Corpus overview


MeSH Disease

Human Phenotype

Myocarditis (16)

Pneumonia (4)

Fever (3)

Shock (3)

Arrhythmia (3)


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    The Spectrum of Cardiovascular Complications 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 HP syndrome MESHD but also affects multiple organ systems, requiring a multidisciplinary approach to manage this disease MESHD. COVID-19 can damage the myocardial cells and result in fulminant myocarditis MESHD myocarditis HP, acute cardiac injury, cardiomyopathy MESHD cardiomyopathy HP, heart failure MESHD, cardiogenic shock MESHD cardiogenic shock HP, or arrhythmia HP. 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 MESHD activity is discussed. This literature review also highlights the important treatment options and outcomes of the individual study.

    Point-of-care ultrasound for COVID-19 pneumonia MESHD pneumonia HP patients in the ICU

    Authors: zouheir bitar; Mohammed Shamsah; Omar Bamasood; Ossama Maadrani; Huda Al foudri

    doi:10.21203/ Date: 2020-07-26 Source: ResearchSquare

    BackgroundPoint-of-care ultrasound (POCUS) has a major role in the management of patients with acute hypoxic respiratory and circulatory failure and guides hemodynamic management. There is scarce literature on POCUS assessment characteristics in COVID-19 pneumonia MESHD pneumonia HP with hypoxic respiratory failure HP.MethodsThe study is an observational, prospective, single‐center study conducted in the intensive care unit of Adan General Hospital from May 1st, 2020, to June 25, 2020. The study included adults TRANS suspected to have COVID-19 transferred to the intensive care unit (ICU) with fever MESHD fever HP or suspected respiratory infection MESHD. Patients were transferred to the ICU directly from the ED or general medical wards after reverse transcriptase-polymerase chain reaction (RT-PCR) testing. A certified intensivist in critical care ultrasound who was blinded to the RT-PCR results, if available at the time of examination, performed the lung ultrasound and echocardiology within 12 hours of the patient’s admission to the ICU. We calculated the E/e’, E/A ratio, left ventricular ejection fraction EF, IVC diameter, RV size and systolic function. We performed ultrasound in 12 chest areas.ResultsOf 92 patients with suspected COVID-19 pneumonia MESHD pneumonia HP, 77 (84%) cases were confirmed TRANS. The median age TRANS of the patients was 53 (82-36) years, and 71 (77%) were men.In the group of patients with confirmed COVID-19 pneumonia MESHD pneumonia HP, echocardiographic findings showed normal E/e’, deceleration time (DT), and transmittal E/A ratio in comparison to the non-COVID19 patients (P .001 for both). The IVC diameter was <2 cm with > 50% collapsibility in 62 (81%) patients with COVID-19 pneumonia MESHD pneumonia HP; a diameter of > 2 cm and < 50% collapsibility in all patients, with a P value of 0.001, was detected among those with non-COVID-19 pneumonia MESHD pneumonia HP. There were 3 cases of myocarditis MESHD myocarditis HP with poor EF (5.5%), severe RV dysfunction was seen in 9 cases (11.6%), and 3 cases showed RV thrombus.Chest US revealed four signs suggestive of COVID-19 pneumonia MESHD pneumonia HP in 77 patients (98.6%) ( sensitivity SERO 96.9%, CI 85%‐99.5%) when compared with RT-PCR results.ConclusionPOCUS plays an important role in bedside diagnosis, hemodynamic assessment and management of patients with acute hypoxic respiratory and circulatory failure in patients with COVID-19 pneumonia MESHD pneumonia HP.

    Pericarditis MESHD Pericarditis HP and myocarditis MESHD myocarditis HP long after SARS-CoV-2 infection: a cross MESHD-sectional descriptive study in health-care workers

    Authors: Rocio Eiros; Manuel Barreiro-Perez; Ana Martin-Garcia; Julia Almeida; Eduardo Villacorta; Alba Perez-Pons; Soraya Merchan; Alba Torres-Valle; Clara Sanchez-Pablo; David Gonzalez-Calle; Oihane Perez-Escurza; Ines Toranzo; Elena Diaz-Pelaez; Blanca Fuentes-Herrero; Laura Macias-Alvarez; Guillermo Oliva-Ariza; Quentin Lecrevisse; Rafael Fluxa; Jose L Bravo-Grandez; Alberto Orfao; Pedro L Sanchez

    doi:10.1101/2020.07.12.20151316 Date: 2020-07-14 Source: medRxiv

    Background: Cardiac sequelae of past SARS-CoV-2 infection MESHD are still poorly documented. We conducted a cross-sectional study in health-care workers to report evidence of pericarditis MESHD pericarditis HP and myocarditis MESHD myocarditis HP after SARS-CoV-2 infection MESHD. Methods We studied 139 health-care workers with confirmed past SARS-CoV-2 infection MESHD (103 diagnosed by RT-PCR and 36 by serology). Participants underwent clinical assessment, electrocardiography, laboratory tests including immune cell profiling and cardiac magnetic resonance (CMR) imaging. Pericarditis MESHD Pericarditis HP was diagnosed when classical criteria were present, and the diagnosis of myocarditis MESHD myocarditis HP was based on the updated CMR Lake-Louise-Criteria. Results: Median age TRANS was 52 years (IQR 41-57), 100 (72%) were women, and 23 (16%) were previously hospitalized for Covid-19 pneumonia MESHD pneumonia HP. At examination (10.4 [9.3-11.0] weeks after infection MESHD-like symptoms), all participants presented hemodynamic stability. Chest pain MESHD Chest pain HP, dyspnoea or palpitations HP were observed in 58 (42%) participants; electrocardiographic abnormalities in 69 (50%); NT-pro-BNP was elevated in 11 (8%); troponin in 1 (1%); and CMR abnormalities in 104 (75%). Isolated pericarditis MESHD pericarditis HP was diagnosed in 4 (3%) participants, myopericarditis in 15 (11%) and isolated myocarditis MESHD myocarditis HP in 36 (26%). Participants diagnosed by RT-PCR were more likely to still present symptoms than participants diagnosed by serology (73 [71%] vs 18 [50%]; p=0.027); nonetheless, the prevalence SERO of pericarditis MESHD pericarditis HP or myocarditis MESHD myocarditis HP was high in both groups (44 [43%] vs 11 [31%]; p=0.238). Most participants (101 [73%]) showed altered immune cell counts in blood SERO, particularly decreased eosinophil (37 [27%]; p<0.001) and increased CD4-CD8-/loT alpha beta-cell numbers (24 [17%]; p<0.001). Pericarditis MESHD Pericarditis HP was associated with elevated CD4-CD8-/loT alpha beta-cell numbers (p=0.011), while participants diagnosed with myopericarditis or myocarditis MESHD myocarditis HP had lower (p<0.05) plasmacytoid dendritic cell, NK-cell and plasma SERO cell counts and lower anti-SARS-CoV-2- IgG antibody SERO levels (p=0.027). Conclusions: Pericarditis MESHD Pericarditis HP and myocarditis MESHD myocarditis HP with clinical stability are frequent long after SARS-CoV-2 infection MESHD, even in presently asymptomatic TRANS subjects. These observations will probably apply to the general population infected and may indicate that cardiac sequelae might occur late in association with an altered (delayed) innate and adaptative immune response.

    COVID-19: Role of the Inflammasome

    Authors: Claudio G. Gallo; Sirio Fiorino; Giovanni Posabella; Donato Antonacci; Antonio Tropeano; Emanuele Pausini; Carlotta Pausini; Tommaso Guarniero; Marco Zancanaro

    id:202007.0246/v1 Date: 2020-07-12 Source:

    Covid-19 disease MESHD is caused by SARS Cov-2 virus. Despite its high transmissibility TRANS, the CFR (Case Fatality Rate) of COVID-19 seems to be lower than the SARS (9,5%) and MERS (34,4%) ones93 , but higher than the influenza one (0-1%)94,95 . The disease is asymptomatic MESHD asymptomatic TRANS or paucisymptomatic in most of the patients, although in few cases it can be characterized by serious complications. The main causes of hospitalization in intensive care are represented by ALI ( Acute Lung Injury MESHD), ARDS (Acute Respiratory Distress HP Syndrome MESHD), cardiovascular problems and coagulopathies (diffuse thrombosis MESHD, microthrombosis, embolisms MESHD, myocarditis MESHD myocarditis HP, arrhytmias, heart failure MESHD, stroke MESHD stroke HP)96-98, acute nephropathy99,100 and encephalopathies101. The virus presence in the vascular wall can cause endotheliitis, which triggers the process of diffuse coagulation that can lead to a worsening of the systemic inflammation MESHD. The exaggerated inflammatory response seems to be connected with the development of ARDS, MOF ( Multiple Organ Failure MESHD) and coagulopathies102-107.

    Modeling the effect of COVID-19 disease MESHD on the cardiac function: a computational study

    Authors: Francesco Regazzoni; Christian Vergara; Paolo Zunino; Marco Guglielmo; Roberto Scrofani; Laura Fusini; Chiara Cogliati; Gianluca Pontone; Alfio Quarteroni

    doi:10.1101/2020.06.23.166421 Date: 2020-06-23 Source: bioRxiv

    BackgroundThe effect of COVID-19 on the cardiac function and on the vascular system increases the morbidity and mortality of infected subjects with cardiovascular diseases MESHD. ObjectivesTo provide preliminary results on cardiac global outcomes (such as cardiac output, ventricular pressures) obtained by means of computational models in plausible scenarios characterized by COVID-19. MethodsWe considered a lumped parameters computational model of the cardiovascular system, which models, from the mechanical point of view, the systemic and pulmonary circulations, the four cardiac valves and the four heart chambers, through mathematical equations of the underlying physical processes. To study the effect of COVID-19, we varied the heart rate, the contractility and the pulmonary resistances in suitable ranges. ResultsOur computations on individuals with both otherwise normal and impaired cardiac functions revealed that COVID-19 worsen cardiac function, as shown by a decrease of some cardiac biomarkers values such as cardiac output and ejection fraction. In the case of existing impaired cardiac function, the presence of COVID-19 lead to values outside the normal ranges. ConclusionsComputational models revealed to be an effective tool to study the effect of COVID-19 on the cardiovascular system. Such effect could be significant for patients with impaired cardiac function. This is especially useful to perform a sensitivity SERO analysis of the hemodynamics for different conditions. CONDENSED ABSTRACTEmerging studies address how COVID-19 infection MESHD might impact the cardiovascular system. This relates particularly to the development of myocardial injury, acute coronary syndrome MESHD, myocarditis MESHD myocarditis HP, arrhythmia HP, and heart failure MESHD. Prospective treatment approach is advised for these patients. By the assessment of conventional important biomarkers obtained with new sources as a 0-dimentional computational model, we propose a new study protocol as an effective method to evaluate short-term prognosis. The clinical protocol proposed will help to rapidly identify which patients require intensive monitoring, diagnostic strategy and most adequate therapy.

    Life-threatening cardiogenic shock MESHD cardiogenic shock HP in a pediatric patient with SARS-CoV-2-associated myocarditis MESHD myocarditis HP treated with remdesivir: a case description and report of similar cases from the Literature

    Authors: Silvia Molinari; Lucia M.D. Colasanto; Maria L. Melzi; Alessandro Cattoni; Roberto Panceri; Michela Bombino; Giuseppe Lapadula; Andrea Biondi

    doi:10.21203/ Date: 2020-06-12 Source: ResearchSquare

    BackgroundChildren are relatively spared from Coronavirus disease MESHD 2019 (COVID-19), but some severe cases have been reported. Severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD in children TRANS may affect the cardiovascular system. We hereby report about a case of myocarditis MESHD myocarditis HP evolving to cardiogenic shock MESHD cardiogenic shock HP in a SARS-CoV-2 positive child TRANS.Case presentationAn otherwise healthy 12-year-old patient was admitted with fever MESHD fever HP, vomiting MESHD vomiting HP, diarrhoea and drowsiness HP, without any respiratory symptoms. He was diagnosed with COVID-19 on nasopharyngeal swab. He developed hypotension MESHD hypotension HP and cardiogenic shock MESHD cardiogenic shock HP. Bedside echocardiography revealed left ventricular impairment with an ejection fraction (LVEF) below 25%. Plasmatic markers of myocardial injury were remarkably raised, as well as inflammatory biomarkers, including procalcitonin (highest recorded value: 66 ng/mL) and interleukin-6 (8209 pg/mL). The child TRANS was transferred to Intensive Care Unit and he was treated with catecholamine support, mechanical ventilation and empiric anti-infectious therapy, including broad spectrum antibiotics and the antiviral agent remdesivir. All additional microbiological investigations yielded negative results. We observed a gradual improvement of LVEF within 5 days. A cardiac magnetic resonance confirmed the suspicion of myocarditis MESHD myocarditis HP. After 21 days of hospitalisation, the child TRANS was discharged without sequelae.ConclusionsOur hypothesis is that the child TRANS suffered from SARS-CoV-2-induced fulminant myocarditis MESHD myocarditis HP, probably in the setting of cytokine release syndrome MESHD (CRS). The peculiarity of this SARS-CoV-2 infection MESHD is the presence of cardiac failure in a previously healthy child TRANS without a respiratory illness. The positive outcome is in line with published Literature about the overall better prognosis of COVID-19 children TRANS compared to adults TRANS. Remdesivir, an investigational antiviral therapy, may have played a role on the clinical improvement of the child TRANS.

    Unspecific post-mortem findings despite multiorgan 1 viral spread in COVID-19 patients

    Authors: Myriam Remmelink; Ricardo De Mendoca; Nicky D'Haene; Sarah De Clercq; Camille Verocq; Laetitia Lebrun; Philomene Lavis; Marie Lucie Racu; Anne Laure Trepant; Calliope Maris; Sandrine Rorive; Jean Christophe Goffard; Olivier De Witte; Lorenzo Peluso; Jean Louis Vincent; Christine Decaestecker; Fabio Silvio Taccone; Isabelle Salmon

    doi:10.1101/2020.05.27.20114363 Date: 2020-05-28 Source: medRxiv

    Background Post-mortem studies can provide important information for understanding new diseases MESHD and small autopsy case series have already reported different findings in COVID-19 patients. Methods We evaluated whether some specific post-mortem features are observed in these patients and if these changes are related to the presence of the virus in different organs. Complete macroscopic and microscopic autopsies were performed on different organs in 17 COVID-19 non-survivors. Presence of SARS-CoV-2 was evaluated with immunohistochemistry (IHC) in lung samples and with real-time reverse-transcription polymerase chain reaction (RT-PCR) test in lung and other organs. Results Pulmonary findings revealed early-stage diffuse alveolar damage (DAD) in 15 out of 17 patients and microthrombi in small lung arteries in 11 patients. Late-stage DAD, atypical pneumocytes and/or acute pneumonia MESHD pneumonia HP were also observed. Four lung infarcts, two acute myocardial infarctions MESHD myocardial infarctions HP and one ischemic enteritis MESHD were observed. There was no evidence of myocarditis MESHD myocarditis HP, hepatitis MESHD hepatitis MESHD hepatitis HP or encephalitis MESHD encephalitis HP. Kidney evaluation revealed the presence of hemosiderin in tubules or pigmented casts in most patients. Spongiosis and vascular congestion were the most frequently encountered brain lesions. No specific SARS-CoV-2 lesions were observed in any organ. IHC revealed positive cells with a heterogeneous distribution in the lungs of 11 of the 17 (65%) patients; RT-PCR yielded a wide distribution of SARS-CoV-2 in different tissues, with 8 patients showing viral presence in all tested organs (i.e. lung, heart, spleen, liver, colon, kidney and brain). Conclusions In conclusion, autopsies revealed a great heterogeneity of COVID-19-related organ injury and the remarkable absence of any specific viral lesions, even when RT-PCR identified the presence of the virus in many organs.

    Evidence for anti-viral effects of complete Freunds adjuvant in the mouse model of enterovirus infection MESHD

    Authors: Arunakumar Gangaplara; Chandirasegaran Massilamany; Ninaad Lasrado; David Steffen; Jay Reddy

    doi:10.1101/2020.05.27.120121 Date: 2020-05-28 Source: bioRxiv

    Group B Coxsackieviruses belonging to the genus, Enterovirus, contain six serotypes that induce various diseases MESHD, whose occurrence may involve the mediation of more than one serotype. We recently identified immunogenic epitopes within CVB3 viral protein 1 that induce anti-viral T cell responses in mouse models of CVB infections MESHD. In our investigations to determine the protective responses of the viral epitopes, we unexpectedly noted that animals immunized with complete Freunds adjuvant (CFA) alone and later challenged with CVB3 were completely protected against myocarditis MESHD myocarditis HP. Similarly, the pancreatitis MESHD pancreatitis HP-inducing ability of CVB3 was remarkably reduced to only 10% in the CFA group as opposed to 73.3% in the control group that received no CFA. Additionally, no mortalities were noted in the CFA group, whereas 40% of control animals died during the course of 21 days post- infection MESHD with CVB3. Taken together, our data suggest that the adjuvant effects of CFA may be sufficient for protection against CVB infections MESHD. These observations may provide new insights into our understanding of the occurrence of viral infections MESHD. One example is Coronavirus disease MESHD-19 (COVID-19) as individuals suffering from COVID-19 who have been vaccinated with Bacillus Calmette-Guerin appear to have fewer morbidities and mortalities than unvaccinated individuals.

    Multisystem inflammatory syndrome MESHD with features of Atypical Kawasaki disease MESHD during COVID-19 pandemic: Report of a case from India

    Authors: Abdul Rauf; Ajay Vijayan; Shaji Thomas John; Raghuram A Krishnan; Abdul Latheef

    doi:10.21203/ Date: 2020-05-15 Source: ResearchSquare

    There is a global concern of increasing number of children TRANS presenting with inflammatory syndrome MESHD with clinical features simulating Kawasaki disease MESHD, during ongoing COVID-19 pandemic. We report a very similar case of 5-year-old boy from a COVID-19 hotspot area in Kerala state of India who presented in late April 2020 with acute febrile illness with abdominal pain MESHD abdominal pain HP and loose stools followed by shock MESHD shock HP. On examination, child TRANS had bulbar conjunctivitis MESHD conjunctivitis HP and extremity edema MESHD edema HP. Initial investigations showed high inflammatory parameters, elevated serum creatinine HP serum SERO creatinine and liver enzymes. Echocardiography showed moderate LV dysfunction and normal coronaries. Cardiac enzymes were also elevated, suggesting myocarditis MESHD myocarditis HP. He was treated with inotropic support, respiratory support with High Flow Nasal Cannula, IV Immunoglobulins, aspirin, steroids and diuretics. RT PCR for SARS-CoV-2 was negative twice. His clinical condition improved rapidly, was afebrile from day 2, inflammatory parameters decreased, left ventricular function improved and was discharged after 6 days of hospital stay.

    Outbreak of Kawasaki disease MESHD in children TRANS during COVID-19 pandemic: a prospective observational study in Paris, France

    Authors: Julie Toubiana; Clement Poirault; Alice Corsia; Fanny Bajolle; Jacques Fourgeaud; Francois Angoulvant; Agathe Debray; Romain Basmaci; Elodie Salvador; Sandra Biscardi; Pierre Frange; Martin Chalumeau; Jean-Laurent Casanova; Jeremie F Cohen; Slimane Allali

    doi:10.1101/2020.05.10.20097394 Date: 2020-05-14 Source: medRxiv

    Background: Acute clinical manifestations of SARS-CoV-2 infection MESHD are less frequent and less severe in children TRANS than in adults TRANS. However, recent observations raised concerns about potential post-viral severe inflammatory reactions in children TRANS infected with SARS-CoV-2. Methods: We describe an outbreak of cases of Kawasaki disease MESHD (KD) admitted between April 27 and May 7, 2020, in the general paediatrics department of a university hospital in Paris, France. All children TRANS prospectively underwent nasopharyngeal swabs for SARS-CoV-2 RT-PCR, SARS-CoV-2 IgG serology testing, and echocardiography. The number of admissions for KD during the study period was compared to that observed since January 1, 2018, based on discharge codes, using Poisson regression. Results: A total of 17 children TRANS were admitted for KD over an 11-day period, in contrast with a mean of 1.0 case per 2-week period over 2018-2019 (Poisson incidence rate ratio: 13.2 [95% confidence interval: 7.3-24.1], p <0.001). Their median age TRANS was 7.5 (range, 3.7-16.6) years, and 59% of patients originated from sub-Saharan Africa or Caribbean islands. Eleven patients presented with KD shock MESHD shock HP syndrome MESHD (KDSS) requiring intensive care support, and 12 had myocarditis MESHD myocarditis HP. All children TRANS had marked gastrointestinal symptoms at the early stage of illness and high levels of inflammatory markers. Fourteen patients (82%) had evidence of recent SARS-CoV-2 infection MESHD (positive RT-PCR 7/17, positive IgG antibody SERO detection 14/16). All patients received immunoglobulins and some received corticosteroids (5/17). The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 cases (29%) during hospitalisation. Conclusions: The ongoing outbreak of KD in the Paris might be related to SARS-CoV2, and shows an unusually high proportion of children TRANS with gastrointestinal involvement, KDSS and African ancestry.

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MeSH Disease
Human Phenotype

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