COronaVIrus Disease-2019 (COVID-19) is associated with a hypercoagulable state. Intracardiac thrombosis is a potentially serious complication but has seldom been evaluated in COVID-19 patients. We ...assessed the incidence, associated factors, and outcomes of COVID-19 patients with intracardiac thrombosis. In 2020, COVID-19 inpatients were identified from the National Inpatient Sample (NIS) database. Data on clinical characteristics, intracardiac thrombosis, and adverse outcomes were collected. Multivariable logistic regression was used to identify factors associated with intracardiac thrombosis, in-hospital mortality, and morbidities. In 2020, 1,683,785 COVID-19 inpatients (mean age 63.8 years, 32.2% females) were studied. Intracardiac thrombosis occurred in 0.10% (1830) of cases. In-hospital outcomes included 13.2% all-cause mortality, 3.5% cardiovascular mortality, 2.6% cardiac arrest, 4.4% acute coronary syndrome (ACS), 16.1% heart failure, 1.3% stroke, and 28.3% acute kidney injury (AKI). Key factors for intracardiac thrombosis were congestive heart failure history and coagulopathy. Intracardiac thrombosis independently linked to higher risks of all-cause mortality (odds ratio OR: 3.32 (2.42-4.54)), cardiovascular mortality (OR: 2.95 (1.96-4.44)), cardiac arrest (OR: 2.04 (1.22-3.43)), ACS (OR: 1.62 (1.17-2.22)), stroke (OR: 3.10 (2.11-4.56)), and AKI (OR: 2.13 (1.68-2.69)), but not heart failure. While rare, intracardiac thrombosis in COVID-19 patients independently raised in-hospital mortality and morbidity risks.
Coronavirus disease 2019 (COVID-19) is known to increase the risk of venous thromboembolism (VTE) and arterial thromboembolism (ATE). However, the incidence, predictors, and outcomes of clinical ...thrombosis for inpatients with COVID-19 are not well known. This study aimed to enhance our understanding of clinical thrombosis in COVID-19, its associated factors, and mortality outcomes.
Hospitalised adult (≥18 years of age) patients with COVID-19 in 2020 were retrospectively identified from the US National Inpatient Sample database. Clinical characteristics, incident VTE, ATE, and in-hospital mortality outcomes were recorded. Multivariable logistic regression was performed to identify clinical factors associated with thrombosis and in-hospital mortality in COVID-19 inpatients.
A total of 1,583,135 adult patients with COVID-19 in the year 2020 were identified from the National Inpatient Sample database; patients with thrombosis were 41% females with a mean age of 65.4 (65.1–65.6) years. The incidence of thrombosis was 6.1% (97,185), including VTE at 4.8% (76,125), ATE at 3.0% (47,790), and the in-hospital mortality rate was 13.4% (212,785). Patients with thrombosis were more likely to have respiratory symptoms of COVID-19 (76.7% vs 75%, p<0.001) compared with patients without thrombosis. The main factors associated with overall thrombosis, VTE, and ATE were paralysis, ventilation, solid tumours without metastasis, metastatic cancer, and acute liver failure. Although all thrombosis categories were associated with higher in-hospital mortality for COVID-19 inpatients in univariable analyses (p<0.001), they were not in multivariable analyses—thrombosis (odds ratio OR 1.24; 95% confidence interval CI 0.90–1.70; p=0.19), VTE (OR 0.70; 95% CI 0.52–1.00; p=0.05), and ATE (OR 1.07; 95% CI 0.92–1.25; p=0.36).
The association of COVID-19 with thrombosis and VTE increases with increasing severity of the COVID-19 disease. Risk stratification of thrombosis is crucial in COVID-19 patients to determine the necessity of thromboprophylaxis.
Le 4 août 2020, vers 18h00, un entrepôt du port de Beyrouth contenant 2 750 tonnes de nitrate d’ammonium a explosé engendrant la plus grande explosion urbaine depuis Hiroshima et Nagasaki. Au cœur de ...ce désastre, la Croix-Rouge libanaise (CRL) a répondu à l’appel, et s’est déployée sur la totalité de la zone sinistrée offrant tout genre de service au peuple dévasté. Au total, plus de 4 000 patients ont été traités sur place et plus de 2 600 ont été transportés vers les hôpitaux de Beyrouth et du Mont Liban. Dans une époque où le Liban est profondément secoué par une crise économique étouffante et par la pandémie de la COVID-19, les défis rencontrés ont été majeurs. La documentation de cet évènement et l’évaluation des réponses de la CRL sont des éléments clés pour l’amélioration de la gestion de catastrophe. Vue la rareté du contexte, les leçons à tirer sont nombreuses.
On August 4th, 2020, at around 6 p.m., a warehouse in the port of Beirut containing 2 750 tons of ammonium nitrate exploded, causing the largest urban explosion since Hiroshima and Nagasaki. In the midst of this disaster, the Lebanese Red Cross (LRC) answered the call, and deployed its services throughout the affected area. In total, more than 4 000 patients were treated on site and more than 2 600 were transported to hospitals in Beirut and Mount Lebanon. During a time where Lebanon was deeply shaken by a stifling economic crisis and by the COVID-19 pandemic, the challenges encountered were critical. Documenting this event and evaluating the LRC's responses are key elements in improving disaster management. Given the uniqueness of the context, the lessons learned are numerous.
A 64-year-old man presented with symptoms indicative of superior vena cava syndrome. Imaging work-up revealed an obstructing right atrial mass, which was subsequently excised and diagnosed as primary ...cardiac lymphoma. Post-surgery, the patient showed significant clinical improvement and was started on a chemotherapy regimen with complete remission at 1 year.
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