COVID-19-associated cardiogenic shock: Difference between revisions
Jump to navigation
Jump to search
| Line 7: | Line 7: | ||
==Overview== | ==Overview== | ||
In Italy, for the first time in a 69-year-old patient, who was presented with [[cardiogenic shock]] due to [[COVID-19]] infection. There is no specific classification for [[COVID-19]] associated [[cardiogenic shock]]. Two mechanisms are more probable to contribute to [[cardiogenic shock]] related to [[Covid-19]] that inculdes direct invasion and [[cytokine storm]]. The prevalence of [[cardiogenic shock-associated COVID-19]] has not yet been reported. According to an observational study in China, [[COVID-19]] associated [[cardiogenic shock]] has a poor prognosis. | |||
==Historical Perspective== | ==Historical Perspective== | ||
| Line 12: | Line 13: | ||
==Classification== | ==Classification== | ||
There is no specific classification for [[COVID-19]] associated [[cardiogenic shock]]. | |||
For more information regarding general classification, see the [[cardiogenic shock classification]]. | * There is no specific classification for [[COVID-19]] associated [[cardiogenic shock]]. For more information regarding general classification, see the [[cardiogenic shock classification]]. | ||
==Pathophysiology== | ==Pathophysiology== | ||
Two mechanisms are more probable to contribute to [[cardiogenic shock]] related to [[Covid-19|Covid-19.]]<ref name="SiddiqiMehra2020">{{cite journal|last1=Siddiqi|first1=Hasan K.|last2=Mehra|first2=Mandeep R.|title=COVID-19 illness in native and immunosuppressed states: A clinical–therapeutic staging proposal|journal=The Journal of Heart and Lung Transplantation|volume=39|issue=5|year=2020|pages=405–407|issn=10532498|doi=10.1016/j.healun.2020.03.012}}</ref> <ref name="YeWang2020">{{cite journal|last1=Ye|first1=Qing|last2=Wang|first2=Bili|last3=Mao|first3=Jianhua|title=The pathogenesis and treatment of the `Cytokine Storm' in COVID-19|journal=Journal of Infection|volume=80|issue=6|year=2020|pages=607–613|issn=01634453|doi=10.1016/j.jinf.2020.03.037}}</ref>: | Two mechanisms are more probable to contribute to [[cardiogenic shock]] related to [[Covid-19|Covid-19.]]<ref name="SiddiqiMehra2020">{{cite journal|last1=Siddiqi|first1=Hasan K.|last2=Mehra|first2=Mandeep R.|title=COVID-19 illness in native and immunosuppressed states: A clinical–therapeutic staging proposal|journal=The Journal of Heart and Lung Transplantation|volume=39|issue=5|year=2020|pages=405–407|issn=10532498|doi=10.1016/j.healun.2020.03.012}}</ref> <ref name="YeWang2020">{{cite journal|last1=Ye|first1=Qing|last2=Wang|first2=Bili|last3=Mao|first3=Jianhua|title=The pathogenesis and treatment of the `Cytokine Storm' in COVID-19|journal=Journal of Infection|volume=80|issue=6|year=2020|pages=607–613|issn=01634453|doi=10.1016/j.jinf.2020.03.037}}</ref>: | ||
* Direct invasion of the virus into the [[cardiomyocytes]] | * Direct invasion of the virus into the [[cardiomyocytes]]Two mechanisms are more probable to contribute to [[cardiogenic shock]] related to [[Covid-19]] | ||
* [[Cytokine storm]] activated by [[T helper cells]] ([[Th1]] and [[Th2]]) and trigger a systemic hyperinflammatory response | * [[Cytokine storm]] activated by [[T helper cells]] ([[Th1]] and [[Th2]]) and trigger a systemic hyperinflammatory response | ||
== Differentiating [[COVID-19]] associated [[cardiogenic shock]] from other Diseases == | |||
*[[Cardiogenic shock]] related to COVID-19 must be differentiated from other diseases which include [[distributive shock]], [[hypovolemic shock]] and mixed ([[distributive]] and [[cardiogenic shock]]): <ref name="BoukhrisHillani2020">{{cite journal|last1=Boukhris|first1=Marouane|last2=Hillani|first2=Ali|last3=Moroni|first3=Francesco|last4=Annabi|first4=Mohamed Salah|last5=Addad|first5=Faouzi|last6=Ribeiro|first6=Marcelo Harada|last7=Mansour|first7=Samer|last8=Zhao|first8=Xiaohui|last9=Ybarra|first9=Luiz Fernando|last10=Abbate|first10=Antonio|last11=Vilca|first11=Luz Maria|last12=Azzalini|first12=Lorenzo|title=Cardiovascular Implications of the COVID-19 Pandemic: A Global Perspective|journal=Canadian Journal of Cardiology|year=2020|issn=0828282X|doi=10.1016/j.cjca.2020.05.018}}</ref> <ref name="RajagopalKeller2020">{{cite journal|last1=Rajagopal|first1=Keshava|last2=Keller|first2=Steven P.|last3=Akkanti|first3=Bindu|last4=Bime|first4=Christian|last5=Loyalka|first5=Pranav|last6=Cheema|first6=Faisal H.|last7=Zwischenberger|first7=Joseph B.|last8=El Banayosy|first8=Aly|last9=Pappalardo|first9=Federico|last10=Slaughter|first10=Mark S.|last11=Slepian|first11=Marvin J.|title=Advanced Pulmonary and Cardiac Support of COVID-19 Patients|journal=Circulation: Heart Failure|volume=13|issue=5|year=2020|issn=1941-3289|doi=10.1161/CIRCHEARTFAILURE.120.007175}}</ref> | *[[Cardiogenic shock]] related to COVID-19 must be differentiated from other diseases which include [[distributive shock]], [[hypovolemic shock]] and mixed ([[distributive]] and [[cardiogenic shock]]): <ref name="BoukhrisHillani2020">{{cite journal|last1=Boukhris|first1=Marouane|last2=Hillani|first2=Ali|last3=Moroni|first3=Francesco|last4=Annabi|first4=Mohamed Salah|last5=Addad|first5=Faouzi|last6=Ribeiro|first6=Marcelo Harada|last7=Mansour|first7=Samer|last8=Zhao|first8=Xiaohui|last9=Ybarra|first9=Luiz Fernando|last10=Abbate|first10=Antonio|last11=Vilca|first11=Luz Maria|last12=Azzalini|first12=Lorenzo|title=Cardiovascular Implications of the COVID-19 Pandemic: A Global Perspective|journal=Canadian Journal of Cardiology|year=2020|issn=0828282X|doi=10.1016/j.cjca.2020.05.018}}</ref> <ref name="RajagopalKeller2020">{{cite journal|last1=Rajagopal|first1=Keshava|last2=Keller|first2=Steven P.|last3=Akkanti|first3=Bindu|last4=Bime|first4=Christian|last5=Loyalka|first5=Pranav|last6=Cheema|first6=Faisal H.|last7=Zwischenberger|first7=Joseph B.|last8=El Banayosy|first8=Aly|last9=Pappalardo|first9=Federico|last10=Slaughter|first10=Mark S.|last11=Slepian|first11=Marvin J.|title=Advanced Pulmonary and Cardiac Support of COVID-19 Patients|journal=Circulation: Heart Failure|volume=13|issue=5|year=2020|issn=1941-3289|doi=10.1161/CIRCHEARTFAILURE.120.007175}}</ref> | ||
Revision as of 00:27, 1 July 2020
For COVID-19 frequently asked inpatient questions, click here
For COVID-19 frequently asked outpatient questions, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: : Alieh Behjat, M.D.[2]
Overview
In Italy, for the first time in a 69-year-old patient, who was presented with cardiogenic shock due to COVID-19 infection. There is no specific classification for COVID-19 associated cardiogenic shock. Two mechanisms are more probable to contribute to cardiogenic shock related to Covid-19 that inculdes direct invasion and cytokine storm. The prevalence of cardiogenic shock-associated COVID-19 has not yet been reported. According to an observational study in China, COVID-19 associated cardiogenic shock has a poor prognosis.
Historical Perspective
- In Italy, for the first time in a 69-year-old patient, who was presented with cardiogenic shock due to COVID-19 infection, myocardial involvement by viral particles was pathologically proved through biopsy. [1]
Classification
- There is no specific classification for COVID-19 associated cardiogenic shock. For more information regarding general classification, see the cardiogenic shock classification.
Pathophysiology
Two mechanisms are more probable to contribute to cardiogenic shock related to Covid-19.[2] [3]:
- Direct invasion of the virus into the cardiomyocytesTwo mechanisms are more probable to contribute to cardiogenic shock related to Covid-19
- Cytokine storm activated by T helper cells (Th1 and Th2) and trigger a systemic hyperinflammatory response
Differentiating COVID-19 associated cardiogenic shock from other Diseases
- Cardiogenic shock related to COVID-19 must be differentiated from other diseases which include distributive shock, hypovolemic shock and mixed (distributive and cardiogenic shock): [4] [5]
Epidemiology and Demographics
- The prevalence of cardiogenic shock-associated COVID-19 has not yet been reported.There are few anecdotal reports of cardiogenic shock related to COVID-19. [1] [6]
Causes
The causes of cardiogenic shock related to COVID-19 might include: [7]
- Newly emerging COVID-19 associated myocarditis, cardiac arrhythmias, cardiomyopathy, or an acute coronary syndrome deteriorated into cardiogenic shock
- Worsening of previous left ventricular failure due to COVID-19
Complications and Prognosis
According to an observational study in China, COVID-19 associated cardiogenic shock has a poor prognosis. In spite of using Extracorporeal membrane oxygenation (ECMO), 83% of patients died. [8] [9]
Diagnosis
History and Symptoms:
The history of patients presented cardiogenic shock related to COVID-19, according to a few anecdotal reports were different. Some did not have any cardiovascular risk factors.
- A 69-year-old patient from Italy has been reported by Tavazzi et al., as a cardiogenic shock-associated COVID-19 case. The patient had flu-like symptoms when he was hospitalized and quickly deteriorated into respiratory distress and cardiogenic shock. [1]
Four patients with cardiogenic shock complication related to COVID-19 were reported by Sanchez-Recalde, et al. They were hospitalized between 1 March and 15 April 2020 including:[6]
- A 42-year-old woman, who had dyslipidemia as a cardiovascular risk factor
- A 50-year-old man, without any cardiovascular risk factors, admitted by severe bilateral pneumonia related to COVID-19. After a few hours, he developed cardiogenic shock.
- A 75-year-old man did not have any cardiovascular risk factors and was admitted due to dyspnea, chest pain, and bilateral SARS-CoV-2 pneumonia.
- A 37-year-old woman, obese with a history of deep venous thrombosis, had symptoms of dyspnea and chest pain
Treatment
References
- ↑ 1.0 1.1 1.2 Tavazzi, Guido; Pellegrini, Carlo; Maurelli, Marco; Belliato, Mirko; Sciutti, Fabio; Bottazzi, Andrea; Sepe, Paola Alessandra; Resasco, Tullia; Camporotondo, Rita; Bruno, Raffaele; Baldanti, Fausto; Paolucci, Stefania; Pelenghi, Stefano; Iotti, Giorgio Antonio; Mojoli, Francesco; Arbustini, Eloisa (2020). "Myocardial localization of coronavirus in COVID‐19 cardiogenic shock". European Journal of Heart Failure. 22 (5): 911–915. doi:10.1002/ejhf.1828. ISSN 1388-9842.
- ↑ Siddiqi, Hasan K.; Mehra, Mandeep R. (2020). "COVID-19 illness in native and immunosuppressed states: A clinical–therapeutic staging proposal". The Journal of Heart and Lung Transplantation. 39 (5): 405–407. doi:10.1016/j.healun.2020.03.012. ISSN 1053-2498.
- ↑ Ye, Qing; Wang, Bili; Mao, Jianhua (2020). "The pathogenesis and treatment of the `Cytokine Storm' in COVID-19". Journal of Infection. 80 (6): 607–613. doi:10.1016/j.jinf.2020.03.037. ISSN 0163-4453.
- ↑ Boukhris, Marouane; Hillani, Ali; Moroni, Francesco; Annabi, Mohamed Salah; Addad, Faouzi; Ribeiro, Marcelo Harada; Mansour, Samer; Zhao, Xiaohui; Ybarra, Luiz Fernando; Abbate, Antonio; Vilca, Luz Maria; Azzalini, Lorenzo (2020). "Cardiovascular Implications of the COVID-19 Pandemic: A Global Perspective". Canadian Journal of Cardiology. doi:10.1016/j.cjca.2020.05.018. ISSN 0828-282X.
- ↑ Rajagopal, Keshava; Keller, Steven P.; Akkanti, Bindu; Bime, Christian; Loyalka, Pranav; Cheema, Faisal H.; Zwischenberger, Joseph B.; El Banayosy, Aly; Pappalardo, Federico; Slaughter, Mark S.; Slepian, Marvin J. (2020). "Advanced Pulmonary and Cardiac Support of COVID-19 Patients". Circulation: Heart Failure. 13 (5). doi:10.1161/CIRCHEARTFAILURE.120.007175. ISSN 1941-3289.
- ↑ 6.0 6.1 Sánchez-Recalde, Ángel; Solano-López, Jorge; Miguelena-Hycka, Javier; Martín-Pinacho, Jesús Javier; Sanmartín, Marcelo; Zamorano, José L. (2020). "COVID-19 and cardiogenic shock. Different cardiovascular presentations with high mortality". Revista Española de Cardiología (English Edition). doi:10.1016/j.rec.2020.04.012. ISSN 1885-5857.
- ↑ Mahajan, Kunal; Chandra, K.Sarat (2020). "Cardiovascular comorbidities and complications associated with coronavirus disease 2019". Medical Journal Armed Forces India. doi:10.1016/j.mjafi.2020.05.004. ISSN 0377-1237.
- ↑ Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H; et al. (2020). "Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study". Lancet Respir Med. 8 (5): 475–481. doi:10.1016/S2213-2600(20)30079-5. PMC 7102538 Check
|pmc=value (help). PMID 32105632 Check|pmid=value (help). - ↑ Dhakal, Bishnu P.; Sweitzer, Nancy K.; Indik, Julia H.; Acharya, Deepak; William, Preethi (2020). "SARS-CoV-2 Infection and Cardiovascular Disease: COVID-19 Heart". Heart, Lung and Circulation. doi:10.1016/j.hlc.2020.05.101. ISSN 1443-9506.