POST-COVID CARDIOVASCULAR MANIFESTATION AMONG THE PATIENTS ATTENDING TERTIARY CARE HOSPITAL IN CHHINDWARA: A QUALITATIVE STUDY

RITESH UPADHYAY; SHASHIKANT ARYA; PAWAN NANDURKAR; DILEEP DANDOTIYA

doi:10.22159/ajpcr.2022.v15i10.46139

Authors

RITESH UPADHYAY Department of Community Medicine, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India.
SHASHIKANT ARYA Department of General Medicine, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India.
PAWAN NANDURKAR Department of Community Medicine, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India.
DILEEP DANDOTIYA Department of Paediatrics, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India.

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i10.46139

Keywords:

Post-COVID, Cardiovascular manifestations, COVID-19

Abstract

Objectives: The objectives of the study were to assess the cardiovascular manifestations in hospitalized and non-hospitalized patients with COVID-19.

Methods: All patients, attending to the dedicated post-COVID outpatient department of Medicine Department, Chhindwara Institute of Medical Sciences from April 2021 to March 2022, with a history of positive RTPCR for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) at least 2 weeks before presentation, were included in the study. Questionnaire along with patients echocardiogram and echo report, Canadian classification used for angina grading and NYHA classification to classify shortness of breath. A total of 650 patients were assessed for demographics, pre-existing comorbidities, health status, date of symptoms onset, COVID-19 diagnosis, health-care utilization, and the presence of any cardiac or other symptoms at the time of the onset of symptoms (retrospectively) and at follow-up days after symptoms onset.

Results: The mean age of the sample (n=650) was 50.34 years. Majority were 346 (53.23%) males. According to responses using Canadian classification for chest pain were 75 (12.5%) Class 2 angina, in NYHA classification, majority 480 (80%) of patients had Class 2 SOB. About 90 (15%) of patients echo showed positive echo findings. The average stay of patients was 7.58+–1.6 days. About 135 (22.5%) of post-COVID patients had cardiac manifestations, majority were male 118 (87.4%). One hundred and two (75.5%) of patients that developed cardiac manifestation had multiple comorbidities, AF (6%) was reported in patients age 62 years and above. NSTEMI was reported in patients with multiple comorbidities.

Conclusion: As the SARS-CoV-2 pandemic progresses, the interactions between coexisting cardiovascular disease and acute cardiovascular manifestations have a major implication on the medical community’s understanding of this disease. This suggests the presence of a post-COVID-19 syndrome and highlights the unmet health-care needs in a subgroup of patients with mild or severe COVID-19.

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References

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323:1061-9.

Weiss SR, Navas-Martin S. Coronavirus pathogenesis and the emerging pathogen severe acute respiratory syndrome coronavirus. Microbiol Mol Biol Rev 2005;69:635-64.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.

Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020;5:811-8.

Smeeth L, Thomas SL, Hall AJ, Hubbard R, Farrington P, Vallance P. Risk of myocardial infarction and stroke after acute infection or vaccination. N Engl J Med 2004;351:2611-8.

Zaim S, Chong JH, Sankaranarayanan V, Harky A. COVID-19 and multiorgan response. Curr Probl Cardiol 2020;45:100618.

Madjid M, Miller CC, Zarubaev VV, Marinich IG, Kiselev OI, Lobzin YV, et al. Influenza epidemics and acute respiratory disease activity are associated with a surge in autopsy-confirmed coronary heart disease death: Results from 8 years of autopsies in 34,892 subjects. Eur Heart J 2007;28:1205-10.

He XW, Lai JS, Cheng J, Wang MW, Liu YJ, Xiao ZC, et al. Impact of complicated myocardial injury on the clinical outcome of severe or critically ill COVID-19 patients. Zhonghua Xin Xue Guan Bing Za Zhi 2020;48:456-60.

Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol 2020;17:259-60.

Wang L, He WB, Yu XM, Liu HF, Zhou WJ, Jiang H. Prognostic value of myocardial injury in patients with COVID-19. Zhonghua Yan Ke Za Zhi 2020;56:E009.

Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol 2020;5:802-10.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020;395:1054-62.

Ali M, Liaqat H, Humayun S, Liaqat A, Liaqat J, Rauf A. Cardiac manifestations in COVID-19 patients-admitted in tertiary care hospital of Peshawar. Eur J Med Health Sci 2022;4:27-33.

Carfì A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. JAMA 2020;324:603-5.

Duyan M, Ozturan IU, Altas M. Delayed parosmia following SARS-CoV-2 infection: A rare late complication of COVID-19. SN Compr Clin Med 2021;3:1200-2.

Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei province. Chin Med J (Engl) 2020;133:1025-31.

Bangalore S, Sharma A, Slotwiner A, Yatskar L, Harari R, Shah B, et al. ST-segment elevation in patients with Covid-19-case series. N Engl J Med 2020;382:2478-80.

Hua A, O’Gallagher K, Sado D, Byrne J. Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19. Eur Heart J 2020;41:2130.

Asif T, Ali Z. Transient ST segment elevation in two patients with COVID-19 and a normal transthoracic echocardiogram. Eur J Case Rep Intern Med 2020;7:001672.

Yoganathan A, Sajjad MS, Harky A. Cardiovascular disease and the impact of COVID-19. J Card Surg 2020;35:2113.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel corona virus pneumonia in Wuhan, China: A descriptive study. Lancet 2020;395:507-13.

Jaillon S, Berthenet K, Garlanda C. Sexual dimorphism in innate immunity. Clin Rev Allergy Immunol 2019;56:308-21.

Xu PP, Tian RH, Luo S, Zu ZY, Fan B, Wang XM, et al. Risk factors for adverse clinical outcomes with COVID-19 in China: A multicenter, retrospective, observational study. Theranostics 2020;10:6372-83.

Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARSCoV-2: A prospective cohort study. Eur Respir J 2020;55:2000524.

Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol 2020;146:110-8.