Volume 2, Issue 1 (Winter 2021)
J Vessel Circ 2021, 2(1): 49-54 |
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Hejazi S F, Shahrab F, Sabokbar T, Hejazi S A. Cardiovascular Complications of COVID-19 in Patients With Multiple Sclerosis: A Lesson From Our Experience. J Vessel Circ 2021; 2 (1) :49-54
URL: http://jvessels.muq.ac.ir/article-1-116-en.html
URL: http://jvessels.muq.ac.ir/article-1-116-en.html
1- Department of Cardiology, Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran., Qom University of Medical Sciences
2- Department of Neurology, Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran., Qom University of Medical Sciences
3- Neuroscience Research Center, Qom University of Medical Sciences, Qom, Iran., Qom University of Medical Sciences
2- Department of Neurology, Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran., Qom University of Medical Sciences
3- Neuroscience Research Center, Qom University of Medical Sciences, Qom, Iran., Qom University of Medical Sciences
Abstract: (1587 Views)
Background and Aim: COVID-19 is an emerging threat that could affect the cardiovascular system in the setting of a cytokine storm syndrome. This study examines the cardiac injury associated with COVID-19 in patients with Multiple Sclerosis (MS).
Case Presentation: We analyzed 6 cases of MS in association with COVID-19 who underwent cardiac evaluation during their hospitalization. The mean age of our patients was 36.6 years. Two patients had Secondary Progressive MS (SPMS), one patient had Primary Progressive MS (PPMS), and the rest had Relapsing-Remitting MS (RRMS). Our patients were on both immunomodulatory and immunosuppressive Disease-Modifying Therapies (DMTs). None of our patients had a cardiovascular risk factor or developed cardiovascular complications. Their electrocardiogram, echocardiography, and cardiac enzymes were within normal limits.
Results: Their mean length of hospitalization was 11.8 days. After a month of follow-up, all patients returned to their baseline neurological status except the one with PPMS and moderate COVID-19, who experienced 0.5 points increase in her expanded disability status scale score.
Conclusion: Patients with MS might be at risk of developing severe COVID-19 in which cardiac injury is a crucial complication. There are limited data describing myocarditis associated with COVID-19 in patients with MS. However, our cases revealed no evidence of cardiac injury in patients with MS, even under immunosuppressive DMTs.
Case Presentation: We analyzed 6 cases of MS in association with COVID-19 who underwent cardiac evaluation during their hospitalization. The mean age of our patients was 36.6 years. Two patients had Secondary Progressive MS (SPMS), one patient had Primary Progressive MS (PPMS), and the rest had Relapsing-Remitting MS (RRMS). Our patients were on both immunomodulatory and immunosuppressive Disease-Modifying Therapies (DMTs). None of our patients had a cardiovascular risk factor or developed cardiovascular complications. Their electrocardiogram, echocardiography, and cardiac enzymes were within normal limits.
Results: Their mean length of hospitalization was 11.8 days. After a month of follow-up, all patients returned to their baseline neurological status except the one with PPMS and moderate COVID-19, who experienced 0.5 points increase in her expanded disability status scale score.
Conclusion: Patients with MS might be at risk of developing severe COVID-19 in which cardiac injury is a crucial complication. There are limited data describing myocarditis associated with COVID-19 in patients with MS. However, our cases revealed no evidence of cardiac injury in patients with MS, even under immunosuppressive DMTs.
Keywords: Cardiovascular diseases, Cardiovascular Diseases- complication, Myocarditis, Multiple sclerosis, COVID-19
Type of Study: Research |
Subject:
cardiovascular diseases
Received: 2020/06/14 | Accepted: 2020/09/5 | Published: 2021/10/1
Received: 2020/06/14 | Accepted: 2020/09/5 | Published: 2021/10/1
References
1. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet. 2020; 395(10224):565-74. [DOI:10.1016/S0140-6736(20)30251-8] [DOI:10.1016/S0140-6736(20)30251-8]
2. Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020; 38(7):1504-7. [DOI:10.1016/j.ajem.2020.04.048] [PMID] [PMCID] [DOI:10.1016/j.ajem.2020.04.048]
3. Zhu H, Rhee JW, Cheng P, Waliany S, Chang A, Witteles RM, et al. Cardiovascular complications in patients with COVID-19: Consequences of viral toxicities and host immune response. Curr Cardiol Rep. 2020; 22(5):32. [DOI:10.1007/s11886-020-01292-3] [PMID] [PMCID] [DOI:10.1007/s11886-020-01292-3]
4. Möhn N, Konen FF, Pul R, Kleinschnitz C, Prüss H, Witte T, et al. Experience in multiple sclerosis patients with COVID-19 and disease-modifying therapies: A review of 873 published cases. J Clin Med. 2020; 9(12):4067. [DOI:10.3390/jcm9124067] [PMID] [PMCID] [DOI:10.3390/jcm9124067]
5. Inciardi RM, Lupi L, Zaccone G, Italia L, Raffo M, Tomasoni D, et al. Cardiac involvement in a patient with Coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020; 5(7):819-24. [DOI:10.1001/jamacardio.2020.1096] [PMID] [PMCID] [DOI:10.1001/jamacardio.2020.1096]
6. 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(7):802-10. [DOI:10.1001/jamacardio.2020.0950] [PMID] [PMCID] [DOI:10.1001/jamacardio.2020.0950]
7. Khodadadi J, Sharifipour E, Ghadir MR, Bozorgqomi N, Shams S, Eshraghi A, et al. Potential cardiomyopathy in a mortality case with COVID-19: A case report. J Vessel Circ. 2020; 1(3):1-8. http://jvessels.muq.ac.ir/article-1-46-en.html
8. Shafi AMA, Shaikh SA, Shirke MM, Iddawela S, Harky A. Cardiac manifestations in COVID‐19 patients-A systematic review. J Card Surg. 2020; 35(8):1988-2008. [DOI:10.1111/jocs.14808] [PMID] [PMCID] [DOI:10.1111/jocs.14808]
9. Hendren NS, Drazner MH, Bozkurt B, Cooper LT. Description and proposed management of the acute COVID-19 cardiovascular syndrome. Circulation. 2020; 141(23):1903-14. [DOI:10.1161/CIRCULATIONAHA.120.047349] [PMID] [PMCID] [DOI:10.1161/CIRCULATIONAHA.120.047349]
10. Louapre C, Collongues N, Stankoff B, Giannesini C, Papeix C, Bensa C, et al. Clinical characteristics and outcomes in patients with Coronavirus Disease 2019 and Multiple Sclerosis. JAMA Neurol. 2020; 77(9):1079-88. [DOI:10.1001/jamaneurol.2020.2581] [PMID] [PMCID] [DOI:10.1001/jamaneurol.2020.2581]
11. Paybast S, Emami A, Koosha M, Baghalha F. Novel Coronavirus Disease (COVID-19) and central nervous system complications: What neurologist need to know. Acta Neurol Taiwan. 2020; 29(1):24-31. [PMID]
12. Trpkov C, MacMullan P, Feuchter P, Kachra R, Heydari B, Merchant N, et al. Rapid response to cytokine storm inhibition using anakinra in a patient with COVID-19 myocarditis. CJC Open. 2021; 3(2):210-3. [DOI:10.1016/j.cjco.2020.10.003] [PMID] [PMCID] [DOI:10.1016/j.cjco.2020.10.003]
13. Faircloth E, Conner C, Dougherty K, Arora S, Thorevska N. Viral heartbreak: A case of COVID-19 myocarditis vs stress-induced cardiomyopathy. Chest. 2020; 158(4):A173. [DOI:10.1016/j.chest.2020.08.185] [PMCID] [DOI:10.1016/j.chest.2020.08.185]
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