tetano
Editor, Senior Moderator
CJC Open
. 2024 Mar 13;6(6):818-825.
doi: 10.1016/j.cjco.2024.03.004. eCollection 2024 Jun. Takotsubo Syndrome in Patients With COVID-19: A Systematic Review
Xiaojia Lu[SUP] 1 [/SUP], Catherine Teng[SUP] 2 [/SUP], Peng Cai[SUP] 3 [/SUP], Jing Liang[SUP] 4 [/SUP], Yanxuan Wang[SUP] 4 [/SUP], Hawa Abu[SUP] 5 [/SUP], Yuan Jia Wang[SUP] 6 [/SUP], John E Madias[SUP] 7 [/SUP], Kan Liu[SUP] 8 [/SUP], Qi Liu[SUP] 9 [/SUP], Pengyang Li[SUP] 10 [/SUP]
Affiliations
in English, French
Background: Respiratory conditions are major physical triggers of takotsubo syndrome (TTS) and portend worse outcomes. However, data on TTS in patients with coronavirus disease-2019 infection (COVID-19) are limited.
Methods: We searched PubMed, Embase, and Cochrane Library databases for case reports for the period 2019-2022 describing TTS in patients with COVID-19 pneumonia (TTS-COVID). We summarized the clinical data and outcomes and compared them to those in patients with TTS with an acute respiratory disease other than COVID-19 as a trigger (TTS-acute respiratory disease) and those with TTS with no respiratory disease (TTS-no respiratory disease).
Results: The mortality rate was higher in those with TTS-COVID (26.0%) than those with TTS-acute respiratory disease (5.7%) or TTS-no respiratory disease (4.2%; P < 0.001 for both). The proportion of men was higher in TTS-COVID (33.3%) than it was in TTS-no respiratory disease (9.1%; P < 0.001). The manifestations of TTS in COVID patients were atypical (dyspnea [70.3%] and cough [40.6%]); few had chest pain (23.4%). Cardiovascular risk factors were common in the TTS-COVID cohort, but fewer patients were on cardioprotective medications in this group than in the other 2 groups. Level of catecholamine use was higher in the TTS-COVID group (37.7%) than it was in the TTS-no respiratory disease (10.9%; P < 0.001) group. Apical ballooning (72.6%) was the most common TTS subtype, and basal segment type was seen in 11.0% of TTS-COVID patients.
Conclusions: COVID-19 patients who developed TTS had high mortality rates and unique features, compared with those in the TTS-acute respiratory disease group or the TTS-no respiratory disease group. Understanding the pathophysiology of TTS in COVID-19 may help prevent TTS and direct therapy in this setting.
. 2024 Mar 13;6(6):818-825.
doi: 10.1016/j.cjco.2024.03.004. eCollection 2024 Jun. Takotsubo Syndrome in Patients With COVID-19: A Systematic Review
Xiaojia Lu[SUP] 1 [/SUP], Catherine Teng[SUP] 2 [/SUP], Peng Cai[SUP] 3 [/SUP], Jing Liang[SUP] 4 [/SUP], Yanxuan Wang[SUP] 4 [/SUP], Hawa Abu[SUP] 5 [/SUP], Yuan Jia Wang[SUP] 6 [/SUP], John E Madias[SUP] 7 [/SUP], Kan Liu[SUP] 8 [/SUP], Qi Liu[SUP] 9 [/SUP], Pengyang Li[SUP] 10 [/SUP]
Affiliations
- PMID: 39022174
- PMCID: PMC11251070
- DOI: 10.1016/j.cjco.2024.03.004
in English, French
Background: Respiratory conditions are major physical triggers of takotsubo syndrome (TTS) and portend worse outcomes. However, data on TTS in patients with coronavirus disease-2019 infection (COVID-19) are limited.
Methods: We searched PubMed, Embase, and Cochrane Library databases for case reports for the period 2019-2022 describing TTS in patients with COVID-19 pneumonia (TTS-COVID). We summarized the clinical data and outcomes and compared them to those in patients with TTS with an acute respiratory disease other than COVID-19 as a trigger (TTS-acute respiratory disease) and those with TTS with no respiratory disease (TTS-no respiratory disease).
Results: The mortality rate was higher in those with TTS-COVID (26.0%) than those with TTS-acute respiratory disease (5.7%) or TTS-no respiratory disease (4.2%; P < 0.001 for both). The proportion of men was higher in TTS-COVID (33.3%) than it was in TTS-no respiratory disease (9.1%; P < 0.001). The manifestations of TTS in COVID patients were atypical (dyspnea [70.3%] and cough [40.6%]); few had chest pain (23.4%). Cardiovascular risk factors were common in the TTS-COVID cohort, but fewer patients were on cardioprotective medications in this group than in the other 2 groups. Level of catecholamine use was higher in the TTS-COVID group (37.7%) than it was in the TTS-no respiratory disease (10.9%; P < 0.001) group. Apical ballooning (72.6%) was the most common TTS subtype, and basal segment type was seen in 11.0% of TTS-COVID patients.
Conclusions: COVID-19 patients who developed TTS had high mortality rates and unique features, compared with those in the TTS-acute respiratory disease group or the TTS-no respiratory disease group. Understanding the pathophysiology of TTS in COVID-19 may help prevent TTS and direct therapy in this setting.