COVID-19-associated cardiogenic shock: Difference between revisions
Jump to navigation
Jump to search
| Line 26: | Line 26: | ||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
*According to a recent study, one-third of critically ill patients with COVID-19 of an ICU in Washington State had clinical signs of [[cardiogenic shock]] and [[cardiomyopathy]]. There are few anecdotal reports of [[cardiogenic shock]] related to [[COVID-19]]. <ref name="TavazziPellegrini2020">{{cite journal|last1=Tavazzi|first1=Guido|last2=Pellegrini|first2=Carlo|last3=Maurelli|first3=Marco|last4=Belliato|first4=Mirko|last5=Sciutti|first5=Fabio|last6=Bottazzi|first6=Andrea|last7=Sepe|first7=Paola Alessandra|last8=Resasco|first8=Tullia|last9=Camporotondo|first9=Rita|last10=Bruno|first10=Raffaele|last11=Baldanti|first11=Fausto|last12=Paolucci|first12=Stefania|last13=Pelenghi|first13=Stefano|last14=Iotti|first14=Giorgio Antonio|last15=Mojoli|first15=Francesco|last16=Arbustini|first16=Eloisa|title=Myocardial localization of coronavirus in COVID‐19 cardiogenic shock|journal=European Journal of Heart Failure|volume=22|issue=5|year=2020|pages=911–915|issn=1388-9842|doi=10.1002/ejhf.1828}}</ref> <ref name="Sánchez-RecaldeSolano-López2020">{{cite journal|last1=Sánchez-Recalde|first1=Ángel|last2=Solano-López|first2=Jorge|last3=Miguelena-Hycka|first3=Javier|last4=Martín-Pinacho|first4=Jesús Javier|last5=Sanmartín|first5=Marcelo|last6=Zamorano|first6=José L.|title=COVID-19 and cardiogenic shock. Different cardiovascular presentations with high mortality|journal=Revista Española de Cardiología (English Edition)|year=2020|issn=18855857|doi=10.1016/j.rec.2020.04.012}}</ref> | *According to a recent study, one-third of critically ill patients with COVID-19 of an ICU in Washington State had clinical signs of [[cardiogenic shock]] and [[cardiomyopathy]].<ref name="pmid32191259">{{cite journal| author=Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M | display-authors=etal| title=Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State. | journal=JAMA | year= 2020 | volume= | issue= | pages= | pmid=32191259 | doi=10.1001/jama.2020.4326 | pmc=7082763 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32191259 }} </ref> There are few anecdotal reports of [[cardiogenic shock]] related to [[COVID-19]]. <ref name="TavazziPellegrini2020">{{cite journal|last1=Tavazzi|first1=Guido|last2=Pellegrini|first2=Carlo|last3=Maurelli|first3=Marco|last4=Belliato|first4=Mirko|last5=Sciutti|first5=Fabio|last6=Bottazzi|first6=Andrea|last7=Sepe|first7=Paola Alessandra|last8=Resasco|first8=Tullia|last9=Camporotondo|first9=Rita|last10=Bruno|first10=Raffaele|last11=Baldanti|first11=Fausto|last12=Paolucci|first12=Stefania|last13=Pelenghi|first13=Stefano|last14=Iotti|first14=Giorgio Antonio|last15=Mojoli|first15=Francesco|last16=Arbustini|first16=Eloisa|title=Myocardial localization of coronavirus in COVID‐19 cardiogenic shock|journal=European Journal of Heart Failure|volume=22|issue=5|year=2020|pages=911–915|issn=1388-9842|doi=10.1002/ejhf.1828}}</ref> <ref name="Sánchez-RecaldeSolano-López2020">{{cite journal|last1=Sánchez-Recalde|first1=Ángel|last2=Solano-López|first2=Jorge|last3=Miguelena-Hycka|first3=Javier|last4=Martín-Pinacho|first4=Jesús Javier|last5=Sanmartín|first5=Marcelo|last6=Zamorano|first6=José L.|title=COVID-19 and cardiogenic shock. Different cardiovascular presentations with high mortality|journal=Revista Española de Cardiología (English Edition)|year=2020|issn=18855857|doi=10.1016/j.rec.2020.04.012}}</ref> | ||
==Causes== | ==Causes== | ||
Revision as of 01:44, 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
- According to a recent study, one-third of critically ill patients with COVID-19 of an ICU in Washington State had clinical signs of cardiogenic shock and cardiomyopathy.[6] There are few anecdotal reports of cardiogenic shock related to COVID-19. [1] [7]
Causes
The causes of cardiogenic shock related to COVID-19 might include: [8]
- 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. [9] [10]
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:[7]
- 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.
- ↑ Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M; et al. (2020). "Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State". JAMA. doi:10.1001/jama.2020.4326. PMC 7082763 Check
|pmc=value (help). PMID 32191259 Check|pmid=value (help). - ↑ 7.0 7.1 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.