This systematic review focuses on the clinical features, physical examination findings, outcomes, and underlying pathology of acute telogen effluvium (TE), a type of diffuse hair loss, occurring in coronavirus disease 2019 (COVID‐19) recovered patients. MEDLINE/PubMed and Embase databases were queried till October 2021 to identify studies reporting acute TE occurring after COVID‐19 recovery. Data were obtained from 19 studies, which included 465 patients who were diagnosed with acute TE. The median age of these patients was 44 years and 67.5% were females. The most common trichoscopic findings were decreased hair density, the presence of empty follicles, or short regrowing hair. The mean duration from COVID‐19 symptom onset to the appearance of acute TE was 74 days, which is earlier than classic acute TE. Most patients recovered from hair loss, while a few patients had persistent hair fall. Our results highlight the need to consider the possibility of post‐COVID‐19 acute TE in patients presenting with hair fall, with a history of COVID‐19 infection, in the context of COVID‐19 pandemic. Despite being a self‐limiting condition, hair loss post‐COVID‐19 is a stressful manifestation. Identifying COVID‐19 infection as a potential cause of acute TE will help the clinicians counsel the patients, relieving them from undue stress.

Background: COVID-19 was initially considered to be a respiratory illness, but current findings suggest that SARS-CoV-2 is increasingly expressed in cardiac myocytes as well. COVID-19 may lead to cardiovascular injuries, resulting in myocarditis, with inflammation of the heart muscle. Objective: This systematic review collates current evidence about demographics, symptomatology, diagnostic, and clinical outcomes of COVID-19 infected patients with myocarditis. Methods: In accordance with PRISMA 2020 guidelines, a systematic search was conducted using PubMed, Cochrane Central, Web of Science and Google Scholar until August, 2021. A combination of the following keywords was used: SARS-CoV-2, COVID-19, myocarditis. Cohorts and case reports that comprised of patients with confirmed myocarditis due to COVID-19 infection, aged >18 years were included. The findings were tabulated and subsequently synthesized. Results: In total, 54 case reports and 5 cohorts were identified comprising 215 patients. Hypertension (51.7%), diabetes mellitus type 2 (46.4%), cardiac comorbidities (14.6%) were the 3 most reported comorbidities. Majority of the patients presented with cough (61.9%), fever (60.4%), shortness of breath (53.2%), and chest pain (43.9%). Inflammatory markers were raised in 97.8% patients, whereas cardiac markers were elevated in 94.8% of the included patients. On noting radiographic findings, cardiomegaly (32.5%) was the most common finding. Electrocardiography testing obtained ST segment elevation among 44.8% patients and T wave inversion in 7.3% of the sample. Cardiovascular magnetic resonance imaging yielded 83.3% patients with myocardial edema, with late gadolinium enhancement in 63.9% patients. In hospital management consisted of azithromycin (25.5%), methylprednisolone/steroids (8.5%), and other standard care treatments for COVID-19. The most common in-hospital complication included acute respiratory distress syndrome (66.4%) and cardiogenic shock (14%). On last follow up, 64.7% of the patients survived, whereas 31.8% patients did not survive, and 3.5% were in the critical care unit. Conclusion: It is essential to demarcate COVID-19 infection and myocarditis presentations due to the heightened risk of death among patients contracting both myocardial inflammation and ARDS. With a multitude of diagnostic and treatment options available for COVID-19 and myocarditis, patients that are under high risk of suspicion for COVID-19 induced myocarditis must be appropriately diagnosed and treated to curb co-infections.

Introduction: COVID-19 vaccines became available after being carefully monitored in clinical trials with safety and efficacy on the human body. However, a few recipients developed unusual side effects, including cerebral venous sinus thrombosis (CVST). We aim to systematically review the baseline features, clinical characteristics, treatment, and outcomes in patients developing CVST post-COVID-19 vaccination. Methods: This study was conducted according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) 2020 guideline. Investigators independently searched PubMed, Embase, and Google Scholar for English language articles published from inception up until September 10, 2021, reporting the incidence of CVST post-COVID-19 vaccines. We analyzed CVST patients’ baseline data, type of vaccines, clinical findings, treatment, and outcomes. Our systematic review process yielded patient-level data. Result: The final analysis included 25 studies that identified 80 patients who developed CVST after the COVID-19 vaccination. Of the 80 CVST cases, 31 (39.24%) patients died. There was no significant relationship between mortality and age ( P = .733), sex ( P = .095), vaccine type ( P = .798), platelet count ( P = .93), and comorbidities such as hypertension ( P = .734) and diabetes mellitus ( P = .758). However, mortality was associated with the duration of onset of CVST symptoms after vaccination ( P = .022). Patients with CVST post-COVID-19 vaccination were more likely to survive if treated with an anticoagulant ( P = .039). Patients who developed intracranial hemorrhage ( P = .012) or thrombosis in the cortical vein ( P = .021) were more likely to die. Conclusion: COVID-19 vaccine-associated CVST is associated with high mortality rate. Timely diagnosis and management can be lifesaving for patients.

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Background: There has been growing interest in studying demand ischemia as a cause of type 2 myocardial infarction (T2MI) in younger patients. Conventional cardiovascular risk factors and their association (and degree) are vaguely defined as predictors of T2MI. Women may be noted to have different predictors given their underrepresentation in clinical trials. Methods: We analyzed young female (18-44 years) hospitalizations from the National Inpatient Sample 2018 for multivariate-adjusted predictors (aOR, 95% confidence interval) of T2MI, STEMI and NSTEMI admissions, and divided the significance level into p<0.01, p<0.05 & p<0.1. Results: Young females (n=6,152,028) had 0.05% STEMI, 0.16% NSTEMI and 0.08% T2MI admissions. Predictors (Table 1) with the highest significance level of association for T2MI (p<0.01), compared to ST/NSTEMI (either 0.01<p<0.05 or not significant), were black race (aOR 1.49) and CHF (aOR 1.97), pulmonary circulation disorder (aOR 1.83) and OSA (aOR 1.62). Valvular heart disease, paralysis, COPD, deficiency anemia predicted a higher risk of T2MI admissions in young women (p<0.05) but not STEMI/NSTEMI admissions. Hypertension, prior MI, dyslipidemia, family history of coronary artery disease, peripheral vascular disease, coagulopathy and fluid-electrolyte disorder predicted a higher risk of T2MI or STEMI/NSTEMI. Collagen vascular disorders and obesity had a higher risk of T2MI/NSTEMI (p<0.01) but not of STEMI (p=0.07). DM, and cocaine abuse predicted higher odds of STEMI/NSTEMI but not of T2MI. Hypothyroid, liver disease, metastatic cancer, AIDS, depression, alcohol abuse and cannabis abuse did not predict a higher risk of T2MI or STEMI/NSTEMI. Hypothyroid, liver disease, metastatic cancer, AIDS, depression, alcohol and cannabis abuse did not predict higher odds of T2MI or STEMI/NSTEMI in young women. Conclusion: Predictors associated with T2MI in young females with a higher order of significance than ST/NSTEMI can be utilized to build a risk score for T2MI in young females.