Corpus overview


MeSH Disease

Human Phenotype


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    Observations on echocardiographic findings in patients with COVID-19

    Authors: Ahsan A Khan; Sunil James; Mengshi Yuan; Latoya Woolery; Nina Huppertz; Mushidur Rahman; Chetan Varma; Stavros Apostolakis; Vinoda Sharma

    doi:10.21203/ Date: 2020-08-12 Source: ResearchSquare

    Background The novel coronavirus (SARS-CoV-2) has created global havoc by causing Coronavirus Disease MESHD 2019 (COVID-19). Cardiovascular involvement MESHD in COVID-19 varies from troponin rise or arrhythmia HP arrhythmia MESHD/ myocarditis HP myocarditis MESHD to fulminant cardiogenic shock HP cardiogenic shock MESHD. There is limited data on echocardiographic findings in such patients. We aimed to assess abnormal echocardiographic findings and contributory factors in patients with COVID-19.Methods We performed retrospective analysis of COVID-19 positive patients who underwent a transthoracic echocardiogram (TTE) at Sandwell and West Birmingham (SWBH) NHS Trust between March 2020 and May 2020. Patients were compared based on TTE changes and divided into two groups (abnormal TTE and normal TTE).Results 66 out of 463 patients with COVID-19 had a TTE. 46 patients (69.7%) had abnormal findings on their TTE. Tricuspid regurgitation HP Tricuspid regurgitation MESHD was the most common abnormality observed (26 (56.5%) patients), followed by aortic regurgitation HP aortic regurgitation MESHD (13 (28.3%) patients) and mitral regurgitation HP mitral regurgitation MESHD (12 (26.1%) patients). Haemoglobin and LDH were predictors of abnormal TTE (Hb OR: 0.97, p = 0.049, LDH, OR: 1.00, p = 0.03). Significantly more patients in the abnormal TTE group died during their inpatient stay compared to normal TTE (p = 0.01). Having an abnormal TTE was an independent predictor of death on regression analysis (OR: 0.229, p = 0.034).Conclusions This is the first detailed observational study looking at echocardiographic changes in admitted COVID-19 patients irrespective of disease severity. The most common abnormality was valve regurgitation MESHD. Patients with abnormal TTE were more likely to die in hospital.

    The Spectrum of Cardiovascular Complications MESHD in COVID-19- A Comprehensive Literature Review

    Authors: Raja Shakeel Mushtaque; Rabia Mushtaque; Shahbano Baloch; Aadil Raza; Haseeb Bhatti; Zohaib Khan

    id:10.20944/preprints202008.0257.v1 Date: 2020-08-11 Source:

    A newly identified novel coronavirus named as severe acute respiratory syndrome MESHD-related coronavirus2 (SARS‐CoV 2) has given rise to the global pandemic. SARS-CoV2 which causes coronavirus disease MESHD 2019 (COVID-19), is a positive-stranded RNA virus with nucleocapsid. It binds to host angiotensin-converting enzyme2 (ACE2) receptor through surface glycoprotein (S protein). These ACE 2 receptors are attached to the cell membranes of many organs. Thus, COVID-19 does not only result in acute respiratory distress syndrome MESHD respiratory distress HP syndrome but also affects multiple organ systems, requiring a multidisciplinary approach to manage this disease. COVID-19 can damage the myocardial cells and result in fulminant myocarditis HP myocarditis MESHD, acute cardiac injury MESHD, cardiomyopathy HP cardiomyopathy MESHD, heart failure MESHD, cardiogenic shock HP cardiogenic shock MESHD, or arrhythmia HP arrhythmia MESHD. COVID-19 seeds harmful immune response through cytokine storm leading to indirect organ damage. In this literature review, the available data is comprehended regarding cardiovascular complications in COVID-19, and the correlation of biomarkers with the disease activity is discussed. This literature review also highlights the important treatment options and outcomes of the individual study.

    Effect of Hydroxychloroquine in Hospitalized Patients with COVID-19: Preliminary results from a multi-centre, randomized, controlled trial.

    Authors: Peter Horby; Marion Mafham; Louise Linsell; Jennifer L Bell; Natalie Staplin; Jonathan R Emberson; Martin Wiselka; Andrew Ustianowski; Einas Elmahi; Benjamin Prudon; Anthony Whitehouse; Timothy Felton; John Williams; Jakki Faccenda; Jonathan Underwood; J Kenneth Baillie; Lucy Chappell; Saul N Faust; Thomas Jaki; Katie Jeffery; Wei Shen Lim; Alan Montgomery; Kathryn Rowan; Joel Tarning; James A Watson; Nicholas J White; Edmund Juszczak; Richard Haynes; Martin J Landray

    doi:10.1101/2020.07.15.20151852 Date: 2020-07-15 Source: medRxiv

    Background: Hydroxychloroquine and chloroquine have been proposed as treatments for coronavirus disease MESHD 2019 (COVID-19) on the basis of in vitro activity, uncontrolled data, and small randomized studies. Methods: The Randomised Evaluation of COVID-19 therapy (RECOVERY) trial is a randomized, controlled, open-label, platform trial comparing a range of possible treatments with usual care in patients hospitalized with COVID-19. We report the preliminary results for the comparison of hydroxychloroquine vs. usual care alone. The primary outcome was 28-day mortality. Results: 1561 patients randomly allocated to receive hydroxychloroquine were compared with 3155 patients concurrently allocated to usual care. Overall, 418 (26.8%) patients allocated hydroxychloroquine and 788 (25.0%) patients allocated usual care died within 28 days (rate ratio 1.09; 95% confidence interval [CI] 0.96 to 1.23; P=0.18). Consistent results were seen in all pre-specified subgroups of patients. Patients allocated to hydroxychloroquine were less likely to be discharged from hospital alive within 28 days (60.3% vs. 62.8%; rate ratio 0.92; 95% CI 0.85-0.99) and those not on invasive mechanical ventilation at baseline were more likely to reach the composite endpoint of invasive mechanical ventilation or death MESHD (29.8% vs. 26.5%; risk ratio 1.12; 95% CI 1.01-1.25). There was no excess of new major cardiac arrhythmia MESHD arrhythmia HP. Conclusions: In patients hospitalized with COVID-19, hydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death MESHD.

    Cardiovascular Implications of Coronavirus Disease MESHD 2019 (COVID-19): A Systematic Review

    Authors: Ravi Ranjan Pradhan; Ajay Kumar Yadav; Shobha Mandal

    doi:10.21203/ Date: 2020-07-02 Source: ResearchSquare

    Background: World Health Organization has declared Coronavirus disease MESHD (COVID-19) as a Public Health Emergency of International Concern. It has killed thousands and millions are infected worldwide. Though COVID-19 is supposed to be primarily a disease of respiratory system, it also has widespread implications on other systems as well. The aim of this systematic review is to summarize the cardiovascular implications of COVID-19. Methods: PubMed, PubMed Central, EMBASE, and Google Scholar were searched for peer-reviewed articles which aimed to delineate the cardiovascular implications of COVID-19.Results: A total of six articles (five original articles and one case report) were included. We found diverse cardiovascular implications of COVID-19 ranging from acute cardiac injury to death MESHD. New onset abnormalities in electrocardiogram or echocardiogragram, elevated plasma SERO levels of cardiac troponin, NT-proBNP, and D-dimer have role in early identification of acute cardiac injury MESHD in such patients. Additionally, cardiac troponin and NT-proBNP can be used to evaluate prognosis and possible need for intensive care in these patients.Conclusion: Acute cardiac injury MESHD is common in patients with COVID-19. Aggressive supportive management based on prognostic indicators along with management of heart failure MESHD, arrhythmias HP arrhythmias MESHD, acute coronary syndrome MESHD and thrombosis MESHD can improve clinical outcomes in such patients.

    Cardiac Arrhythmias MESHD Arrhythmias HP and COVID-19 – a Meta-analysis of Recent Reports

    Authors: Husam M. I. Salah; Jawahar L. Mehta

    doi:10.21203/ Date: 2020-06-23 Source: ResearchSquare

    Introduction: The 2019 novel coronavirus disease MESHD (COVID-19) is a current pandemic. Cardiovascular manifestations of COVID-19 have been described in many studies; however, no studies have examined the prevalence SERO and characterizations of cardiac arrhythmias MESHD arrhythmias HP among patients with COVID-19 infection MESHD. The aim of this meta-analysis was to examine the prevalence SERO of cardiac arrhythmias MESHD arrhythmias HP among patients with COVID-19 infection MESHD.Method: PubMed, Google Scholar, and ResearchGate databases were searched for relevant articles from inception until June 14, 2020. Inclusion criteria were: 1) Cohort studies or case series studies; 2) Study population included individuals with confirmed COVID-19 infection MESHD; 3) Arrhythmic events were reported in the study. All other studies were excluded. MedCalc software was used to analyze the pooled data. The random-effect model was utilized to obtain the prevalence SERO of arrhythmia HP arrhythmia MESHD among the included patients and its 95% confidence interval. Cohran's Q and I2 index were used for heterogeneity measurements. The main planned outcome was the prevalence SERO of arrhythmia HP arrhythmia MESHD among patients with COVID-19 infection MESHD.Results: Thirteen studies with a total of 2861 patients met our inclusion criteria. The prevalence SERO of arrhythmia HP arrhythmia MESHD among patients with COVID-19 infection MESHD was 8.1% (95% CI [6.10, 10.37]). 82.8% of the patients who had arrhythmia HP arrhythmia MESHD has severe illness (95% CI [70.916, 92.124]).Conclusion: The prevalence SERO of arrhythmias HP arrhythmias MESHD among patients with COVID-19 infection MESHD is 8.1%, which is much higher than in the general population (2.35%). 

    Risk factors and electrocardiogram characteristics for mortality of critical inpatients with COVID-19

    Authors: Lingzhi Li; Shudi Zhang; Bing He; Xiaobei Chen; Shihong Wang; Zhao Qingyan

    doi:10.21203/ Date: 2020-06-05 Source: ResearchSquare

    Background The novel severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) has subsequently spread worldwide. The number of death MESHD has increased rapidly. However, the possible risk factors that lead to death in critical inpatients with coronavirus disease MESHD 2019 (COVID-19) are not yet fully known. This study was to explore the risk factors for mortality of critical inpatients with COVID-19.Methods In this single-centered, retrospective study, we enrolled 113 critical patients with COVID-19 in Renmin Hospital of Wuhan University between Feb 1, 2020 and Mar 15, 2020. Data were collected using a standard method including clinical records and laboratory findings. Outcomes of survivors and death were compared.Results A total of 113 critical patients (from 29 to 95 years) with COVID-19 were recruited, 50 (44.25%) died and 63 recovered (55.75%). The proportion of patients with ventricular arrhythmia HP ventricular arrhythmia MESHD was higher in the death group than the recovery group (24.0% vs 4.4%; p = 0.021), and was higher among myocardial damage MESHD cases than non-myocardial damage cases (26.1% vs 4.3%; p = 0.013). Multivariate analysis confirmed four independent predictors related to mortality of COVID-19: age > 70 yrs (HR 1.84, 95% CI 1.03–3.28), initial neutrophil count more than 6.5 × 109/L (HR 3.43, 95% CI 1.84–6.40), C-reactive protein greater more than 100 mg/L (HR 1.93, 95% CI 1.04–3.59), and lactate dehydrogenase more than 300 U/L (HR 2.90, 95% CI 1.26–6.67). Immunoglobulin treatment (HR 0.39, 95% CI 0.21–0.73) can reduce the risk of death MESHD. There was no significant difference in the QT interval between patients with and without hydroxychloroquine treatment.Conclusions Old age TRANS (> 70 years), neutrophilia HP, C-reactive protein greater more than 100 mg/L and lactate dehydrogenase more than 300 U/L are high-risk factors for mortality of critical patients with COVID-19. The incidence of ventricular arrhythmia HP ventricular arrhythmia MESHD was higher in deceased patients than survivors.

    Hydroxychloroquine alone or in combination with azithromycin to prevent major clinical events in hospitalised patients with coronavirus infection MESHD (COVID-19): rationale and design of a randomised, controlled clinical trial

    Authors: Alexandre B Cavalcanti; Fernando G Zampieri; Luciani CP Azevedo; Regis G Rosa; Alvaro Avezum; Viviane C Veiga; Renato D Lopes; Leticia Kawano-Dourado; Lucas P Damiani; Adriano J Pereira; Ary Serpa Neto; Remo Furtado; Bruno Tomazini; Fernando A Bozza; Israel S Maia; Maicon Falavigna; Thiago C Lisboa; Henrique Fonseca; Flavia R Machado; Otavio Berwanger; COALITION COVID-19 Brazil I Investigators

    doi:10.1101/2020.05.19.20106997 Date: 2020-05-26 Source: medRxiv

    Introduction: Hydroxychloroquine and its combination with azithromycin have been suggested to improve viral clearance in patients with COVID-19, but its effect on clinical outcomes remains uncertain. Methods and analysis: We describe the rationale and design of an open-label pragmatic multicentre randomised (concealed) clinical trial of 7 days of hydroxychloroquine (400 mg BID) plus azithromycin (500 mg once daily), hydroxychloroquine 400 mg BID, or standard of care for moderately severe hospitalised patients with suspected or confirmed COVID-19 (in-patients with up to 4L/minute oxygen supply through nasal catheter). Patients are randomised in around 50 recruiting sites and we plan to enrol 630 patients with COVID-19. The primary endpoint is a 7-level ordinal scale measured at 15-days: 1)not hospitalised, without limitations on activities; 2)not hospitalised, with limitations on activities; 3)hospitalised, not using supplementary oxygen; 4)hospitalised, using supplementary oxygen; 5)hospitalised, using high-flow nasal cannula or non-invasive ventilation; 6)hospitalised, on mechanical ventilation; 7)death. Secondary endpoints are the ordinal scale at 7 days, need for mechanical ventilation and rescue therapies during 15 days, need of high-flow nasal cannula or non-invasive ventilation during 15 days, length of hospital stay, in-hospital mortality, thromboembolic MESHD events, occurrence of acute kidney injury HP acute kidney injury MESHD, and number of days free of respiratory support at 15 days. Secondary safety outcomes include prolongation of QT interval MESHD on electrocardiogram, ventricular arrhythmias HP ventricular arrhythmias MESHD, and liver toxicity MESHD. The main analysis will consider all patients with confirmed COVID-19 in the groups they were randomly assigned. Ethics and dissemination: This study has been approved by Brazil's National Ethic Committee (CONEP) and National Health Surveillance Agency (ANVISA). An independent data monitoring committee will perform interim analyses and evaluate adverse events throughout the trial. Results will be submitted for publication after enrolment and follow-up are complete, as well as presented and reported to local health agencies. identifier: NCT04322123

    Human iPSC-Derived Cardiomyocytes are Susceptible to SARS-CoV-2 Infection MESHD

    Authors: Arun Sharma; Gustavo Garcia Jr.; Vaithilingaraja Arumugaswami; Clive N Svendsen

    doi:10.1101/2020.04.21.051912 Date: 2020-04-21 Source: bioRxiv

    Coronavirus disease 2019 (COVID-19) is a viral pandemic caused by the severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2). COVID-19 is predominantly defined by respiratory symptoms, but cardiac complications including arrhythmias HP arrhythmias MESHD, heart failure MESHD, and viral myocarditis HP myocarditis MESHD are also prevalent. Although the systemic ischemic MESHD and inflammatory responses caused by COVID-19 can detrimentally affect cardiac function, the direct impact of SARS-CoV-2 infection MESHD on human cardiomyocytes is not well-understood. We used human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) as a model system to examine the mechanisms of cardiomyocyte-specific infection by SARS-CoV-2. Microscopy and immunofluorescence demonstrated that SARS-CoV-2 can enter and replicate within hiPSC-CMs, localizing at perinuclear locations within the cytoplasm. Viral cytopathic effect induced hiPSC-CM apoptosis MESHD and cessation of beating after 72 hours of infection MESHD. These studies show that SARS-CoV-2 can infect hiPSC-CMs MESHD in vitro, establishing a model for elucidating the mechanisms of infection MESHD and potentially a cardiac-specific antiviral drug screening platform.

    Cardiovascular Diseases MESHD and COVID-19 Mortality and Intensive Care Unit Admission: A Systematic Review and Meta-analysis

    Authors: Amirhossein Hessami; Amir Shamshirian; Keyvan Heydari; Fatemeh Pourali; Reza Alizadeh-Navaei; Mahmood Moosazadeh; Saeed Abrotan; Layla Shojaei; Sogol Sedighi; Danial Shamshirian; Nima Rezaei

    doi:10.1101/2020.04.12.20062869 Date: 2020-04-16 Source: medRxiv

    Background: High rate of cardiovascular disease MESHD ( CVD MESHD) have been reported among patients with novel coronavirus disease MESHD (COVID-19). Meanwhile there were controversies among different studies about CVD MESHD burden in COVID-19 patients. Hence, we aimed to study CVD MESHD burden among COVID-19 patients, using a systematic review and meta-analysis. Methods: We have systematically searched databases including PubMed, Embase, Cochrane Library, Scopus, Web of Science as well as medRxiv pre-print database. Hand searched was also conducted in journal websites and Google Scholar. Meta-analyses were carried out for Odds Ratio (OR) of mortality and Intensive Care Unit (ICU) admission for different CVDs. We have also performed a descriptive meta-analysis on different CVDs. Results: Fifty-six studies entered into meta-analysis for ICU admission and mortality outcome and 198 papers for descriptive outcomes, including 159,698 COVID-19 patients. Results of meta-analysis indicated that acute cardiac injury MESHD, (OR: 13.29, 95% CI 7.35-24.03), hypertension HP hypertension MESHD (OR: 2.60, 95% CI 2.11-3.19), heart Failure MESHD (OR: 6.72, 95% CI 3.34-13.52), arrhythmia HP arrhythmia MESHD (OR: 2.75, 95% CI 1.43-5.25), coronary artery disease MESHD (OR: 3.78, 95% CI 2.42-5.90), and cardiovascular disease MESHD (OR: 2.61, 95% CI 1.89-3.62) were significantly associated with mortality. Arrhythmia HP Arrhythmia MESHD (OR: 7.03, 95% CI 2.79-17.69), acute cardiac injury MESHD (OR: 15.58, 95% CI 5.15-47.12), coronary heart disease MESHD (OR: 2.61, 95% CI 1.09-6.26), cardiovascular disease MESHD (OR: 3.11, 95% CI 1.59-6.09), and hypertension HP hypertension MESHD (OR: 1.95, 95% CI 1.41-2.68) were also significantly associated with ICU admission in COVID-19 patients. Conclusion: Findings of this study revealed a high burden of CVDs among COVID-19 patients, which was significantly associated with mortality and ICU admission. Proper management of CVD MESHD patients with COVID-19 and monitoring COVID-19 patients for acute cardiac conditions is highly recommended to prevent mortality and critical situations.

    Clinical features of critically ill MESHD patients with COVID-19 infection MESHD in China

    Authors: Bo Hu; Dawei Wang; Chang Hu; Ming Hu; Fangfang Zhu; Hui Xiang; Beilei Zhao; Xiaoyi Zhang; Kianoush B. Kashani; Zhiyong Peng

    doi:10.21203/ Date: 2020-03-02 Source: ResearchSquare

    Importance: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections MESHD outbreak in China is now a global issue. There is only a limited understanding of the clinical characteristics of patients with SARS-CoV-2 infections MESHD is available.Objective:To describe the characteristics, management strategies, and outcomes of critically ill MESHD patients with SARS-CoV-2 infection MESHD.Design, Setting, and Patients: This is aretrospective, multi-center case series of 50 critically ill MESHD patients with confirmed SARS-CoV-2 infection MESHD who were admitted at Zhongnan Hospital of Wuhan University and Wuhan Pulmonary Hospital in Wuhan, China, from January 8 to February 9, 2020.Exposures:Documented Corona Virus Disease MESHD, 2019 (COVID-19).Main Outcome Measures: Demographic, clinical, laboratory, imaging data were collected along with management strategies, complications and outcomes of enrolled individuals. Results Fifty critically ill MESHD patients with SARS-CoV-2 infections MESHD were enrolled. Their median age TRANS was 62 (range, 29-92) [IQR,49.5-69.0] years, 68% were male TRANS, and 28 (56%) patients had comorbidities, the most common being hypertension HP hypertension MESHD. In this cohort, 20(40%) patients survived ,16(32%) patients died, and the rest remained hospitalized. The invasive mechanical ventilator was used in 36(72%) patients with 15(30%) of them requiring prone positioning, and 17(34%) switched to ECMO. The compliance scores of lungs (Cstat)on the day of ICU admission among survivors were higher than those in non-survivors [42.0(18.0-47.0), vs. 19.5(14.0-24.2), p=0.038].The blood SERO IL-6 levels and neutrophils counts at the first day of ICU admission were significantly higher in non-survivors compared to survivors [123.7(85.3-228.8), vs. 20.2(6.8-67.2) ng/ml, p=0.025 for IL-6, and 20.2(6.8-67.2) vs. 4.01(1.99-7.05) × 10⁹/L, p=0.02 for neutrophils counts].The heart rates, PaCO2, lung injury MESHD scale (LIS), and positive end-expiratory pressure levels were constantly higher for 10 days in non-survivors than those who survived (p<0.05). The frequency of vasopressor uses and neuromuscular blockers was higher in non-survivors from day 1 to day 10 compared to survivors (p<0.05). In the whole cohort, the most common complications were ARDS (97%), shock HP shock MESHD (44%), arrhythmia HP arrhythmia MESHD (38%), acute cardiac injury MESHD (26%), and acute kidney injury HP acute kidney injury MESHD (22%). A secondary bacterial infection MESHD was noted in 17(34%) patients. Univariate analysis indicated that lower lung complianceand higher neutrophil counts at the day of ICU admission were related to higher mortality (p-0.03, and 0.04, respectively)ConclusionWe demonstrated that SARS-CoV-2 infection MESHD-related critical illness predominantly affected old individuals with comorbidities and characterized by severe hypoxemic respiratory failure MESHD respiratory failure HP, often requiring prolonged mechanical ventilation and rescue therapies. Low lung compliance and persistently elevated PaCO2 indicated poor outcomes.

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MeSH Disease
Human Phenotype

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