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  1. Article ; Online: COVID-19: A Potential Risk Factor for Acute Pulmonary Embolism.

    Martin, Angel I / Rao, Gaurav

    Methodist DeBakey cardiovascular journal

    2020  Volume 16, Issue 2, Page(s) 155–157

    Abstract: ... inflammatory markers. The possibility of COVID-19 as an independent risk factor for APEs should be further ... acute pulmonary embolisms (APEs). There has been an increase in observational reports of venous ... A COVID-19-positive patient presented with pleuritic chest pain and cough and was found to have ...

    Abstract A COVID-19-positive patient presented with pleuritic chest pain and cough and was found to have acute pulmonary embolisms (APEs). There has been an increase in observational reports of venous thromboembolic events in patients who are positive for COVID-19, especially in the setting of elevated inflammatory markers. The possibility of COVID-19 as an independent risk factor for APEs should be further explored in this novel pandemic.
    MeSH term(s) Acute Disease ; Adult ; Anticoagulants/therapeutic use ; COVID-19 ; Chest Pain/diagnosis ; Chest Pain/etiology ; Computed Tomography Angiography/methods ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Cough/diagnosis ; Cough/etiology ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Male ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Pulmonary Embolism/complications ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/drug therapy ; Severe Acute Respiratory Syndrome/complications ; Severe Acute Respiratory Syndrome/diagnosis ; Severity of Illness Index ; Tomography, X-Ray Computed/methods ; Treatment Outcome
    Chemical Substances Anticoagulants
    Keywords covid19
    Language English
    Publishing date 2020-05-27
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2544079-2
    ISSN 1947-6108 ; 1947-6108
    ISSN (online) 1947-6108
    ISSN 1947-6108
    DOI 10.14797/mdcj-16-2-155
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  2. Article: COVID-19: A Potential Risk Factor for Acute Pulmonary Embolism

    Martin, Angel I / Rao, Gaurav

    Methodist Debakey Cardiovasc J

    Abstract: ... inflammatory markers. The possibility of COVID-19 as an independent risk factor for APEs should be further ... acute pulmonary embolisms (APEs). There has been an increase in observational reports of venous ... A COVID-19-positive patient presented with pleuritic chest pain and cough and was found to have ...

    Abstract A COVID-19-positive patient presented with pleuritic chest pain and cough and was found to have acute pulmonary embolisms (APEs). There has been an increase in observational reports of venous thromboembolic events in patients who are positive for COVID-19, especially in the setting of elevated inflammatory markers. The possibility of COVID-19 as an independent risk factor for APEs should be further explored in this novel pandemic.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #646674
    Database COVID19

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  3. Article ; Online: COVID-19 coagulopathy - what should we treat?

    Chowdary, Pratima

    Experimental physiology

    2022  Volume 107, Issue 7, Page(s) 749–758

    Abstract: ... microcirculation and potential contribution to the hypoxaemia of COVID-19 acute lung injury; and changes ... controlled trials are considered.: Abstract: Coronavirus disease 19 (COVID-19) causes acute ... deposition might benefit early disease. Essentially, COVID-19 is a multi-system disorder with pulmonary ...

    Abstract New findings: What is the topic of this review? Overview of the coagulation abnormalities, including elevated D-dimers widely reported with COVID-19, often labelled as COVID coagulopathy. What advances does it highlight? The review highlights the changes in bronchoalveolar haemostasis due to apoptosis of alveolar cells, which contributes to acute lung injury and acute respiratory distress syndrome; the pathophysiological mechanisms, including endothelial dysfunction and damage responsible for thrombosis of pulmonary microcirculation and potential contribution to the hypoxaemia of COVID-19 acute lung injury; and changes in coagulation proteins responsible for the hypercoagulability and increased risk of thrombosis in other venous and arterial beds. The rationale for anticoagulation and fibrinolytic therapies is detailed, and potential confounders that might have led to less than expected improvement in the various randomised controlled trials are considered.
    Abstract: Coronavirus disease 19 (COVID-19) causes acute lung injury with diffuse alveolar damage, alveolar-capillary barrier disruption, thrombin generation and alveolar fibrin deposition. Clinically, hypoxaemia is associated with preserved lung compliance early in the disease, suggesting the lack of excessive fluid accumulation typical of other lung injuries. Notably, autopsy studies demonstrate infection of the endothelium with extensive capillary thrombosis distinct from the embolic thrombi in pulmonary arteries. The inflammatory thrombosis in pulmonary vasculature secondary to endothelial infection and dysfunction appears to contribute to hypoxaemia. This is associated with elevated D-dimers and acquired hypercoagulability with an increased risk of deep vein thrombosis. Hypercoagulability is secondary to elevated plasma tissue factor levels, von Willebrand factor, fibrinogen, reduced ADAMTS-13 with platelet activation and inhibition of fibrinolysis. Multi-platform randomised controlled studies of systemic therapeutic anticoagulation with unfractionated and low molecular mass heparins demonstrated a survival benefit over standard care with full-dose anticoagulation in patients with non-severe disease who require supplemental oxygen, but not in severe disease requiring ventilatory support. Late intervention and the heterogeneous nature of enrolled patients can potentially explain the apparent lack of benefit in severe disease. Improvement in oxygenation has been demonstrated with intravenous fibrinolytics in small studies. Inhaled anticoagulants, thrombolytic agents and non-specific proteolytic drugs in clinical trials for decreasing alveolar fibrin deposition might benefit early disease. Essentially, COVID-19 is a multi-system disorder with pulmonary vascular inflammatory thrombosis that requires an interdisciplinary approach to combination therapies addressing both inflammation and intravascular thrombosis or alveolar fibrin deposits to improve outcomes.
    MeSH term(s) Acute Lung Injury/drug therapy ; Anticoagulants/therapeutic use ; COVID-19 ; Fibrin/metabolism ; Humans ; Hypoxia/drug therapy ; SARS-CoV-2 ; Thrombophilia/drug therapy ; Thrombophilia/etiology ; Thrombosis/drug therapy
    Chemical Substances Anticoagulants ; Fibrin (9001-31-4)
    Language English
    Publishing date 2022-06-22
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1016295-1
    ISSN 1469-445X ; 0958-0670
    ISSN (online) 1469-445X
    ISSN 0958-0670
    DOI 10.1113/EP089404
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  4. Book ; Online: COVID-19

    Martin, A. I. / Rao, G.

    Journal Articles

    A Potential Risk Factor for Acute Pulmonary Embolism

    2020  

    Keywords covid19
    Publishing date 2020-01-01T08:00:00Z
    Publisher Donald and Barbara Zucker School of Medicine Academic Works
    Publishing country us
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.

    Reza, Rezaur Rahman / Parajuli, Aalok / Padullaparthi, Tripura / Aloori, Swetha / Baddam, Anusha / Parajuli, Aakriti / Karnati, Susannah Shiny / Nasir, Hira

    Cureus

    2023  Volume 15, Issue 8, Page(s) e43295

    Abstract: ... vaccine also has the potential to cause acute and long-term cardiovascular effects, which include ... myocarditis, pericarditis, myopericarditis, myocardial infarction, pulmonary embolism, thrombotic ... Although the efficacy and safety of the coronavirus disease 2019 (COVID-19) vaccine have been ...

    Abstract Although the efficacy and safety of the coronavirus disease 2019 (COVID-19) vaccine have been established, side effects and adverse events related to the COVID-19 vaccine are still coming out. COVID-19 vaccine also has the potential to cause acute and long-term cardiovascular effects, which include myocarditis, pericarditis, myopericarditis, myocardial infarction, pulmonary embolism, thrombotic thrombocytopenia, and pulmonary hemorrhage. Although uncommon, takotsubo cardiomyopathy (TCM) has also been reported following COVID-19 vaccination. We report a case of TCM following the COVID-19 vaccine in a 59-year-old female who presented with intermittent chest pain and dyspnea following the COVID-19 vaccine booster dose. She had no identifiable triggers for TCM, no risk factors for cardiovascular disease, and normal cardiac enzyme levels, ruling out other causes of cardiac dysfunction. The diagnosis of TCM was supported by imaging findings and the absence of obstructive or thrombotic lesions on angiography.
    Language English
    Publishing date 2023-08-10
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.43295
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  6. Article ; Online: Cardiovascular manifestations in COVID-19 patients

    Jyotsna Maddury / Mani Krishna / Achukatla Kumar

    Apollo Medicine, Vol 19, Iss 3, Pp 168-

    2022  Volume 176

    Abstract: ... virus. COVID-19 morbidity is increased in the presence of CAD risk factors. Effect of CAD risk factors ... with pulmonary embolism had significantly higher hs-cTnT and NT pro-BNP levels than those without pulmonary embolism ... Most important medical challenge during the past 2 years is the COVID-19 pandemic due to SARS-CoV-2 ...

    Abstract Most important medical challenge during the past 2 years is the COVID-19 pandemic due to SARS-CoV-2 virus. COVID-19 morbidity is increased in the presence of CAD risk factors. Effect of CAD risk factors and COVID-19 infection are bidirectional. Preexisting conditions, such as cardiovascular disease (CVD), hypertension, diabetes, and obesity, increase the severity as well as mortality rate of COVID. COVID-19 disease induces multiple cardiovascular manifestations, such as myocarditis, acute myocardial injury, acute myocardial infarction (MI), stress-induced cardiomyopathy, cardiogenic shock, arrhythmias, and, subsequently, heart failure (HF) and cardiac arrest. Increase of troponin suggests a hyperinflammatory state or may be due to acute myocarditis. Elevated troponin without other laboratory markers elevation suggests aggressive COVID-19 disease than myocardial injury. Stress or takotsubo cardiomyopathy occurred primarily in women with COVID-19 and these women have more severe HF. The patients with COVID-19 positive more frequently have multivessel thrombosis, stent thrombosis, and a higher thrombus when compared to COVID-19-negative STEMIs. Because of higher thrombus burden more usage of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors and thrombus aspiration and higher heparin doses to achieve therapeutic activated clotting times were also noted. Patients with pulmonary embolism had significantly higher hs-cTnT and NT pro-BNP levels than those without pulmonary embolism. In COVID-19, arrhythmias noticed are atrioventricular/ventricular block, sinus tachycardia, sinus bradycardia, atrial arrhythmias, and ventricular arrhythmias. Consideration for potential drug interactions should be taken when treating CVD patients with COVID-19.
    Keywords arrhythmia ; covid-19 ; myocardial infarction ; myocarditis ; recommendations ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Vaccination and the risk of post-acute sequelae after COVID-19 in the Omicron-predominant period.

    Huh, Kyungmin / Kim, Young-Eun / Bae, Gi Hwan / Moon, Jong Youn / Kang, Ji-Man / Lee, Jacob / Bae, Jang-Whan / Peck, Kyong Ran / Jung, Jaehun

    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

    2024  Volume 30, Issue 5, Page(s) 666–673

    Abstract: ... associated with a decreased risk of post-acute sequelae of COVID-19, suggesting its potential role ... pulmonary embolism (0.66; 0.52-0.84), venous thromboembolism (0.54; 0.44-0.66), acute renal failure (0.56; 0.46-0.67 ... of post-acute sequelae of COVID-19.: Methods: This retrospective cohort study utilized a combined ...

    Abstract Objectives: To assess the association of primary and third doses of vaccination with the risk of post-acute sequelae of COVID-19.
    Methods: This retrospective cohort study utilized a combined database of nationwide health care claims data, COVID-19 patient registry, and vaccination records from South Korea. Individuals diagnosed with COVID-19 in the Omicron variant-dominant period of January-March 2022 were tracked for 30-120 days post-infection. The exposure of interest was the receipt of primary and third doses of the SARS-CoV-2 vaccine. The occurrence of 26 specific conditions in eight domains was compared using Cox regression with inverse probability of treatment weighting.
    Results: This study included 394 773 unvaccinated individuals and 7 604 081 individuals receiving ≥2 doses of vaccine. Compared with unvaccinated individuals, vaccination with at least two doses was associated with a reduced risk (adjusted hazard ratio; 95% CI) of several conditions, including ischaemic heart disease (0.73; 0.57-0.94), heart failure (0.55; 0.48-0.63), cardiac dysrhythmia (0.72; 0.61-0.85), cardiac arrest (0.41; 0.33-0.51), pulmonary embolism (0.66; 0.52-0.84), venous thromboembolism (0.54; 0.44-0.66), acute renal failure (0.56; 0.46-0.67), new dialysis (0.45; 0.34-0.59), chronic obstructive pulmonary disease (0.74; 0.65-0.84), acute pancreatitis (0.64; 0.51-0.80), and diabetes (0.82; 0.71-0.95). The risks of heart failure, cardiac dysrhythmias, cardiac arrest, pulmonary embolism, and new dialysis were lower in those who were vaccinated with three doses compared with those who were vaccinated with two doses.
    Discussion: Vaccination was associated with a decreased risk of post-acute sequelae of COVID-19, suggesting its potential role in mitigating the indirect impacts of COVID-19.
    MeSH term(s) Humans ; COVID-19/prevention & control ; COVID-19/epidemiology ; Male ; Female ; Retrospective Studies ; COVID-19 Vaccines/adverse effects ; COVID-19 Vaccines/administration & dosage ; Middle Aged ; SARS-CoV-2 ; Republic of Korea/epidemiology ; Aged ; Vaccination/adverse effects ; Adult ; Risk Factors
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2024-02-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 1328418-6
    ISSN 1469-0691 ; 1470-9465 ; 1198-743X
    ISSN (online) 1469-0691
    ISSN 1470-9465 ; 1198-743X
    DOI 10.1016/j.cmi.2024.01.028
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    Zs.MO 284: Show issues

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  8. Article ; Online: Thromboembolism in COVID-19: the unsolved problem.

    Casale, Matteo / Dattilo, Giuseppe / Imbalzano, Egidio / Gigliotti DE Fazio, Marianna / Morabito, Claudia / Mezzetti, Maurizio / Busacca, Paolo / Signorelli, Salvatore S / Brunetti, Natale D / Correale, Michele

    Panminerva medica

    2020  Volume 65, Issue 1, Page(s) 51–57

    Abstract: ... dysfunction, and stasis. COVID-19 and hospitalizations for COVID-19 may carry several potential risk factors ... synthesis: A novel disease (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2 ... coronavirus," "2019 n-CoV," venous thromboembolism," "pulmonary embolism," "deep vein thrombosis ...

    Abstract Introduction: The recent Sars-CoV-2 pandemic (COVID-19) has led to growing research to explain the poor clinical prognosis in some patients. While early observational studies highlighted the role of the virus in lung failure, in a second moment thrombosis emerged as a possible explanation of the worse clinical course in some patients. Despite initial difficulties in management of such patients, the constant increase of literature in the field is to date clarifying some questions from clinicians. However, several other questions need answer.
    Evidence acquisition: We performed systematic research using Embase and PubMed, inserting the keywords and mesh terms relative to the new coronavirus and to VTE: "COVID-19," "SARS," "MERS," "coronavirus," "2019 n-CoV," venous thromboembolism," "pulmonary embolism," "deep vein thrombosis," "thromboembolism," "thrombosis." Boolean operators "AND," "OR," "NOT" were used where appropriate. We found 133 articles of interest but only 20 were selected, providing the most representative information.
    Evidence synthesis: A novel disease (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) infection was responsible for thousands of hospitalizations for severe acute respiratory syndrome, with several cases of thrombotic complications due to excessive inflammation, platelet activation, endothelial dysfunction, and stasis. COVID-19 and hospitalizations for COVID-19 may carry several potential risk factors for thrombosis. Severe coagulation abnormalities may occur in almost all the severe and critical ill COVID-19 cases.
    Conclusions: Despite a strong pathophysiological rationale, the evidence in literature is not enough to recommend an aggressive antithrombotic therapy in COVID-19. However, it is our opinion that an early use, even at home at the beginning of the disease, could improve the clinical course.
    MeSH term(s) Humans ; Anticoagulants/therapeutic use ; COVID-19/complications ; Disease Progression ; SARS-CoV-2 ; Thrombosis/etiology ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology
    Chemical Substances Anticoagulants
    Keywords covid19
    Language English
    Publishing date 2020-06-16
    Publishing country Italy
    Document type Journal Article ; Systematic Review
    ZDB-ID 123572-2
    ISSN 1827-1898 ; 0031-0808
    ISSN (online) 1827-1898
    ISSN 0031-0808
    DOI 10.23736/S0031-0808.20.03999-3
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    Zs.B 179: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  9. Article ; Online: Positive COVID-19 Diagnosis Following Primary Elective Total Joint Arthroplasty: Increased Complication and Mortality Rates.

    Heckmann, Nathanael D / Wang, Jennifer C / Piple, Amit S / Bouz, Gabriel J / Chung, Brian C / Oakes, Daniel A / Christ, Alexander B / Lieberman, Jay R

    The Journal of arthroplasty

    2023  Volume 38, Issue 9, Page(s) 1682–1692.e2

    Abstract: ... associated with THA. COVID-19 patients were at increased risk of pulmonary embolism (aOR 4.09, P = .001 ... risk cohort who may require more aggressive medical interventions. Given the potential limitations ... arthroplasty (TJA) in patients who subsequently contracted COVID-19.: Methods: A large national database was ...

    Abstract Background: This study analyzed complication rates following primary elective total joint arthroplasty (TJA) in patients who subsequently contracted COVID-19.
    Methods: A large national database was queried for adult patients who underwent primary elective TJA in 2020. Patients who contracted COVID-19 after total knee arthroplasty (TKA) or total hip arthroplasty (THA) underwent 1:6 matching (age [±6 years], sex, month of surgery, COVID-19-related comorbidities) to patients who did not. Differences between groups were assessed using univariate and multivariate analyses. Overall, 712 COVID-19 patients were matched to 4,272 controls (average time to diagnosis: 128-117 days [range, 0-351]).
    Results: Of patients diagnosed <90 days postoperatively, 32.5%-33.6% required COVID-19-driven readmission. Discharge to a skilled nursing facility (adjusted odds ratio [aOR] 1.72, P = .003) or acute rehabilitation unit (aOR 4.93, P < .001) and Black race (aOR 2.28, P < .001) were associated with readmission after TKA. Similar results were associated with THA. COVID-19 patients were at increased risk of pulmonary embolism (aOR 4.09, P = .001) after TKA and also periprosthetic joint infection (aOR 4.65, P < .001) and sepsis (aOR 11.11, P < .001) after THA. The mortality rate was 3.51% in COVID-19 patients and 7.94% in readmitted COVID-19 patients compared to 0.09% in controls, representing a 38.7 OR and 91.8 OR of death, respectively. Similar results were observed for TKA and THA separately.
    Conclusion: Patients who contracted COVID-19 following TJA were at greater risk of numerous complications, including death. These patients represent a high-risk cohort who may require more aggressive medical interventions. Given the potential limitations presently, prospectively collected data may be warranted to validate these findings.
    MeSH term(s) Adult ; Humans ; COVID-19 Testing ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; COVID-19/diagnosis ; COVID-19/epidemiology ; Arthroplasty, Replacement, Knee/adverse effects ; Arthroplasty, Replacement, Hip/adverse effects ; Risk Factors ; Retrospective Studies
    Language English
    Publishing date 2023-05-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632770-9
    ISSN 1532-8406 ; 0883-5403
    ISSN (online) 1532-8406
    ISSN 0883-5403
    DOI 10.1016/j.arth.2023.04.052
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    Zs.A 2134: Show issues Location:
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  10. Article ; Online: Unexpected Pulmonary Embolism Late After Recovery from Mild COVID-19?

    De Pace, Doranna / Ariotti, Sara / Persampieri, Simone / Patti, Giuseppe / Lupi, Alessandro

    European journal of case reports in internal medicine

    2021  Volume 8, Issue 12, Page(s) 2854

    Abstract: ... venous thromboembolism as a cause of sudden dyspnoea in patients with low risk scores for pulmonary embolism ... of bilateral acute pulmonary embolism occurring 3 months after recovery from a paucisymptomatic SARS-CoV-2 ... infection. The only VTE risk factor demonstrable was a history of previous SARS-CoV-2 ...

    Abstract SARS-CoV-2 infection is associated with an increased risk of venous thromboembolism (VTE), which is common during active illness but unusual in milder cases and after healing. We describe a case of bilateral acute pulmonary embolism occurring 3 months after recovery from a paucisymptomatic SARS-CoV-2 infection. The only VTE risk factor demonstrable was a history of previous SARS-CoV-2 infection, with laboratory signs of residual low-grade inflammation. Clinicians should be aware of VTE as a potential cause of sudden dyspnoea after COVID-19 resolution, especially in the presence of persistent systemic inflammation.
    Learning points: Venous thromboembolism may occur after COVID-19, even in milder SARS-CoV-2 infections and late after coronavirus clearance.Laboratory signs of systemic inflammation are clues for suspecting venous thromboembolism as a cause of sudden dyspnoea in patients with low risk scores for pulmonary embolism but with previous COVID-19 infection.
    Language English
    Publishing date 2021-12-21
    Publishing country Italy
    Document type Journal Article
    ISSN 2284-2594
    ISSN (online) 2284-2594
    DOI 10.12890/2021_002854
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