A Systematic Review of the Cardiovascular Manifestations and Outcomes in the Setting of Coronavirus-19 Disease

Thakkar, Samarthkumar; Arora, Shilpkumar; Kumar, Ashish; Jaswaney, Rahul; Faisaluddin, Mohammed; Din, Mohammad Ammad Ud; Shariff, Mariam; Barssoum, Kirolos; Patel, Harsh; Arora, Nirav; Jani, Chinmay; Savani, Sejal; DeSimone, Christopher V.; Mulpuru, Siva K.; Deshmukh, Abhishek

doi:10.1101/2020.08.09.20171330

Cited by 12 publications

(13 citation statements)

References 80 publications

(149 reference statements)

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“…Even though the primary manifestations of COVID-19 arise from the respiratory system (namely pneumonia and acute respiratory distress syndrome) (8), it is well known that COVID-19 also affects other systems, the majority of which express ACE2. Such extra-respiratory manifestations may include neurological, gastrointestinal and cardiovascular dysfunctions (9)(10)(11)(12). Even though the majority of infected individuals will develop mild-to-moderate disease, a fraction of patients will be hospitalized in order to receive oxygen supplementation and supportive therapy (13,14).…”

Section: Introductionmentioning

confidence: 99%

Immune response (IgG) following full inoculation with BNT162b2 COVID‑19 mRNA among healthcare professionals

et al. 2021

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Soon after the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in December, 2019, numerous research teams, assisted by vast capital investments, achieved vaccine development in a fraction of time. However, almost 8 months following the initiation of the European vaccination programme, the need for prospective monitoring of the vaccine-induced immune response, its determinants and related side-effects remains a priority. The present study aimed to quantify the immune response following full vaccination with the BNT162b2 coronavirus disease 2019 (COVID-19) mRNA vaccine by measuring the levels of immunoglobulin G (IgG) titers in healthcare professionals. Moreover, common side-effects and factors associated with IgG titers were identified. For this purpose, blood samples from 517 individuals were obtained and analysed. Blood sampling was performed at a mean period of 69.0±23.5 days following the second dose of the vaccine. SARS-CoV-2 IgG titers had an overall mean value of 4.23±2.76. Females had higher titers than males (4.44±2.70 and 3.89 ±2.84, respectively; P=0.007), while non-smokers had higher titers than smokers (4.48±2.79 and 3.80±2.64, respectively; P=0.003). An older age was also associated with lower antibody titers (P<0.001). Moreover, the six most prevalent adverse effects were pain at the injection site (72.1%), generalized fatigue (40.5%), malaise (36.3%), myalgia (31,0%), headache (25.8%) and dizziness/weakness (21.6%). The present study demonstrated that the immune response after receiving the BNT162b2 COVID-19 mRNA vaccine is dependent on various modifiable and non-modifiable factors. Overall, the findings of the present study highlight two key aspects of the vaccination programs: First, the need for prospective immunosurveillance studies in order to estimate the duration of immunity, and second, the need to identify those individuals who are at a greater risk of developing low IgG titers in order to evaluate the need for a third dose of the vaccine.

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Section: Introductionmentioning

confidence: 99%

Immune response (IgG) following full inoculation with BNT162b2 COVID‑19 mRNA among healthcare professionals

et al. 2021

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“…The severe acute respiratory syndrome virus-2 (SARS-CoV-2) virus that causes coronavirus disease 2019 (COVID-19) was identified in Wuhan, Hubei province of China in December 2019 by the Chinese Center for Disease and Prevention from the throat swab of a patient [1]. The Coronavirus infection mainly affects the respiratory system and is presented with fever, dry cough, and difficulty of breathing, and lately, the patient may deteriorate associated with pneumonia and acute respiratory distress syndrome [1][2][3][4] despite recent evidence on the clinical manifestation of the gastrointestinal tract, cardiac, dermatologic, cardiac and central nervous system [5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis

2020

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Background The coronavirus disease 2019 (COVID-19) pandemic puts perioperative providers and staff at risk of viral exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) during aerosol-generating procedures, particularly in asymptomatic carriers.However, the perioperative risk for adverse outcomes in SARS-CoV-2 infected patients remain uncertain and the topic of debate. The current study was designed to determine the postoperative mortality in COVID-19 patients based on a systematic review and meta-analysis of the global published peer-reviewed literature. Methods A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 29, 2019, to August15, 2020, without language restriction. All observational studies reporting the prevalence of mortality were included while case reports and reviews were excluded. The data from each study were extracted with two independent authors with a customized format excel sheet and the disagreements were resolved by the third author. The methodological quality of included studies was evaluated using a standardized critical appraisal Tool adapted from the Joanna Briggs Institute. Results A total of 715 articles were identified from different databases and 45 articles were selected for evaluation after the successive screening. Twenty-three articles with 2947 participants were included. The meta-analysis revealed a very high global rate of postoperative mortality among COVID-19 patients of 20% (95% CI: 15 to 26) and a postoperative ICU admission rate of 15% (95% confidence interval (CI):10 to 21). Conclusion The unexpected high postoperative mortality rate in SARS-CoV-2 infected patients of 20% in the global literature mandates further scrutiny in assuring appropriate surgical indications and perioperative surgical safety measures in this vulnerable cohort of patients. Registration This systematic review and meta-analysis was registered in Prospero’s international prospective register of systematic reviews (CRD42020203362) on August 10, 2020.

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“…Additionally, coagulation abnormalities secondary to coronavirus and blood pressure control derangements are triggers for hemorrhagic stroke in COVID-19 patients. 45 Qureshi et al. suggested avoiding antiplatelet medication in suspected or confirmed COVID-19 infection if possible, for the first 24 h after receiving intravenous rt-PA (IV tPA) and endovascular mechanical thrombectomy (EVT) in AIS patients.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of COVID-19 Complications and their Possibilities as Potential Triggers of Stroke

Patel

Malik

Mehta

et al. 2021

Journal of Stroke and Cerebrovascular Diseases

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Introduction There is limited literature on coronavirus disease 2019 (COVID -19) complications such as thromboembolism, cardiac complications etc. as possible trigger for stroke. Hence, we aim to evaluate the prevalence and outcomes of COVID-19 related cardiovascular complications and secondary infection and their possibility as potential triggers for the stroke. Methods Data from observational studies describing the complications [acute cardiac injury (ACI), cardiac arrhythmias (CA), disseminated intravascular coagulation (DIC), septic shock, secondary infection] and outcomes of COVID‐19 hospitalized patients from December 1, 2019 to June 30, 2020, were extracted following PRISMA guidelines. Adverse outcomes defined as intensive care units, oxygen saturation less than 90%, invasive mechanical ventilation, severe disease, and in‐hospital mortality. The odds ratio and 95% confidence interval were obtained, and forest plots were created using random‐effects models. A short review of these complications as triggers of stroke was conducted. Results 16 studies with 3480 confirmed COVID-19 patients, prevalence of ACI [38%vs5.9%], CA [26%vs5.3%], DIC [4%vs0.74%], septic shock [18%vs0.36%], and infection [30%vs12.5%] was higher among patients with poor outcomes. In meta-analysis, ACI [aOR:9.93(95%CI:3.95–25.00], CA [7.52(3.29–17.18)], DIC [7.36(1.24–43.73)], septic shock [30.12(7.56–120.10)], and infection [10.41(4.47–24.27)] had higher odds of adverse outcomes. Patients hospitalized with acute ischemic stroke and intracerebral hemorrhage, had complications like pulmonary embolism, venous thromboembolism, DIC, etc. and had poor outcomes Conclusion The complications like acute cardiac injury, cardiac arrhythmias, DIC, septic shock, and secondary infection had poor outcomes. Patients with stroke were having history of these complications. Long term monitoring is required in such patients to prevent stroke and mitigate adverse outcomes.

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A Systematic Review of the Cardiovascular Manifestations and Outcomes in the Setting of Coronavirus-19 Disease

Cited by 12 publications

References 80 publications

Immune response (IgG) following full inoculation with BNT162b2 COVID‑19 mRNA among healthcare professionals

Immune response (IgG) following full inoculation with BNT162b2 COVID‑19 mRNA among healthcare professionals

Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis

Outcomes of COVID-19 Complications and their Possibilities as Potential Triggers of Stroke

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