COVID-19: News & Updates from February 2021

By Jasdeep Dalawari MD | 03/04/2021

As a response to the Coronavirus/Covid-19 outbreak, many medical associations and organizations have released statements specifically related to treatment for cardiovascular patients.

These resources provide credible and trustworthy information. Many if not most, speak to the need for more detailed research and data, to help guide us as we develop new standards of practice to ensure optimal care based on clinical practice rather than speculation.
 

The best strategies to prevent contracting COVID-19 are:
  • Wear a mask in public places
  • Social distancing - stay at least 6 feet away from other people
  • Wash your hands frequently - with warm soapy water for at least 30 seconds
  • Avoid crowds, confined and poorly ventilated spaces.

Eagle's Eye View: COVID-19 Tip of the Week

02 February, 2021 - ACC Eagle's Eye View: COVID-19 Tip of the Week

Dr. Kim Eagle provides a weekly tip for clinicians on the front lines of the COVID-19 pandemic. How do health care workers hospitalized with COVID-19 fare when compared to the general population?

Please visit the ACC COVID-19 Hub for additional resources and information...

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Outcomes of In- and Out-of-Hospital Cardiac Arrest in COVID-19

05 February, 2021 - American College of Cardiology

Authors: Sultanian P, Lundgren P, Strömsöe A, et al.

Citation:
Cardiac Arrest in COVID-19: Characteristics and Outcomes of In- and Out-of-Hospital Cardiac Arrest. A Report From the Swedish Registry for Cardiopulmonary Resuscitation. Eur Heart J 2021;Feb 5: [Epub ahead of print].

Summary By:Thomas C. Crawford, MD, FACC>

Quick Takes

  • During the pandemic phase, COVID-19 was involved in ≥10% of all out-of-hospital cardiac arrests (OHCAs) and 16% of in-hospital cardiac arrests (IHCAs).
  • Among COVID-19 cases, 30-day mortality was increased 3.4-fold in OHCA and 2.3-fold in IHCA.

 

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COVID-19 Modeling and the Path to Herd Immunity

08 February, 2021 - Medscape
Video and transcript article of  Eric J. Topol, MD's interview with data scientist Youyang Gu, MA, previously with MIT, now doing credible work on COVID-19 specifically related to big data statistical models and using them to make data-based predictions.

 

See the latest version of the US and gloabl map:
Visual display using artificial intelligence to accurately forecast infections, deaths, and recovery timelines of the COVID-19/coronavirus pandemic in the US and globally.
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AP-NORC poll: A third of US adults skeptical of COVID shots

10 February, 2021 - The Associated Press-NORC Center for Public Affairs Research
NEW YORK (AP) — About 1 in 3 Americans say they definitely or probably won’t get the COVID-19 vaccine, according to a new poll that some experts say is discouraging news if the U.S. hopes to achieve herd immunity and vanquish the outbreak.

 

The poll from The Associated Press-NORC Center for Public Affairs Research found that while 67% of Americans plan to get vaccinated or have already done so, 15% are certain they won’t and 17% say probably not. Many expressed doubts about the vaccine’s safety and effectiveness.

 

The poll suggests that substantial skepticism persists more than a month and a half into a U.S. vaccination drive that has encountered few if any serious side effects. Resistance was found to run higher among younger people, people without college degrees, Black Americans and Republicans.

 

Dr. Anthony Fauci, the government’s leading infectious-disease scientist, has estimated that somewhere between 70% and 85% of the U.S. population needs to get inoculated to stop the scourge that has killed close to 470,000 Americans. More recently, he said the spread of more contagious variants of the virus increases the need for more people to get their shots — and quickly.

 

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Researchers Investigate What COVID-19 Does to the Heart

10 February, 2021 - jamanetwork.com
 
The first sign of heart damage was in their blood. In early case reports from Wuhan, China, where the novel coronavirus emerged, an unexpected number of patients hospitalized with the respiratory infection had elevated levels of cardiac troponin, a marker of myocardial—heart muscle—injury.
 
Next came the echocardiograms suggesting functional abnormalities in many patients’ hearts. Soon it was obvious that myocardial injury heralded poor prognosis for patients hospitalized with coronavirus disease 2019 (COVID-19).
 

“It was quite clear that people that came into the hospital sick that had heart injury were the ones that were at greatest risk of requiring mechanical ventilation and, ultimately, at the greatest risk of dying,” said Aaron Baggish, MD, director of the cardiovascular performance program at Massachusetts General Hospital.
 
It wasn’t surprising that patients with preexisting cardiovascular issues—prior heart failure, coronary artery disease, hypertension—were more likely to fare poorly, based on other respiratory illnesses. But so were those without a history of heart problems who had elevated troponin levels.
 
Physicians and scientists wondered then, as now: How common is heart injury across the spectrum of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, from asymptomatic cases to critical disease?
 

Researchers are also working to explain the cardiac damage, with recent attention shifting from viral myocarditis to systemic inflammation. But experts said that the most important question is the clinical one: What will COVID-19–associated heart injury mean, over the short-term and long-term, for the tens of millions of people around the world infected with the virus?

 

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The Coronavirus is Here to Stay — here’s what that means

16 February, 2021 - Nature.com
A Nature survey shows many scientists expect the virus that causes COVID-19 to become endemic, but it could pose less danger over time.

 

For much of the past year, life in Western Australia has been coronavirus-free. Friends gathered in pubs; people kissed and hugged their relatives; children went to school without temperature checks or wearing masks. The state maintained this enviable position only by placing heavy restrictions on travel and imposing lockdowns — some regions entered a snap lockdown at the beginning of the year after a security guard at a hotel where visitors were quarantined tested positive for the virus. But the experience in Western Australia has provided a glimpse into a life free from the SARS-CoV-2 coronavirus. If other regions, aided by vaccines, aimed for a similar zero-COVID strategy, then could the world hope to rid itself of the virus?

 

It’s a beautiful dream but most scientists think it’s improbable. In January, Nature asked more than 100 immunologists, infectious-disease researchers and virologists working on the coronavirus whether it could be eradicated. Almost 90% of respondents think that the coronavirus will become endemic — meaning that it will continue to circulate in pockets of the global population for years to come (see 'Endemic future')...

 

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Damage to the heart found in more than half of COVID-19 patients discharged from hospitals

7 February, 2021 - EurekAlert! - European Society of Cardiology
Around 50% of patients who have been hospitalised with severe COVID-19 and who show raised levels of a protein called troponin have damage to their hearts. The injury was detected by magnetic resonance imaging (MRI) scans at least a month after discharge, according to new findings published today (Thursday) in the European Heart Journal [1].

 

Damage includes inflammation of the heart muscle (myocarditis), scarring or death of heart tissue (infarction), restricted blood supply to the heart (ischaemia) and combinations of all three.

 

The study of 148 patients from six acute hospitals in London is the largest study to date to investigate convalescing COVID-19 patients who had raised troponin levels indicating a possible problem with the heart...

 

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This Week in Cardiology Podcast

19 February, 2021 - Medscape -
>For the week ending February 19, 2021, John Mandrola, MD comments on the following news and features stories.

Discussed:
COVID - Cases declines last week, the slope of decline has too.
Bernard Lown - Cardiologist & Antiwar Activist dies at 99

Click here to Subscribe to the Podcast 

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COVID-19 vaccine still important for those with cardiovascular risk factors

20 February, 2021 - SCNOW.com - ABDALLAH KAMOUH, M.D. MUSC Health-Cardiology
During the past year, more than 110 million people were infected by the COVID-19 virus. More than 28 million of these infections took place in the United States, responsible for more than 480,000 deaths.
 
Although death related to COVID-19 infection spans all ages, patients with cardiovascular risk factors, with heart disease and stroke, are more susceptible to die than the general population.
 
COVID-19 can directly affect the heart. Patients infected with the virus can have high-grade fever, fluctuation in blood pressure, low oxygen levels and clotting of the blood.
 
All of these factors can lead to an increased risk of heart failure decompensation, heart attacks, abnormal heart rhythm and cardiac death more so in patients with underlying heart disease.
 
Given the threat of COVID-19 infection for patients with heart disease, the Centers for Disease Control and Prevention (CDC), the American Heart Association (AHA) and many other national heart organizations encourage patients with heart diseases and stroke to take the COVID-19 vaccine.
 
Some people have expressed concerns about taking the vaccine. Science and medical experts and national medical associations are confident that the benefit of vaccination far exceeds the very small, rare risks.
 

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Many Black Americans aren’t rushing to get the COVID-19 vaccine – a long history of medical abuse suggests why

24 February, 2021 - theconversation.com - 
Black Americans have been the least inclined of any racial or ethnic group to say they’d get vaccinated against the coronavirus.
 
The proportion of Black people who said they’ll probably or definitely take the shot has risen over time – but even by mid-January, with two COVID-19 vaccines authorized for emergency use in the U.S., only 35% of Black survey respondents said they’d get it as soon as they could, or already had gotten the shot...

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6 COVID-19 treatments helping patients survive

01 March, 2021 - theconversation.com - 
A year ago, when U.S. health authorities issued their first warning that COVID-19 would cause severe “disruption to everyday life,” doctors had no effective treatments to offer beyond supportive care.
 
There is still no quick cure, but thanks to an unprecedented global research effort, several treatments are helping patients survive COVID-19 and stay out of the hospital altogether.
 
COVID-19 treatments target two broad problems: the coronavirus’s ability to spread through the body, and the damage caused by the body’s immune system response. When the virus enters the body, it takes over cells and uses them to replicate itself. In response, the body sends inflammatory signals and immune cells to fight the virus. In some patients, that inflammatory response can continue even after the virus is under control, leading to damage in the lungs and other organs.
 
The best tool is prevention, including using face masks and vaccines. Vaccines train the immune system to fight off attackers. With less risk of an uncontrolled infection, they can cut the risk of death from COVID-19 to near zero. But vaccine supplies are limited, even with a third vaccine now authorized for U.S. use, so treatments for infected patients remain crucial.
 
As doctors who work with COVID-19 patients, we have been following the drug trials and success stories. Here are six treatments commonly used today for COVID-19.
 
chart - Treatments for COVID-19 and their timing

Treatments for COVID-19 and their timing. Georgios D. Kitsios, CC BY-ND
 
As you’ll see, timing matters...

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About Jasdeep Dalawari MD

Experienced General and Specialist Physician with a demonstrated history of working in the medical practice industry. Skilled in Interventional, Endovascular, Vascular, and General Cardiovascular Medicine; Emergency Medicine; Healthcare Consulting, including Peer Review, Expert Witness, and Utilization Review; and Medical Education. Strong healthcare services professional with an MS focused in Health Administration from Virginia Commonwealth University.