Prof S Price
- Myocarditis: relatively uncommon
- Myocardial injury: relatively common
- Resources from European Society of Cardiology – link
- COVID-19 is, in the end, an endothelial disease
- Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: a survey by the European Society of Cardiology
- Survey: 3101 responses, 141 countries, 6 continents
- 88.3% total lockdown, 7.1% partial lockdown
- 78.8% stated reduction in numbers presenting with STEMI (65.2%>40% reduction)
- 58.5% that >40% STEMI admitted beyond optimal intervention window
- Rapid rule in/rule out algorithms now recommended to use ESC 0h/1h algorithm ( or 1h/2h algorithm (second best option) if a hs-cTn test with a validated algorithm is available
- If elective non-invasive/invasive imaging is needed after the rule-out of MI, invasive angiography is the best option in those with a very high clinical likelihood of UA. Stress testing with imaging or CCTA is best in those with low-to-modest clinical risk.
- Rhythm monitoring for up to 24 h or to PCI (whichever comes first) is recommended for those at low risk for arrhythmias and monitoring >24h if at increased risk
- Early routine invasive approach within 24 hours for NSTEMI based on hs-cTn measurements, GRACE score >140, dynamic/new STT changes.
Take home message
- ILD is not one disease
- Acute excacerbation in every type of ILD
- The landscape is changing; finally…
- Position antifibrotic therapy fibrotic ILD not clear yet; immunosuppressants.
From the disease lung fibrosis to criteria, towards phenotyping, towards personalized medicine.
Prof S Koch
- Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China
- Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study
- Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke
EID risk is increasing due to climate change and loss of biodiversity
-> we need to adress this now
Neurological manifestation of Covid-19 occur in ~ 36%
Cerebrovasculare Manifestions occur in ~ 5% of Covid-19 patients based on
–pathological coagulation or hyperinflammation
–includes younger patients or patients with typical riskfactors
–leads to more severe outcome
-> check carefully coagulation parameters and risk factors
Altered conscious state is seen in ~ 65% of Covid-19 ICU patients
–based on encephalopathy or seizures
-> EEG monitoring, MRI
Optimizing preoperative fluid therapy Encourage use of clear carbohydrate drinks up until 2 h prior to surgery!
- Less catabolism
- Less postoperative nausea and vomiting
- Less insulin resistance
- Less perioperative anxiety