Disturbing effect of lockdown for COVID-19 on the incidence of infective endocarditis: a word of caution

Camp, Guy Van; Beenhouwer, H. De; Beles, Monika; Collet, Carlos; Nasser, Riwa; Schelfaut, Dan; Pěnička, Martin

doi:10.1007/s00392-020-01686-x

Cited by 11 publications

(11 citation statements)

References 10 publications

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“…While an association between acute viral respiratory disease and subsequent cardiovascular events had been described for other diseases (e.g., influenza) [5,6], several centers reported a decline in hospital admissions for acute cardiovascular and cerebrovascular emergencies during the COVID pandemic [7][8][9][10][11][12][13][14][15][16][17][18][19]. Since acute cardiovascular and cerebrovascular diseases remain leading causes for morbidity and mortality, further investigation of this concerning trend is warranted to identify potential implications for both health-care professionals and regulators.…”

Section: Introductionmentioning

confidence: 98%

Temporal trends in the presentation of cardiovascular and cerebrovascular emergencies during the COVID-19 pandemic in Germany: an analysis of health insurance claims

et al. 2020

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Aims The first reports of declining hospital admissions for major cardiovascular emergencies during the COVID-19 pandemic attracted public attention. However, systematic evidence on this subject is sparse. We aimed to investigate the rate of emergent hospital admissions, subsequent invasive treatments and comorbidities during the COVID-19 pandemic in Germany. Methods and results This was a retrospective analysis of health insurance claims data from the second largest insurance fund in Germany, BARMER. Patients hospitalized for acute myocardial infarction, acute limb ischemia, aortic rupture, stroke or transient ischemic attack (TIA) between January 1, 2019, and May 31, 2020, were included. Admission rates per 100,000 insured, invasive treatments and comorbidities were compared from January-May 2019 (pre-COVID) to January-May 2020 (COVID). A total of 115,720 hospitalizations were included in the current analysis (51.3% females, mean age 72.9 years). Monthly admission rates declined from 78.6/100,000 insured (pre-COVID) to 70.6/100,000 (COVID). The lowest admission rate was observed in April 2020 (61.6/100,000). Administration rates for ST-segment elevation myocardial infarction (7.3-6.6), non-ST-segment elevation myocardial infarction (16.8-14.6), acute limb ischemia (5.1-4.6), stroke (35.0-32.5) and TIA (13.7-11.9) decreased from pre-COVID to COVID. Baseline comorbidities and the percentage of these patients treated with interventional or open-surgical procedures remained similar over time across all entities. In-hospital mortality in hospitalizations for stroke increased from pre-COVID to COVID (8.5-9.8%). Conclusions Admission rates for cardiovascular and cerebrovascular emergencies declined during the pandemic in Germany, while patients' comorbidities and treatment allocations remained unchanged. Further investigation is warranted to identify underlying reasons and potential implications on patients' outcomes. Moritz Seiffert and Fabian J. Brunner share the first authorship.

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Section: Introductionmentioning

confidence: 98%

Temporal trends in the presentation of cardiovascular and cerebrovascular emergencies during the COVID-19 pandemic in Germany: an analysis of health insurance claims

et al. 2020

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“…With to date at least 4,440,000 cases of coronavirus infectious disease 2019 (COVID- 19) worldwide and estimated 302,000 deaths by June 2020, the pandemic caused by the new coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) binds the attention of the international community and medical professionals all over the world [1][2][3][4][5]. As this pandemic continues to unfold across continents, data on the clinical characteristics and outcomes of COVID-19 patients are urgently demanded [6].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 among heart transplant recipients in Germany: a multicenter survey

et al. 2020

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Aims Heart transplantation may represent a particular risk factor for severe coronavirus infectious disease 2019 (COVID-19) due to chronic immunosuppression and frequent comorbidities. We conducted a nationwide survey of all heart transplant centers in Germany presenting the clinical characteristics of heart transplant recipients with COVID-19 during the first months of the pandemic in Germany. Methods and results A multicenter survey of all heart transplant centers in Germany evaluating the current status of COVID-19 among adult heart transplant recipients was performed. A total of 21 heart transplant patients with COVID-19 was reported to the transplant centers during the first months of the pandemic in Germany. Mean patient age was 58.6 ± 12.3 years and 81.0% were male. Comorbidities included arterial hypertension (71.4%), dyslipidemia (71.4%), diabetes mellitus (33.3%), chronic kidney failure requiring dialysis (28.6%) and chronic-obstructive lung disease/asthma (19.0%). Most patients received an immunosuppressive drug regimen consisting of a calcineurin inhibitor (71.4%), mycophenolate mofetil (85.7%) and steroids (71.4%). Eight of 21 patients (38.1%) displayed a severe course needing invasive mechanical ventilation. Those patients showed a high mortality (87.5%) which was associated with right ventricular dysfunction (62.5% vs. 7.7%; p = 0.014), arrhythmias (50.0% vs. none; p = 0.012), and thromboembolic events (50.0% vs. none; p = 0.012). Elevated high-sensitivity cardiac troponin T-and N-terminal prohormone of brain natriuretic peptide were significantly associated with the severe form of COVID-19 (p = 0.017 and p < 0.001, respectively). Conclusion Severe course of COVID-19 was frequent in heart transplanted patients. High mortality was associated with right ventricular dysfunction, arrhythmias, thromboembolic events, and markedly elevated cardiac biomarkers.

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“…In the current COVID-19 pandemic, symptoms related to IE might be incorrectly attributed to a diagnosis of SARS-CoV-2 infection. Observational studies conducted in Spain and Belgium report a 34% and 33% decrease in the absolute number of IE definitive diagnoses respectively when comparing 2020 with 2019, indicating a substantial risk of underdiagnosis [ 7 - 8 ]. Conversely, COVID-19 itself might represent a risk factor for IE, increasing the probability of a concomitant presentation.…”

Section: Discussionmentioning

confidence: 99%

“…It should also be noted that patients might avoid medical care during the pandemic and hospital resources might be relocated according to the needs [ 8 ]. Even though transesophageal echocardiography (TEE) is a very sensitive examination and the cornerstone for the diagnosis of IE, current recommendations of European Association of Cardiovascular Imaging (EACVI) suggest that its use should be restricted due to the high risk of contamination of the operators [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Staphylococcus lugdunensis Native Valve Endocarditis in a Patient With Confirmed COVID-19: A Cautionary Tale of an Old Disease Not to Be Forgotten in the Pandemic Era

Mouzakitis¹,

Kleinaki²,

Petropoulou³

et al. 2021

Cureus

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The coronavirus disease 2019 (COVID-19) pandemic has radically altered priorities and planning in the global medical community with continuously increasing numbers of infected patients. Cardiovascular disease accounts for the most common comorbidity encountered in patients with COVID-19. Infective endocarditis (IE) represents a grave medical condition as it may compromise circulatory homeostasis, renal function, and lead to embolic complications. COVID-19 also causes coagulopathy-associated complications. In this report we describe the case of a patient presenting to the accident and emergency department with fever and chills. COVID-19 was confirmed and further workup revealed concomitant severe native valve IE with Staphylococcus lugdunensis. Medical community worldwide should remain alert and continue working towards early recognition of these intricate interactions.

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Disturbing effect of lockdown for COVID-19 on the incidence of infective endocarditis: a word of caution

Cited by 11 publications

References 10 publications

Temporal trends in the presentation of cardiovascular and cerebrovascular emergencies during the COVID-19 pandemic in Germany: an analysis of health insurance claims

Temporal trends in the presentation of cardiovascular and cerebrovascular emergencies during the COVID-19 pandemic in Germany: an analysis of health insurance claims

COVID-19 among heart transplant recipients in Germany: a multicenter survey

Staphylococcus lugdunensis Native Valve Endocarditis in a Patient With Confirmed COVID-19: A Cautionary Tale of an Old Disease Not to Be Forgotten in the Pandemic Era

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