Acute Cardiac Injury in Coronavirus Disease 2019 and Other Viral Infections—A Systematic Review and Meta-Analysis

Cheng, Matthew P.; Cau, Alessandro; Lee, Todd C.; Brodie, Daniel; Slutsky, Arthur S.; Marshall, John C.; Murthy, Srinivas; Lee, Terry; Singer, Joel; Demir, Koray; Boyd, John H.; Ohm, Hyejee; Maslove, David; Goffi, Alberto; Bogoch, Isaac I.; Sweet, David; Walley, Keith R.; Russell, James A.; Corona, Angiotensin Receptor Blocker Coronavirus Study

doi:10.1097/ccm.0000000000005026

Cited by 27 publications

(33 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among them, PCT and CRP are two inflammatory marker proteins that have been studied deeply [ 15 ]. And, in recent years, HBP has also been gradually used in the diagnosis of bacterial infections [ 16 ].…”

Section: Results Analysis and Discussionmentioning

confidence: 99%

Diagnostic Value of the Triple Combination of Serum Heparin-Binding Protein, Procalcitonin, and C-Reactive Protein in Children with Acute Bacterial Upper Respiratory Tract Infection

Yang

Zhang

Lin

et al. 2022

Journal of Healthcare Engineering

View full text Add to dashboard Cite

To investigate the role of the triple combination serum heparin-binding protein (HBP), procalcitonin (PCT), and C-reactive protein (CRP) in children with acute bacterial upper respiratory tract infection (ABURTI). A total of 130 children with upper respiratory tract infection admitted to the Department of Pediatrics of Fujian Maternity and Child Health Hospital from September 2019 to January 2021 were selected as the research group. According to the results of pathogenic analysis, children were further subdivided into a bacterial infection group (n = 67) and a viral infection group (n = 63). Additionally, 65 children who underwent physical examinations in our hospital during the same period were collected and included into the control group (n = 65). All patients selected were treated with cefixime granules orally for 5 days. Serum HBP level, serum PCT level, and serum CRP level were measured by double antibody Sandwich Enzyme Linked Immunosorbent Assay (ELISA), fluorescence method, and immunoturbidimetric assay, respectively. The expression levels of the three indicators in the serum of all subjects were compared, and the receiver operating characteristic (ROC) curve was used to analyze their diagnostic value in children with ABURTI. Furthermore, according to clinical efficacy of children with bacterial infections, they were divided into a good efficacy group (markedly effective) and a poor efficacy group (effective + ineffective) to compare serum HBP, PCT, and CRP levels between the two groups. The ROC curve was drawn to analyze the value of the three indicators in predicting the curative effect in children with ABURTI. Pearson test was used to analyze the correlation among the expression of HBP, PCT, and CRP. Results showed that the expression levels of HBP, PCT, and CRP in the serum of children in the bacterial infection group were significantly higher than those in the other two groups. The positive rates of HBP, PCT, and CRP in children in the bacterial infection group were also significantly higher than those of the other two groups. The area under the curve (AUC) of the combined diagnosis of HBP, PCT, and CRP was 0.973, which was significantly higher than that of the single detection by any of the three indicators, which were 0.849, 0.819, and 0.854, respectively. The expression levels of HBP, PCT, and CRP in the serum of children in the good efficacy group were significantly lower than those in the poor efficacy group, and the AUC of the triple combination for predicting treatment efficacy was 0.959. Pearson test showed that there was a positive correlation between the serum expression of HBP, PCT, and CRP in children. HBP, PCT, and CRP were highly correlated in children with ABURTI, and their combined detection was of high diagnostic value among ABURTI patients, indicating that the three were expected to become potential indicators for efficacy prediction.

show abstract

Section: Results Analysis and Discussionmentioning

confidence: 99%

Diagnostic Value of the Triple Combination of Serum Heparin-Binding Protein, Procalcitonin, and C-Reactive Protein in Children with Acute Bacterial Upper Respiratory Tract Infection

Yang

Zhang

Lin

et al. 2022

Journal of Healthcare Engineering

View full text Add to dashboard Cite

show abstract

“…In contrast to the paucity of data regarding lymphocytic myocarditis in COVID-19, there is a significant proportion of autopsy [127] and EMB [128] specimens displaying an increased interstitial macrophage infiltration of the myocardium. Such high levels of myocardial macrophages point to non-specific myocardial inflammation resulting from high systemic levels of cytokines instead of direct viral-mediated myocarditis [127,129], as reported in other forms of pneumonias, although the occurrence of myocardial injury appears significantly higher in COVID than non-COVID pneumonia [120].…”

Section: Myocardial Inflammationmentioning

confidence: 72%

“…In several cohort studies from China, myocardial injury, as defined by elevated values of serum TnI, was reported in 7-28% of patients and was significantly associated with severe forms of the disease, the levels of inflammatory biomarkers, and mortality [38,116,117]. An elevation of cardiac biomarkers, including TnI and natriuretic peptides, has been reported in numerous cohort studies, with a prevalence reaching up to 50%, most notably in ICU-hospitalized patients [118][119][120] and with considerable prognostic value (OR for mortality 6.64, p = 0.03), according to a recent meta-analysis [121].…”

Section: Reduction Of Right Ventricular Contractility Evidence Of Myocardial Injury In Covid-19mentioning

confidence: 99%

“…A variety of clinical manifestations associated with cardiac injury has been reported, including right and left ventricle dysfunction, acute heart failure and cardiogenic shock, myocardial ischemia, ventricular arrhythmias, pericardial effusions, and stress cardiomyopathy [122], which have been grouped under the acronym ACovCS (acute COVID-19 cardiovascular syndrome) [120]. Furthermore, a series of cardiac magnetic resonance imaging studies have indicated some forms of myocardial involvement in a significant proportion of COVID-19 patients, including asymptomatic and recovering patients.…”

Section: Reduction Of Right Ventricular Contractility Evidence Of Myocardial Injury In Covid-19mentioning

confidence: 99%

See 1 more Smart Citation

The Right Ventricle in COVID-19

Bonnemain

Ltaief

Liaudet

2021

JCM

View full text Add to dashboard Cite

Infection with the novel severe acute respiratory coronavirus-2 (SARS-CoV2) results in COVID-19, a disease primarily affecting the respiratory system to provoke a spectrum of clinical manifestations, the most severe being acute respiratory distress syndrome (ARDS). A significant proportion of COVID-19 patients also develop various cardiac complications, among which dysfunction of the right ventricle (RV) appears particularly common, especially in severe forms of the disease, and which is associated with a dismal prognosis. Echocardiographic studies indeed reveal right ventricular dysfunction in up to 40% of patients, a proportion even greater when the RV is explored with strain imaging echocardiography. The pathophysiological mechanisms of RV dysfunction in COVID-19 include processes increasing the pulmonary vascular hydraulic load and others reducing RV contractility, which precipitate the acute uncoupling of the RV with the pulmonary circulation. Understanding these mechanisms provides the fundamental basis for the adequate therapeutic management of RV dysfunction, which incorporates protective mechanical ventilation, the prevention and treatment of pulmonary vasoconstriction and thrombotic complications, as well as the appropriate management of RV preload and contractility. This comprehensive review provides a detailed update of the evidence of RV dysfunction in COVID-19, its pathophysiological mechanisms, and its therapy.

show abstract

“…Myocardial injury can occur via ischemic and non-ischemic mechanisms and the overall rate of acute cardiac injury in older studies has been reported to be between 7.2 and 36%, with rates as high as 59% in those who died (18,43,44). The rate of acute cardiac injury has been found to be higher in the case of infection with viruses, such as SARS-CoV-2, that bind the ACE2 receptor, than in those with viruses that do not (45). Cardiac injury can occur early or later in the course of COVID-19 infection and recurrent episodes of cardiac injury may occur, with the latter events being associated with worse outcome (46).…”

Section: Acute Myocardial Injurymentioning

confidence: 99%

Emerging Role of Platelet-Endothelium Interactions in the Pathogenesis of Severe SARS-CoV-2 Infection-Associated Myocardial Injury

et al. 2022

View full text Add to dashboard Cite

Cardiovascular dysfunction and disease are common and frequently fatal complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Indeed, from early on during the SARS-CoV-2 virus pandemic it was recognized that cardiac complications may occur, even in patients with no underlying cardiac disorders, as part of the acute infection, and that these were associated with more severe disease and increased morbidity and mortality. The most common cardiac complication is acute cardiac injury, defined by significant elevation of cardiac troponins. The potential mechanisms of cardiovascular complications include direct viral myocardial injury, systemic inflammation induced by the virus, sepsis, arrhythmia, myocardial oxygen supply-demand mismatch, electrolyte abnormalities, and hypercoagulability. This review is focused on the prevalence, risk factors and clinical course of COVID-19-related myocardial injury, as well as on current data with regard to disease pathogenesis, specifically the interaction of platelets with the vascular endothelium. The latter section includes consideration of the role of SARS-CoV-2 proteins in triggering development of a generalized endotheliitis that, in turn, drives intense activation of platelets. Most prominently, SARS-CoV-2–induced endotheliitis involves interaction of the viral spike protein with endothelial angiotensin-converting enzyme 2 (ACE2) together with alternative mechanisms that involve the nucleocapsid and viroporin. In addition, the mechanisms by which activated platelets intensify endothelial activation and dysfunction, seemingly driven by release of the platelet-derived calcium-binding proteins, SA100A8 and SA100A9, are described. These events create a SARS-CoV-2–driven cycle of intravascular inflammation and coagulation, which contributes significantly to a poor clinical outcome in patients with severe disease.

show abstract

Acute Cardiac Injury in Coronavirus Disease 2019 and Other Viral Infections—A Systematic Review and Meta-Analysis

Cited by 27 publications

References 50 publications

Diagnostic Value of the Triple Combination of Serum Heparin-Binding Protein, Procalcitonin, and C-Reactive Protein in Children with Acute Bacterial Upper Respiratory Tract Infection

Diagnostic Value of the Triple Combination of Serum Heparin-Binding Protein, Procalcitonin, and C-Reactive Protein in Children with Acute Bacterial Upper Respiratory Tract Infection

The Right Ventricle in COVID-19

Emerging Role of Platelet-Endothelium Interactions in the Pathogenesis of Severe SARS-CoV-2 Infection-Associated Myocardial Injury

Contact Info

Product

Resources

About