocardial ischemia with pulmonary embolism is uncommon and of adverse prognosis. This justifies a rapid and adapted multidisciplinary management. CONCLUSION In the absence of contraindication, thromboprohylaxis should be initiated for all hospitalized patients with COVID-19 to minimize the risk of thromboembolic complications.
Collapse
Affiliation(s)
- Abdelaziz boudihi
- Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
- Department of Cardiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco
| | - Charmake Derar
- Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
- Department of Cardiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco
| | - Mosaab Mazouzi
- Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
- Department of Cardiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco
| | - Nabila ismaili
- Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
- Department of Cardiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco
| | - Noha el ouafi
- Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
- Department of Cardiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco
| |
Collapse
|
|
25
|
Rahman A, Chakraborty C, Anwar A, Karim MR, Islam MJ, Kundu D, Rahman Z, Band SS. SDN-IoT empowered intelligent framework for industry 4.0 applications during COVID-19 pandemic. CLUSTER COMPUTING 2022; 25:2351-2368. [PMID: 34341656 PMCID: PMC8318841 DOI: 10.1007/s10586-021-03367-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/29/2021] [Accepted: 07/18/2021] [Indexed: 05/09/2023]
Abstract
The industrial ecosystem has been unprecedentedly affected by the COVID-19 pandemic because of its immense contact restrictions. Therefore, the manufacturing and socio-economic operations that require human involvement have significantly intervened since the beginning of the outbreak. As experienced, the social-distancing lesson in the potential new-normal world seems to force stakeholders to encourage the deployment of contactless Industry 4.0 architecture. Thus, human-less or less-human operations to keep these IoT-enabled ecosystems running without interruptions have motivated us to design and demonstrate an intelligent automated framework. In this research, we have proposed "EdgeSDN-I4COVID" architecture for intelligent and efficient management during COVID-19 of the smart industry considering the IoT networks. Moreover, the article presents the SDN-enabled layer, such as data, control, and application, to effectively and automatically monitor the IoT data from a remote location. In addition, the proposed convergence between SDN and NFV provides an efficient control mechanism for managing the IoT sensor data. Besides, it offers robust data integration on the surface and the devices required for Industry 4.0 during the COVID-19 pandemic. Finally, the article justified the above contributions through particular performance evaluations upon appropriate simulation setup and environment.
Collapse
Affiliation(s)
- Anichur Rahman
- National Institute of Textile Engineering and Research (NITER), Constituent Institute of the University of Dhaka, Savar, Dhaka, Bangladesh
| | - Chinmay Chakraborty
- Electronics and Communication Engineering, Birla Institute of Technology, Mesra, Jharkhand India
| | - Adnan Anwar
- Centre for Cyber Security Resaerch and Innovation (CSRI), Deakin University, Melbourne, VIC 3220 Australia
| | - Md. Razaul Karim
- Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | | | - Dipanjali Kundu
- National Institute of Textile Engineering and Research (NITER), Constituent Institute of the University of Dhaka, Savar, Dhaka, Bangladesh
| | - Ziaur Rahman
- Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Shahab S. Band
- National Yunlin University of Science and Technology, 123 University Road, Section 3, Douliu, Taiwan
| |
Collapse
|
|
26
|
Takahashi T, Ota Y, Ota K, Suzuki S, Sano R, Shiota M. Robotic-assisted total hysterectomy with low pneumoperitoneal pressure (6 mmHg) and use of surgical plume evacuator system to minimize potential airborne particles according to the joint statement on minimally invasive gynecologic surgery during the COVID-19 pandemic: A case report from Japan. Gynecol Minim Invasive Ther 2022; 11:127-130. [PMID: 35746902 PMCID: PMC9212180 DOI: 10.4103/gmit.gmit_131_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 10/29/2020] [Accepted: 12/31/2020] [Indexed: 12/01/2022] Open
Abstract
We presented a case of uncontrolled genital bleeding caused by subserosal fibroid and treated by robotic-assisted hysterectomy during the coronavirus disease 2019 (COVID-19) pandemic. A 49-year-old woman had severe anemia with hypermenorrhea due to submucosal fibroid. Hysterectomy was deemed necessary to control genital bleeding. However, at that time, the number of confirmed COVID-19 cases has been increasing in Japan. Serious concerns have been raised about the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) dissemination during minimally invasive surgery due to pneumoperitoneum-associated aerosolization of particles. We tried to prevent the spread of surgical plume by performing surgery under low pneumoperitoneal pressure at 6 mmHg and by using an evacuation/filtration system. As a result, we successfully performed robotic-assisted hysterectomy with minimized risk of spreading surgical plume-containing aerosol particles into the operating room. It is essential to follow the guidelines issued by the relevant societies and act accordingly to reduce the risk of SARS-CoV-2 infection in medical settings while performing surgery. We hope that our experience will help prevent secondary cases of future SARS-CoV-2 infections.
Collapse
|
|
27
|
Colorado HA, Mendoza DE, Lin HT, Gutierrez-Velasquez E. Additive manufacturing against the Covid-19 pandemic: a technological model for the adaptability and networking. JOURNAL OF MATERIALS RESEARCH AND TECHNOLOGY 2022; 16:1150-1164. [PMID: 35865362 PMCID: PMC8686453 DOI: 10.1016/j.jmrt.2021.12.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 12/10/2021] [Indexed: 05/05/2023]
Abstract
This investigation analyzes the main contributions that additive manufacturing (AM) technology provides to the world in fighting against the pandemic COVID-19 from a materials and applications perspective. With this aim, different sources, which include academic reports, initiatives, and industrial companies, have been systematically analyzed. The AM technology applications include protective masks, mechanical ventilator parts, social distancing signage, and parts for detection and disinfection equipment (Ju, 2020). There is a substantially increased number of contributions from AM technology to this global issue, which is expected to continuously increase until a sound solution is found. The materials and manufacturing technologies in addition to the current challenges and opportunities were analyzed as well. These contributions came from a lot of countries, which can be used as a future model to work in massive collaboration, technology networking, and adaptability, all lined up to provide potential solutions for some of the biggest challenges the human society might face in the future.
Collapse
Affiliation(s)
- Henry A Colorado
- CCComposites Laboratory, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - David E Mendoza
- CCComposites Laboratory, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Hua-Tay Lin
- School of Electromechanical Engineering, Guangdong University of Technology, Guangzhou, 510006, China
| | - Elkin Gutierrez-Velasquez
- Faculty of Mechanical, Electronic and Biomedical Engineering (FIMEB), Universidad Antonio Nariño. Medellin, Colombia
| |
Collapse
|
|
28
|
COVID-19 Infection: A Novel Fatal Pandemic of the World in 2020. PRACTICAL CARDIOLOGY 2022. [PMCID: PMC7893320 DOI: 10.1016/b978-0-323-80915-3.00003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In the last days of 2019, a new coronavirus was found in Wuhan, China, in the patients with the signs of an unknown respiratory syndrome for the first time. It was called COVID-19 and in just a few months the biggest pandemic happened in the world. In several months of this outbreak, many studies were published and different aspects of this infection were evaluated. In this chapter, a review of the infection with COVID-19 including signs, symptoms, and methods of diagnosis, with the emphasis on the cardiovascular complications and management of the patients are mentioned. Unfortunately, until now, no definite treatment or vaccination is found and the prevalence of this fatal infection is increasing each day. The best way to prevent COVID-19 is still self-protection and education to all members of society.
Collapse
|
|
29
|
Varney JA, Dong VS, Tsao T, Sabir MS, Rivera AT, Ghula S, Moriles KE, Cherukuri ML, Fazal R, Azevedo CB, Mohamed RM, Jackson GR, Fleming SE, Rochez DE, Abbas KS, Shah JH, Minh LHN, Osman F, Rafla SM, Huy NT. COVID-19 and arrhythmia: An overview. J Cardiol 2021; 79:468-475. [PMID: 35074257 PMCID: PMC8632592 DOI: 10.1016/j.jjcc.2021.11.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/03/2021] [Accepted: 11/01/2021] [Indexed: 12/15/2022]
Abstract
Arrhythmias in COVID-19 patients are associated with hypoxia, myocardial ischemia, cytokines, inflammation, electrolyte abnormalities, pro-arrhythmic or QT-prolonging medications, and underlying heart conditions such as severe congestive heart failure, inherited arrhythmia syndromes, or congenital heart conditions. In the pediatric population, multisystem inflammatory syndrome can lead to cardiac injury and arrhythmias. In addition, arrhythmias and cardiac arrests are most prevalent in the critically ill intensive care unit COVID-19 patient population. This review presents an overview of the association between COVID-19 and arrhythmias by detailing possible pathophysiological mechanisms, existing knowledge of pro-arrhythmic factors, and results from studies in adult and pediatric COVID-19 populations, and the clinical implications.
Collapse
Affiliation(s)
- Joseph A Varney
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Vinh S Dong
- AU/UGA Medical Partnership, Internal Medicine, Athens, GA, USA
| | - Tiffany Tsao
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Mariam S Sabir
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Amanda T Rivera
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Suhaib Ghula
- The University of Buckingham School of Medicine, Buckingham, United Kingdom
| | | | | | - Rahim Fazal
- AU/UGA Medical Partnership, Internal Medicine, Athens, GA, USA
| | - Chelsea B Azevedo
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Rana Mk Mohamed
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Garrett R Jackson
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Shannon E Fleming
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Diana E Rochez
- American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
| | | | | | - Le Huu Nhat Minh
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Faizel Osman
- Department of Cardiology, University Hospital Coventry, Coventry, United Kingdom
| | - Samir M Rafla
- Department of Cardiology and Angiology, Alexandria University, Alexandria, Egypt
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
| |
Collapse
|
|
30
|
O'Sullivan P, Younger J, Van Pelt N, O'Malley S, Lenturut-Katal D, Hirschfeld CB, Vitola JV, Cerci R, Williams MC, Shaw LJ, Raggi P, Villines TC, Dorbala S, Choi AD, Cohen Y, Goebel B, Malkovskiy E, Randazzo M, Pascual TNB, Pynda Y, Dondi M, Paez D, Einstein AJ, Better N. Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID). Heart Lung Circ 2021; 30:1477-1486. [PMID: 34053885 PMCID: PMC8126176 DOI: 10.1016/j.hlc.2021.04.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/13/2021] [Accepted: 04/20/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. METHODS A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. RESULTS In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p<0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p<0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. CONCLUSION A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology.
Collapse
Affiliation(s)
| | - John Younger
- Royal Brisbane Hospital, Brisbane, Qld, Australia; University of Queensland, Brisbane, Qld, Australia
| | | | - Sue O'Malley
- Christchurch Hospital, Christchurch, New Zealand
| | | | - Cole B Hirschfeld
- Department of Medicine, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA
| | | | | | - Michelle C Williams
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Leslee J Shaw
- Department of Medicine, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Paolo Raggi
- Department of Medicine and Division of Cardiology, University of Alberta, Edmonton, Canada
| | | | | | - Andrew D Choi
- The George Washington University School of Medicine, Washington, DC, USA
| | - Yosef Cohen
- Technion Israel Institute of Technology, Haifa, Israel
| | - Benjamin Goebel
- Department of Medicine, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Eli Malkovskiy
- Department of Medicine, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA; Seymour, Paul and Gloria Milstein Division of Cardiology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA
| | - Michael Randazzo
- Department of Medicine, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA
| | | | | | | | - Diana Paez
- International Atomic Energy Agency, Vienna, Austria
| | - Andrew J Einstein
- Department of Medicine, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA; Seymour, Paul and Gloria Milstein Division of Cardiology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA; Department of Radiology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA
| | - Nathan Better
- Royal Melbourne Hospital, Melbourne, Vic, Australia; University of Melbourne, Melbourne, Vic, Australia.
| |
Collapse
|
|
31
|
Massaro G, Lecis D, Martuscelli E, Chiricolo G, Sangiorgi GM. Clinical Features and Management of COVID-19–Associated Hypercoagulability. Card Electrophysiol Clin 2021; 14:41-52. [PMID: 35221084 PMCID: PMC8556574 DOI: 10.1016/j.ccep.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
|
32
|
Poonia A, Giridhara P, Arora YK, Sharma V. ST-elevation myocardial infarction in patients with Covid-19 -- A case series. IHJ CARDIOVASCULAR CASE REPORTS (CVCR) 2021. [PMCID: PMC8522676 DOI: 10.1016/j.ihjccr.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Choice of initial revascularization strategy is unclear in Covid-19 patients with acute ST-elevation myocardial infarction (STEMI). We present clinical, angiographic profile, and response to therapy in 09 covid-19 STEMI patients. STEMI was the initial presentation in 6 and developed in first-week of covid symptoms in 3 patients. D-dimer and C-reactive protein was raised in all. Right coronary artery was the most common culprit artery. Five patients underwent primary-PCI. Three out of 4 patients who underwent thrombolysis, required rescue-PCI. All 9 patients had high thrombus burden with total or near-total occlusion of culprit artery and 3 of them required thrombosuction.
Collapse
|
|
33
|
Yamaji K, Mitsutake Y, Nakano M, Nakamura T, Fukumoto Y. Robotic-assisted percutaneous coronary intervention in the COVID-19 pandemic. J Cardiol 2021; 79:455-459. [PMID: 34454811 PMCID: PMC8373664 DOI: 10.1016/j.jjcc.2021.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/12/2022]
Abstract
Coronavirus disease-2019 (COVID-19) has a profound impact on the health care system worldwide. In the COVID-19 pandemic, hospitals are required to halt elective surgeries and procedures for preventing nosocomial infections and saving medical resources. In these situations, emergency procedures are required for life-threatening cardiovascular diseases such as acute coronary syndrome and cardiogenic shock. To prevent the spread of COVID-19, a social distance is essentially required. In ordinary percutaneous coronary intervention (PCI), operators manipulate the devices standing at the patient's tableside during the whole procedure, which may involve a certain risk of exposure to patients with COVID-19. A robotic-assisted PCI (R-PCI) allows operators to manipulate devices remotely, sitting at a cockpit located several meters away from the patient, and in addition, the assistant can be at the foot of the bed, much further from the access site. R-PCI can help to minimize the radiation exposure and the amount of person-to-person contact, and consequently may reduce the risk for the exposure to the virus.
Collapse
Affiliation(s)
- Kazunori Yamaji
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshiaki Mitsutake
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan.
| | - Masaharu Nakano
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takuya Nakamura
- Center of Clinical Engineering, Kurume University Hospital, Kurume, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan
| |
Collapse
|
|
34
|
Firman D, Mangkuanom AS, Iryuza N, Fahri I, Artha IMJR, Mulia E, Syukri M, Yonas E, Pranata R, Alkatiri AA. Decrease in the Number of Patients Presenting With ST-Segment Elevation Myocardial Infarction Across Catheterization Centers in Indonesia During the Coronavirus Disease 2019 Pandemic. Front Cardiovasc Med 2021; 8:676592. [PMID: 34490361 PMCID: PMC8418056 DOI: 10.3389/fcvm.2021.676592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has become a global problem, put a heavy burden on the health care system, and resulted in many fatalities across the globe. A reduction in the number of cardiac emergencies, especially ST-segment elevation myocardial infarction (STEMI), is observed worldwide. In this study, we aimed to analyze the trends of cases and presentation of STEMI across several cardiac catheterization centers in Indonesia. Method: This retrospective study was performed by combining medical record data from five different hospitals in Indonesia. We compared data from the time period between February to June 2019 with those between February and June 2020. Patients who were diagnosed with STEMI and underwent primary percutaneous coronary intervention (PPCI) procedures were included in the study. Results: There were 41,396 emergency department visits in 2019 compared with 29,542 in 2020. The number of patients with STEMI declined significantly from 338 in 2019 to 190 in 2020. Moreover, the total number of PPCI procedures reduced from 217 in 2019 to 110 in 2020. The proportion of PPCI was not significantly reduced (64.2 vs. 57.9%). The majority of the patients were men, with a mean age of 54 years in 2019 and 55 years in 2020. We observed a significantly longer door-to-balloon time in 2020 than in 2019 (p < 0.001). We also observed a difference in the door-to-balloon time and ischemic time between the two periods. Conclusion: We observed a decline in the number of patients presenting with STEMI to our centers. However, we observed no significant decline in the percentage of PPCI performed across our centers during this pandemic.
Collapse
Affiliation(s)
- Doni Firman
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Arwin Saleh Mangkuanom
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Nanda Iryuza
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Ismir Fahri
- Department of Cardiology and Vascular Medicine, Mohammad Yunus General Hospital, Bengkulu, Indonesia
| | - I Made Junior Rina Artha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Indonesia
| | - Erwin Mulia
- Department of Cardiology and Vascular Medicine, Bumi Waras Hospital, Lampung, Indonesia
| | - Muhammad Syukri
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Andalas, DR. M. Djamil General Hospital, Padang, Indonesia
| | - Emir Yonas
- Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia
| | - Raymond Pranata
- Faculty of Medicine, Universitas Pelita Harapan, Banten, Indonesia
| | - Amir Aziz Alkatiri
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| |
Collapse
|
|
35
|
Chaganti BT, Cherukuri L, Birudaraju D, Roy SK, Budoff MJ. The evolving pandemic of COVID-19 and increasing role of cardiac computed tomography. Coron Artery Dis 2021; 32:372-374. [PMID: 32897900 DOI: 10.1097/mca.0000000000000962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Bhanu T Chaganti
- Division of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas
| | - Lavanya Cherukuri
- Division of cardiology, The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, California, USA
| | - Divya Birudaraju
- Division of cardiology, The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, California, USA
| | - Sion K Roy
- Division of cardiology, The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, California, USA
| | - Matthew J Budoff
- Division of cardiology, The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, California, USA
| |
Collapse
|
|
36
|
Kaur I, Behl T, Aleya L, Rahman H, Kumar A, Arora S, Bulbul IJ. Artificial intelligence as a fundamental tool in management of infectious diseases and its current implementation in COVID-19 pandemic. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:40515-40532. [PMID: 34036497 PMCID: PMC8148397 DOI: 10.1007/s11356-021-13823-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 04/05/2021] [Indexed: 04/15/2023]
Abstract
The world has never been prepared for global pandemics like the COVID-19, currently posing an immense threat to the public and consistent pressure on the global healthcare systems to navigate optimized tools, equipments, medicines, and techno-driven approaches to retard the infection spread. The synergized outcome of artificial intelligence paradigms and human-driven control measures elicit a significant impact on screening, analysis, prediction, and tracking the currently infected individuals, and likely the future patients, with precision and accuracy, generating regular international and national data on confirmed, recovered, and death cases, as the current status of 3,820,869 infected patients worldwide. Artificial intelligence is a frontline concept, with time-saving, cost-effective, and productive access to disease management, rendering positive results in physician assistance in high workload conditions, radiology imaging, computational tomography, and database formulations, to facilitate availability of information accessible to researchers all over the globe. The review tends to elaborate the role of industry 4.0 technology, fast diagnostic procedures, and convolutional neural networks, as artificial intelligence aspects, in potentiating the COVID-19 management criteria and differentiating infection in SARS-CoV-2 positive and negative groups. Therefore, the review successfully supplements the processes of vaccine development, disease management, diagnosis, patient records, transmission inhibition, social distancing, and future pandemic predictions, with artificial intelligence revolution and smart techno processes to ensure that the human race wins this battle with COVID-19 and many more combats in the future.
Collapse
Affiliation(s)
- Ishnoor Kaur
- Chitkara College of Pharmacy, Chitkara University, Chandigarh, Punjab, India
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Chandigarh, Punjab, India.
| | - Lotfi Aleya
- Chrono-Environment Laboratory, UMR CNRS 6249, Bourgogne Franche-Comté University, Besançon, France
| | - Habibur Rahman
- Department of Global Medical Science, Wonju College of Medicine, Yonsei University, Seoul, South Korea
- Department of Pharmacy, Southeast University, Banani, Dhaka, 1213, Bangladesh
| | - Arun Kumar
- Chitkara College of Pharmacy, Chitkara University, Chandigarh, Punjab, India
| | - Sandeep Arora
- Chitkara College of Pharmacy, Chitkara University, Chandigarh, Punjab, India
| | - Israt Jahan Bulbul
- Department of Pharmacy, Southeast University, Banani, Dhaka, 1213, Bangladesh
| |
Collapse
|
|
37
|
Kamarullah W, Sabrina AP, Rocky MA, Gozali DR. Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis. Indian Heart J 2021; 73:404-412. [PMID: 34474750 PMCID: PMC8257902 DOI: 10.1016/j.ihj.2021.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/20/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION There has been a concern whether the decrease in ST-segment elevation myocardial infarction (STEMI) cases during the COVID-19 pandemic era is related to unsatisfactory performance of STEMI systems of care as well as worsening of the clinical outcomes in STEMI patients. Thus, our meta-analysis was conducted to evaluate this matter. METHODS We compared the predetermined variables in this meta-analysis during the early and late pandemic. Using a combination of adapted search terms to fit the requirements of several search engines (PubMed, EuropePMC, SCOPUS, ProQuest, and EBSCOhost), we reviewed all observational studies citing our outcomes of interest before and during the outbreak. RESULTS Thirty-five records comprising a total of 62,247 participants were identified. Overall, our meta-analysis showed that there was a huge reduction of nearly 80% for STEMI admission during the outbreak (n = 10,263) in contrast to before the outbreak period (n = 51,984). STEMI patients who were admitted during the outbreak received less primary PCI and had longer symptom-to-FMC (first medical contact) time along with prolonged door-to-balloon (DTB) time. A decrease in the achievement of final TIMI (thrombolysis in myocardial infarction) 3 flow after primary PCI was also observed in this study. However, the number of in-hospital mortality was similar between two groups. CONCLUSION There was a decrease in the STEMI care performance and worsening of clinical outcomes in STEMI patients, especially in the early pandemic period. Overall, concise health services must be implemented following a responsibility to obey health protocols to deliver high-quality services related to STEMI systems of care amidst the global pandemic.
Collapse
Affiliation(s)
- William Kamarullah
- Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
| | | | | | | |
Collapse
|
|
38
|
Carrión Arcela JP, Custodio-Sánchez P, Coca Caycho TG. [Impact of the COVID-19 pandemic on ST - elevation myocardial infarction management in a reference center of northern Peru]. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2021; 2:159-166. [PMID: 37727520 PMCID: PMC10506557 DOI: 10.47487/apcyccv.v2i3.148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/14/2021] [Indexed: 09/21/2023]
Abstract
Objective To evaluate the impact of the COVID-19 pandemic on the ST-Elevation myocardial infarction (STEMI) management in a reference center of northern Peru. Methods Observational, analytical, retrospective cohort-type study, derivated from the Acute Coronary Syndrome registry of the Almanzor Aguinaga Asenjo National Hospital. The characteristics of the patients with STEMI and their 30-day outcomes were compared in 02 cohorts according to the time of medical care: prior to the pandemic or during the pandemic. Results During the COVID-19 pandemic, hospitalizations for STEMI decreased by 53%, there was a greater use of fibrinolysis to the detriment of primary angioplasty, with increases in the time of first medical contact (100 vs. 240 minutes, p = 0.006) and ischemic time to percutaneous coronary intervention (900 vs. 2880 minutes, p <0.001). This generated a higher frequency of post-infarction heart failure (21.1% vs. 46.7%, p = 0.002) and a lower left ventricular ejection fraction at discharge (49.2 +/- 8.6 vs 44.8 +/- 9.3, p = 0.009), without an increase in in-hospital cardiovascular mortality. Conclusions The COVID-19 has had a negative impact on the treatment of patients with STEMI. We found less hospitalizations, prolonged reperfusion times, and higher frequency of post-infarction heart failure and lower left ventricular ejection fraction at discharge.
Collapse
Affiliation(s)
- Jean Pierre Carrión Arcela
- Servicio de Cardiología. Hospital Luis Heysen Incháustegui. EsSalud. Chiclayo. Perú.Servicio de CardiologíaHospital Luis Heysen Incháustegui. EsSaludChiclayoPerú
| | - Piero Custodio-Sánchez
- Servicio de Cardiología. Hospital Nacional Almanzor Aguinaga Asenjo. EsSalud. Chiclayo. Perú.Servicio de CardiologíaHospital Nacional Almanzor Aguinaga Asenjo. EsSaludChiclayoPerú
| | - Tatiana Gisell Coca Caycho
- Servicio de Cardiología. Hospital Nacional Almanzor Aguinaga Asenjo. EsSalud. Chiclayo. Perú.Servicio de CardiologíaHospital Nacional Almanzor Aguinaga Asenjo. EsSaludChiclayoPerú
| |
Collapse
|
|
39
|
Mehmood K, Bao Y, Petropoulos GP, Abbas R, Abrar MM, Saifullah, Mustafa A, Soban A, Saud S, Ahmad M, Hussain I, Fahad S. Investigating connections between COVID-19 pandemic, air pollution and community interventions for Pakistan employing geoinformation technologies. CHEMOSPHERE 2021; 272:129809. [PMID: 33582510 PMCID: PMC7846247 DOI: 10.1016/j.chemosphere.2021.129809] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/19/2021] [Accepted: 01/27/2021] [Indexed: 09/01/2023]
Abstract
Several major cities that witnessed heavy air pollution by particulate matter (PM2.5) concentration and nitrogen dioxide (NO2) have contributed to high rate of infection and severity of the coronavirus disease (COVID-19) pandemic. Owing to the negative impact of COVID-19 on health and economy, it is imperative to predict the pandemic trend of the COVID-19 outbreak. Pakistan is one of the mostly affected countries by recent COVID-19 pandemic in terms of COVID-cases and economic crises. Like other several Asian countries to combat the virus impacts, Pakistan implemented non-pharmacological interventions (NPI), such as national lockdowns. The current study investigates the effect of major interventions across three out of four provinces of Pakistan for the period from the start of the COVID-19 in March 22, 2020 until June 30, 2020, when lockdowns were started to be eased. High-resolution data on NO2 was recorded from Sentinel-5's Precursor spacecraft with TROPOspheric Monitoring Instrument (Sentinel-5P TROPOMI). Similarly, PM2.5 data were collected from sampling sties to investigate possible correlation among these pollutants and COVID-19. In addition, growth and susceptible-infected-recovered (SIR) models utilizing time-series data of COVID-19 from February 26 to December 31, 2020, with- and without NPI that encompass the predicted number of infected cases, peak time, impact on the healthcare system and mortality in Pakistan. Maximum mean PM2.5 concentration of 108 μgm-3 was recorded for Lahore with the range from 51 to 215 μgm-3, during strict lockdown (L), condition. This is three times higher than Pak-EPA and US-EPA and four times for WHO guidelines, followed by Peshawar (97.2 and 58 ± 130), Islamabad (83 and 158 ± 58), and Karachi (78 and 50 ± 140). The majority of sampling sites in Lahore showed NO2 levels higher than 8.75E-5 (mol/m2) in 2020 compared to 2019 during "L" period. The susceptible-infected-recovered (SIR) model depicted a strong correlation (r) between the predicted and reported cases for Punjab (r = 0.79), Sindh (r = 0.91), Khyber Pakhtunkhwa (KPK) (r = 94) and Islamabad (r = 0.85). Findings showed that major NPI and lockdowns especially have had a large effect on minimizing transmission. Continued community intervention should be undertaken to keep transmission of SARS-CoV-2 under control in cities where higher incidence of COVID-19 cases until the vaccine is available. This study provides a methodological framework that if adopted can assist epidemiologist and policy makers to be well-prepared in advance in cities where PM2.5 concentration and NO2 levels are already high in order to minimize the potential risk of further spread of COVID-19 cases.
Collapse
Affiliation(s)
- Khalid Mehmood
- School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing, 210044, China
| | - Yansong Bao
- Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters, CMA Key Laboratory for Aerosol-Cloud-Precipitation, Nanjing University of Information Science & Technology, Nanjing 210044, China; School of Atmospheric Physics, Nanjing University of Information Science & Technology, Nanjing 210044, China.
| | - George P Petropoulos
- Department of Geography, Harokopio University of Athens, El. Venizelou 70, Kallithea, 17671, Athens, Greece
| | - Roman Abbas
- Multan Medical and Dental College, Multan, Pakistan
| | - Muhammad Mohsin Abrar
- National Engineering Laboratory for Improving Quality of Arable Land, Institute of Agricultural Resources and Regional Planning, Chinese Academy of Agricultural Sciences, Beijing, 100081, China
| | - Saifullah
- Department of Environmental Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Adnan Mustafa
- National Engineering Laboratory for Improving Quality of Arable Land, Institute of Agricultural Resources and Regional Planning, Chinese Academy of Agricultural Sciences, Beijing, 100081, China
| | - Ahmad Soban
- Software Engineering Department Balochistan University of Information Technology, Engineering and Management Sciences (BUITEMS), Pakistan
| | - Shah Saud
- Department of Horticulture, Northeast Agricultural University, Harbin, China
| | - Manzoor Ahmad
- Department of Agriculture, Bacha Khan University Charsadda, 24461, Khyber Pakhtunkhwa, Pakistan
| | - Izhar Hussain
- Department of Plant Breeding & Genetics, University of Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Shah Fahad
- Department of Agronomy, University of Haripur, Khyber Pakhtunkhwa, Pakistan.
| |
Collapse
|
|
40
|
Dharma S, Dakota I, Firdaus I, Danny SS, Zamroni D, Yudha A, Susanto A, Siswanto BB. Performance of Primary Angioplasty for STEMI during the COVID-19 Outbreak. Int J Angiol 2021; 30:148-154. [PMID: 34054273 DOI: 10.1055/s-0041-1727133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
There has been concern whether the declining cases of ST-segment elevation myocardial infarction (STEMI) during the coronavirus disease 2019 (COVID-19) outbreak associate with primary angioplasty performance. We assessed the performance of primary angioplasty in a tertiary care hospital in Jakarta, Indonesia, by comparing the door-to-device (DTD) time and thrombolysis in myocardial infarction (TIMI) flow after angioplasty between two periods of admission: during the outbreak of COVID-19 (March 1 to May 31, 2020) and before the outbreak (March 1, to May 31, 2019). Overall, there was a relative reduction of 44% for STEMI admission during the outbreak ( n = 116) compared with before the outbreak ( N = 208). Compared with before the outbreak period ( n = 141), STEMI patients who admitted during the outbreak and received primary angioplasty ( n = 70) had similar median symptom onset-to-angioplasty center admission (360 minutes for each group), similar to radial access uptake (90 vs. 89.4%, p = 0.88) and left anterior descending infarct-related artery (54.3 vs. 58.9%, p = 0.52). The median DTD time and total ischemia time were longer (104 vs. 81 minutes, p < 0.001, and 475.5 vs. 449 minutes, p = 0.43, respectively). However, the final achievement of TIMI 3 flow was similar (87.1 vs. 87.2%), and so was the in-hospital mortality (5.7 vs. 7.8%). During the COVID-19 outbreak, we found a longer DTD time for primary angioplasty, but the achievement of final TIMI 3 flow and in-hospital mortality were similar as compared with before the outbreak. Thus, primary angioplasty should remain the standard of care for STEMI during the COVID-19 outbreak.
Collapse
Affiliation(s)
- Surya Dharma
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Indonesian Cardiovascular Research Center, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Iwan Dakota
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Isman Firdaus
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Siska Suridanda Danny
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Dian Zamroni
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Ardi Yudha
- Indonesian Cardiovascular Research Center, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Agus Susanto
- Catheterization Laboratory Nurse Manager, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Bambang Budi Siswanto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| |
Collapse
|
|
41
|
Paradigm of technological convergence and digital transformation: The challenges of CH sectors in the global COVID-19 pandemic and commencing resilience-based structure for the post-COVID-19 era. DIGITAL APPLICATIONS IN ARCHAEOLOGY AND CULTURAL HERITAGE 2021; 21. [PMCID: PMC9764235 DOI: 10.1016/j.daach.2021.e00182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Technology and digitalization are vital for helping organizations to survive in the competitive marketplace. The global COVID-19 pandemic has fixated attention on the cultural heritage sectors. This study presents technological convergence and new digital platforms that require business societies to transform into new sustainable meanings. The concept of technological convergence to the autonomous ecosystem is supported by cutting-edge technologies, a distinctive life cycle for value-added creation. This study is based on a five-part conceptual context to examine the impact of pandemic on the cultural heritage sectors. The major impacts like institutional issues, financial limitations, data access policies, and stakeholders diverging views are fully addressed. An additional impression of this study is that it has comprehensively expressed the opportunities and capabilities of technological convergence in terms of competence, integration, impound and novelty for higher value creation most related to the cultural heritage sectors in the current and post COVID-19 pandemic era.
Collapse
|
|
42
|
Invasive Therapies for Acute Coronary Syndromes in the COVID-19 Era. Curr Cardiol Rep 2021; 23:69. [PMID: 33961122 PMCID: PMC8102148 DOI: 10.1007/s11886-021-01501-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 12/15/2022]
Abstract
Purpose of Review To identify and address the challenges associated with the care of ACS patients during the coronavirus 2019 pandemic. Recent Findings The COVID-19 pandemic has had a considerable global impact with over 2.0 million deaths worldwide so far. There has been considerable evidence suggesting that COVID-19 increases the risk of acute coronary syndromes (ACS). Summary We propose characterizing ACS patients into 3 distinct categories to better assist in appropriate triage and management: critically ill patients, non-critically ill ST elevation myocardial infarction (STEMI) patients, and non-critically ill non-ST elevation myocardial infarction (NSTEMI)/unstable angina (UA) patients. We thoroughly review treatments strategies, management considerations, and current consensus statements for the care of COVID-19 patients with ACS. As we continue to gain more experience with management of COVID-19 in ACS patients and as health-care workers and patients continue to get vaccinated, we must continue to adapt our strategies to treat this high-risk group of patients.
Collapse
|
|
43
|
Liu J, Virani SS, Alam M, Denktas AE, Hamzeh I, Khalid U. Coronavirus disease-19 and cardiovascular disease: A risk factor or a risk marker? Rev Med Virol 2021; 31:e2172. [PMID: 32959951 PMCID: PMC7536956 DOI: 10.1002/rmv.2172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 12/19/2022]
Abstract
Severe acute respiratory syndrome coronavirus-2 causes the clinical syndrome of coronavirus disease of 2019 (COVID-19) which has become a global pandemic resulting in significant morbidity and mortality. While the virus primarily affects the respiratory system, it also causes a wide variety of complex cardiac manifestations such as acute myopericarditis, acute coronary syndrome, congested heart failure, cardiogenic shock and cardiac arrhythmias. There are numerous proposed mechanisms of cardiac injury, including direct cellular injury, pro-inflammatory cytokine storm, myocardial oxygen-demand mismatch, and systemic inflammation causing multi-organ failure. Additionally, medications commonly used to treat COVID-19 patients have various cardiovascular side effects. We aim to provide a succinct review about the pathophysiology and cardiac manifestations of COVID-19, as well as treatment considerations and the various adaptations made to the current healthcare structure as a result of the pandemic.
Collapse
Affiliation(s)
- Jing Liu
- Department of MedicineSection of CardiologyBaylor College of MedicineHoustonTexasUSA
| | - Salim S. Virani
- Department of MedicineSection of CardiologyBaylor College of MedicineHoustonTexasUSA
- Department of MedicineMichael E. DeBakey VA Medical CenterSection of CardiologyHoustonTexasUSA
| | - Mahboob Alam
- Department of MedicineSection of CardiologyBaylor College of MedicineHoustonTexasUSA
| | - Ali E. Denktas
- Department of MedicineSection of CardiologyBaylor College of MedicineHoustonTexasUSA
| | - Ihab Hamzeh
- Department of MedicineSection of CardiologyBaylor College of MedicineHoustonTexasUSA
| | - Umair Khalid
- Department of MedicineSection of CardiologyBaylor College of MedicineHoustonTexasUSA
- Department of MedicineMichael E. DeBakey VA Medical CenterSection of CardiologyHoustonTexasUSA
| |
Collapse
|
|
44
|
Chang AY, Cullen MR, Harrington RA, Barry M. The impact of novel coronavirus COVID-19 on noncommunicable disease patients and health systems: a review. J Intern Med 2021; 289:450-462. [PMID: 33020988 PMCID: PMC7675448 DOI: 10.1111/joim.13184] [Citation(s) in RCA: 130] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic affecting all levels of health systems. This includes the care of patients with noncommunicable diseases (NCDs) who bear a disproportionate burden of both COVID-19 itself and the public health measures enacted to combat it. In this review, we summarize major COVID-19-related considerations for NCD patients and their care providers, focusing on cardiovascular, pulmonary, renal, haematologic, oncologic, traumatic, obstetric/gynaecologic, operative, psychiatric, rheumatologic/immunologic, neurologic, gastrointestinal, ophthalmologic and endocrine disorders. Additionally, we offer a general framework for categorizing the pandemic's disruptions by disease-specific factors, direct health system factors and indirect health system factors. We also provide references to major NCD medical specialty professional society statements and guidelines on COVID-19. COVID-19 and its control policies have already resulted in major disruptions to the screening, treatment and surveillance of NCD patients. In addition, it differentially impacts those with pre-existing NCDs and may lead to de novo NCD sequelae. Likely, there will be long-term effects from this pandemic that will continue to affect practitioners and patients in this field for years to come.
Collapse
Affiliation(s)
- Andrew Y. Chang
- From theDivision of Cardiovascular MedicineStanford UniversityStanfordCAUSA
- Department of MedicineStanford UniversityStanfordCAUSA
- Center for Innovation in Global HealthStanford UniversityStanfordCAUSA
| | - Mark R. Cullen
- Department of MedicineStanford UniversityStanfordCAUSA
- Division of Primary Care and Population HealthStanford UniversityStanfordCAUSA
| | | | - Michele Barry
- Department of MedicineStanford UniversityStanfordCAUSA
- Center for Innovation in Global HealthStanford UniversityStanfordCAUSA
| |
Collapse
|
|
45
|
Fernando H, Dinh D, Duffy SJ, Brennan A, Sharma A, Clark D, Ajani A, Freeman M, Peter K, Stub D, Hiew C, Reid CM, Oqueli E. Rescue PCI in the management of STEMI: Contemporary results from the Melbourne Interventional Group registry. IJC HEART & VASCULATURE 2021; 33:100745. [PMID: 33786363 PMCID: PMC7988313 DOI: 10.1016/j.ijcha.2021.100745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/12/2021] [Accepted: 02/19/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Fibrinolysis is an important reperfusion strategy in the management of ST-elevation myocardial infarction (STEMI) when timely access to primary percutaneous coronary intervention (PPCI) is unavailable. Rescue PCI is generally thought to have worse outcomes than PPCI in STEMI. We aimed to determine short- and long-term outcomes of patients with rescue PCI versus PPCI for treatment of STEMI. METHODS AND RESULTS Patients admitted with STEMI (excluding out-of-hospital cardiac arrest) within the Melbourne Interventional Group (MIG) registry between 2005 and 2018 treated with either rescue PCI or PPCI were included in this retrospective cohort analysis. Comparison of 30-day major adverse cardiac events (MACE) and long-term mortality between the two groups was performed. There were 558 patients (7.1%) with rescue PCI and 7271 with PPCI. 30-day all-cause mortality (rescue PCI 6% vs. PPCI 5%, p = 0.47) and MACE (rescue PCI 10.3% vs. PPCI 8.9%, p = 0.26) rates were similar between the two groups. Rates of in-hospital major bleeding (rescue PCI 6% vs. PPCI 3.4%, p = 0.002) and 30-day stroke (rescue PCI 2.2% vs. PPCI 0.8%, p < 0.001) were higher following rescue PCI. The odds ratio for haemorrhagic stroke in the rescue PCI group was 10.3. Long-term mortality was not significantly different between the groups (rescue PCI 20% vs. PPCI 19%, p = 0.33). CONCLUSIONS With contemporary interventional techniques and medical therapy, rescue PCI remains a valuable strategy for treating patients with failed fibrinolysis where PPCI is unavailable and it has been suggested in extenuating circumstances where alternative revascularisation strategies are considered.
Collapse
Affiliation(s)
- Himawan Fernando
- Department of Cardiology, Alfred Hospital, Melbourne, Australia
- Atherothrombosis Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Diem Dinh
- Centre of Cardiovascular Research and Education in Therapeutics (CCRE), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Stephen J. Duffy
- Department of Cardiology, Alfred Hospital, Melbourne, Australia
- Centre of Cardiovascular Research and Education in Therapeutics (CCRE), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Angela Brennan
- Centre of Cardiovascular Research and Education in Therapeutics (CCRE), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Anand Sharma
- Department of Cardiology, Ballarat Health Services, Ballarat, Victoria, Australia
| | - David Clark
- Department of Cardiology Austin Health, Melbourne, Victoria, Australia
| | - Andrew Ajani
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Melanie Freeman
- Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
| | - Karlheinz Peter
- Department of Cardiology, Alfred Hospital, Melbourne, Australia
- Atherothrombosis Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Dion Stub
- Department of Cardiology, Alfred Hospital, Melbourne, Australia
| | - Chin Hiew
- Department of Cardiology, Barwon Health, Geelong, Victoria, Australia
| | - Christopher M. Reid
- Centre of Cardiovascular Research and Education in Therapeutics (CCRE), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Ernesto Oqueli
- Department of Cardiology, Ballarat Health Services, Ballarat, Victoria, Australia
- School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
|
46
|
Du H, Feng L, Xu Y, Zhan E, Xu W. Clinical Influencing Factors of Acute Myocardial Infarction Based on Improved Machine Learning. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:5569039. [PMID: 33854744 PMCID: PMC8019385 DOI: 10.1155/2021/5569039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/25/2021] [Accepted: 03/14/2021] [Indexed: 11/26/2022]
Abstract
At present, there is no method to predict or monitor patients with AMI, and there is no specific treatment method. In order to improve the analysis of clinical influencing factors of acute myocardial infarction, based on the machine learning algorithm, this paper uses the K-means algorithm to carry out multifactor analysis and constructs a hybrid model combined with the ART2 network. Moreover, this paper simulates and analyzes the model training process and builds a system structure model based on the KNN algorithm. After constructing the model system, this paper studies the clinical influencing factors of acute myocardial infarction and combines mathematical statistics and factor analysis to carry out statistical analysis of test results. The research results show that the system model constructed in this paper has a certain effect in the clinical analysis of acute myocardial infarction.
Collapse
Affiliation(s)
- Hongwei Du
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Linxing Feng
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Yan Xu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Enbo Zhan
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Wei Xu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| |
Collapse
|
|
47
|
Case Selection During the COVID-19 Pandemic: Who Should Go to the Cardiac Catheterization Laboratory? CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021; 23:27. [PMID: 33758493 PMCID: PMC7972331 DOI: 10.1007/s11936-020-00892-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 12/14/2022]
Abstract
Purpose of review To summarize the best available evidence and recommendations regarding case selection for cardiac catheterization laboratory (CCL) during the coronavirus disease 2019 (COVID-19) pandemic with emphasis on ST segment elevation myocardial infarction (STEMI) management. Recent findings The restructuring of cardiovascular services to preserve hospital beds and personal protective equipment during the COVID-19 pandemic had a profound effect on healthcare delivery around the world with unintended consequences. In the United States, a significant 38% reduction in CCL activations for STEMI was noted in the early phase of the pandemic. Similarly, a 34% decline in utilization of invasive angiography, an 18% reduction in primary percutaneous coronary intervention (PPCI), and a 19% increase in door-to-balloon (D2B) times were also observed. These trends coincided with a significant increase in out-of-hospital cardiac arrests and late MI presentations. A shift to pharmacological reperfusion has been advocated in Asia, which resulted in increased morbidity and mortality. Summary COVID-19 has negatively affected many aspects of STEMI care, including timely access to mechanical reperfusion, which has resulted in increased morbidity and mortality. Balancing optimal STEMI care with the risk of infection to healthcare workers during the pandemic is challenging. Recommendations provided by consensus documents are a helpful guidance.
Collapse
|
|
48
|
Firouzi A, Baay M, Mazayanimonfared A, Pouraliakbar H, Sadeghipour P, Noohi F, Maleki M, Mehdi Peighambari M, Kiavar M, Abdi S, Maadani M, Shakerian F, Zahedmehr A, Kiani R, Alemzadeh-Ansari MJ, Rashidinejad A, Hosseini Z. Effects of the COVID-19 Pandemic on the Management of Patients With ST-elevation Myocardial Infarction in a Tertiary Cardiovascular Center. Crit Pathw Cardiol 2021; 20:53-55. [PMID: 32467422 PMCID: PMC7288762 DOI: 10.1097/hpc.0000000000000228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND In the Coronavirus Disease 2019 (COVID-19) pandemic, the appropriate reperfusion strategy in patients with ST-segment elevation myocardial infarction (STEMI) is unclear. METHODS This retrospective single-center study consecutively enrolled patients who presented with STEMI and scheduled for primary percutaneous coronary intervention (PPCI) during the outbreak of COVID-19. Due to the delay in the reporting of the polymerase chain reaction test results, our postprocedural triage regarding COVID-19, followed by the isolation strategy, was based on lung computerized tomography scan results. RESULTS Forty-eight patients with STEMI referred to our center. PPCI was done for 44 (91%) of these patients. The mean symptom-to-device time was 490.93 ± 454.608 minutes, and the mean first medical contact-to-device time was and 154.12 ± 36.27 minutes. Nine (18%) patients with STEMI were diagnosed as having typical/indeterminate features indicating COVID-19 involvement. During hospitalization, 1 (2.0%) patient died of cardiogenic shock. The study population was followed for 35.9 ± 12.7 days. Two patients expired in another centers due to COVID-19. No cardiac catheterization laboratory staff members were infected by COVID-19 during the study period. CONCLUSIONS Our small report indicates that by taking the recommended safety measures and using appropriate PPE, we can continue PPCI as the main reperfusion strategy safely and effectively.
Collapse
Affiliation(s)
- Ata Firouzi
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Baay
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Mazayanimonfared
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Feridoun Noohi
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Maleki
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Mehdi Peighambari
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Kiavar
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seifollah Abdi
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Maadani
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Alemzadeh-Ansari
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rashidinejad
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
49
|
Medetalibeyoglu A, Emet S, Senkal N, Aydogan M, Kose M, Tukek T. Cardiovascular view of intermediate and high-risk COVID-19 patients: single-centre experience with low mortality and intensive care hospitalisation rates. Cardiovasc J Afr 2021; 32:79-86. [PMID: 33165497 PMCID: PMC8756026 DOI: 10.5830/cvja-2020-041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/30/2020] [Indexed: 11/06/2022] Open
Abstract
AIM The purpose of this article was to report the low rates of intensive care unit admission and mortality in intermediate- and high-risk COVID-19 patients, and to share our clinical approach with other colleagues. In addition, we sought to reveal the relationship between myocardial injury and clinical outcomes such as death, intensive care unit uptake and hospital stay, and the relationship between inflammatory parameters and cardiac biomarkers in a cardiovascular perspective. METHODS Patients admitted to the emergency department in the Department of Internal Medicine, Faculty of Medicine, Istanbul University, with laboratory or clinically and radiologically confirmed COVID-19 were included in this retrospective cross-sectional study, which was conducted from 11 March to 10 April 2020. The demographic (age and gender) and clinical (symptoms, co-morbidities, treatments, complications and outcomes) characteristics, laboratory findings, and results of cardiac examinations (cardiac biomarkers and electrocardiography) of patients during hospitalisation were collected from their medical records by two investigators. Data were analysed using SPSS version 25.0 (IBM). A two-sided p < 0.05 was considered statistically significant. Analysis began on 11 April 2020. RESULTS Mortality and intensive care unit admission rates were statistically significantly higher in patients with cardiac injury than in those without. There was a positive correlation between levels of high-sensitivity TNT and fibrinogen, D-dimer, ferritin, procalcitonin and C-reactive protein (r = 0.24, p < 0.01; r = 0.37, p < 0.01; r = 0.25, p < 0.01, r = 0.34, p < 0.01; r = 0.31, p < 0.01). CONCLUSIONS The first general data of our 309 patients regarding low mortality and intensive care admission rates, and particular treatment algorithms specific to our centre should be helpful in determining better treatment strategies in the future. Our study emphasises the importance and frequency of cardiovascular outcomes, and the significance of some cardiac biomarkers in predicting COVID-19 prognosis.
Collapse
Affiliation(s)
- Alpay Medetalibeyoglu
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Samim Emet
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Naci Senkal
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Aydogan
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Kose
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tufan Tukek
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
|
50
|
Kermani-Alghoraishi M, Shirvani E, Khosravi A, Roghani-Dehkordi F, Shemirani H, Farshidi H, Assareh AR, Moezi SA, Sarrafzadegan N. Survey of coronary catheterization laboratory activity in Iran during the coronavirus disease-2019 pandemic. ARYA ATHEROSCLEROSIS 2021; 17:1-7. [PMID: 36338533 PMCID: PMC9635727 DOI: 10.22122/arya.v17i0.2320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND With the onset of the coronavirus disease-2019 (COVID-19) pandemic, hospitalization and treatment of non-covid patients decreased worldwide. The aim of this study is to evaluate the admission and treatment of patients with coronary artery diseases (CADs) by examining coronary Cath labs activities in some centers of Iran during the COVID-19 period. METHODS A retrospective, multi-center survey was conducted in four cites in Iran which participated in National Persian Registry Of CardioVascular diseasE (N-PROVE). Two periods of COVID-19 occurrence peak in Iran were compared with the same date in 2019. Information was collected on the number of diagnostic and therapeutic coronary catheterizations in both stable ischemic heart diseases (SIHDs) and acute coronary syndrome (ACS) settings. RESULTS In the first peak of COVID-19 pandemic, coronary angiographies and angioplasties decreased by 37 and 38% compared to the same period in 2019, respectively. The most common indication for coronary angiography during this period was ACS [especially ST-Segment Elevation Myocardial Infarction (STEMI)]; however, at the time of peak decrease, the SIHDs were the most. In the second peak of COVID-19 pandemic in Iran, 34% and 27% decrease in diagnostic and therapeutic coronary procedures were seen, respectively. During this period, the number of elective admissions increased, although it was still lower than that in 2019. The tendency to rescue percutaneous coronary intervention increased in most centers during the COVID-19 era, especially in the second peak. CONCLUSION A significant reduction in the coronary Cath lab activity has been observed during the COVID-19 pandemic that can indicate an increased risk of cardiovascular mortality and morbidity.
Collapse
Affiliation(s)
- Mohammad Kermani-Alghoraishi
- Assistant Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Shirvani
- Assistant Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Alireza Khosravi; Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan
University of Medical Sciences, Isfahan, Iran;
| | - Farshad Roghani-Dehkordi
- Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hasan Shemirani
- Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Farshidi
- Professor, Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ahmad Reza Assareh
- Professor, Atherosclerosis Research Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyyed Ali Moezi
- Assistant Professor, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Nizal Sarrafzadegan
- Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|