Clinical features and outcomes of 2019 novel coronavirus–infected patients with cardiac injury

liu, youbin; Li, Jinglong; liu, Dehui; Song, Haiqu; Chen, Chunlin; lv, Mingfang; Pei, Xing; Huang, Zhongwei

doi:10.1101/2020.03.11.20030957

Cited by 20 publications

(23 citation statements)

References 9 publications

(7 reference statements)

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“…Additionally, we found in our normalized dataset that heart tissues also had the third highest level of ACE2 expression. This observation is also in line with reports showing that COVID-19 patients complicated with cardiac diseases are subject to the highest mortality risk 40,41 . Together, the consistence between our results and clinical observations demonstrated that ACE2 expression is a reasonable indicator for susceptibility to SARS-CoV-2 infection.…”

Section: Discussionsupporting

confidence: 92%

Atlas of ACE2 gene expression in mammals reveals novel insights in transmisson of SARS-Cov-2

Sun

et al. 2020

Preprint

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Background: COVID-19 has become a worldwide pandemic. It is caused by a novel coronavirus named SARS-CoV-2 with elusive origin. SARS-CoV-2 infects mammalian cells by binding to ACE2, a transmembrane protein. Therefore, the conservation of ACE2 and its expression pattern across mammalian species, which are yet to be comprehensively investigated, may provide valuable insights into tracing potential hosts of SARS-CoV-2. Methods:We analyzed gene conservation of ACE2 across mammals and collected more than 140 transcriptome datasets from human and common mammalian species, including presumed hosts of SARS-CoV-2 and other animals in close contact with humans. In order to enable comparisons across species and tissues, we used a unified pipeline to quantify and normalize ACE2 expression levels. Results:We first found high conservation of ACE2 genes among common mammals at both DNA and peptide levels, suggesting that a broad range of mammalian species can potentially be the hosts of SARS-CoV-2. Next, we showed that high level of ACE2 expression in certain human tissues is consistent with clinical symptoms of COVID-19 patients. Furthermore, we observed that ACE2 expressed in a species-specific manner in the mammals examined. Notably, high expression in skin and eyes in cat and dog suggested that these animals may play roles in transmitting SARS-CoV-2 to humans. Conclusions:Through building the first atlas of ACE2 expression in pets and livestock, we identified species and tissues susceptible to SARS-CoV-2 infection, yielding novel insights into the viral transmission.

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Section: Discussionsupporting

confidence: 92%

Atlas of ACE2 gene expression in mammals reveals novel insights in transmisson of SARS-Cov-2

Sun

et al. 2020

Preprint

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“…The increased incidence of cardiac injury among those with severe systemic inflammatory response syndromes (SIRS) and shock in the setting of COVID-19 also highlights an important relationship between the immune response to the virus and the cardiovascular system. In addition, a high prevalence of pre-existing cardio-metabolic disease has been noted among those with severe COVID-19 [16,17], and those with pre-existing cardiovascular conditions suffer increased mortality during COVID-19 infection [18]. In particular, the reported case fatality rates for COVID-19 are 10.5% in patients with cardiovascular disease, 7.3% in patients with diabetes, and 6.0% in those with hypertension, higher than the case-fatality rate of 3-4% observed world-wide for patients without these co-morbidities [7••].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

et al. 2020

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Purpose of Review Coronavirus disease of 2019 (COVID-19) is a cause of significant morbidity and mortality worldwide. While cardiac injury has been demonstrated in critically ill COVID-19 patients, the mechanism of injury remains unclear. Here, we review our current knowledge of the biology of SARS-CoV-2 and the potential mechanisms of myocardial injury due to viral toxicities and host immune responses. Recent Findings A number of studies have reported an epidemiological association between history of cardiac disease and worsened outcome during COVID infection. Development of new onset myocardial injury during COVID-19 also increases mortality. While limited data exist, potential mechanisms of cardiac injury include direct viral entry through the angiotensinconverting enzyme 2 (ACE2) receptor and toxicity in host cells, hypoxia-related myocyte injury, and immune-mediated cytokine release syndrome. Potential treatments for reducing viral infection and excessive immune responses are also discussed. Summary COVID patients with cardiac disease history or acquire new cardiac injury are at an increased risk for in-hospital morbidity and mortality. More studies are needed to address the mechanism of cardiotoxicity and the treatments that can minimize permanent damage to the cardiovascular system.

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“…The ratio of CRRT use to ICU admissions was 19.7%. The four unpublished reports included 593 patients, with 151 patients requiring ICU admission and 36 receiving CRRT ( 14 – 17 ). Among all the included patients with COVID-19, about 20% of the patients who had acute respiratory distress syndrome or needed ICU admission received CRRT.…”

Section: Resultsmentioning

confidence: 99%

Frequency of Continuous Renal Replacement Therapy Use Early in Coronavirus Disease 2019 Pandemic

Baduashvili

Oberle

Devitt

2020

Critical Care Explorations

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Objectives: A subset of patients with coronavirus disease 2019 develop renal failure and require continuous renal replacement therapy. We reviewed the available literature to understand the frequency of continuous renal replacement therapy use among patients with coronavirus disease 2019 who required intensive care. Data Sources: The authors reviewed PubMed and Google Scholar for published studies and MedRxiv.com for unpublished studies. Study Selection: Observational and randomized studies that report the frequency of continuous renal replacement therapy use in adult patients with coronavirus disease 2019. Data Extraction: Data from the eligible studies were extracted independently by two authors into Microsoft Excel. Data Synthesis: We identified 12 eligible studies (eight published, four unpublished). We found that up to 20% of patients admitted to ICUs may require continuous renal replacement therapy. Conclusions: Given the high utilization of continuous renal replacement therapy by critically ill patients with coronavirus disease 2019, there may be an urgent need to mobilize inpatient dialysis resources to cope with the anticipated increase in the demand.

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Clinical features and outcomes of 2019 novel coronavirus–infected patients with cardiac injury

Cited by 20 publications

References 9 publications

Atlas of ACE2 gene expression in mammals reveals novel insights in transmisson of SARS-Cov-2

Atlas of ACE2 gene expression in mammals reveals novel insights in transmisson of SARS-Cov-2

Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

Frequency of Continuous Renal Replacement Therapy Use Early in Coronavirus Disease 2019 Pandemic

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