#Covid19 and the Heart! A great session at #ESCCongress. Lots of information, lots of speakers- and this is not-so-short thread of my "take home" messages

1- Women have less critical events and death.
2- Women have less cardiac comorbidities compared to men with covid

#epeeps

#ESCCongress Covid & Heart Thread /3

HTN, Lipids, Diabetes, CAD, heart failure ALL associated with worse prognosis (critical events and deaths) in women

BNP & Trop associated with worse prognosis in women

Women had less ITU transfer or hospital death than men
@DrMarthaGulati

#ESCCongress Covid & Heart Thread /4

Risk factors for thromboembolism, bleeding & death?

Cardiovascular comorbidities, liver problems, cancer, OSA & #Covid severity - high respiratory rate, high heart rate, leucocytosis

@ShrillaB @CJohnston1903 @JeffreyChansky @AlexFrogoudaki

#ESCCongress Covid & Heart Thread /5

And did quality of academic publishing change during covid? Sadly yes...A detailed analysis of Jan-Apr 2019 from @NEJM @TheLancet @JAMA_current looked into this. Quality in 2020 not as good and driven by covid papers

#cardioed @Drroxmehran

#ESCCongress Covid & Heart Thread /6

Has academic publishing in covid changed? According to Giuilio Stefanini YES- quality was lower & need to maintain a rigorous #peer #review process

@ShraboniGhosal @wordfinga @DrLaviniaGabara
@SaludHEALTHinfo @RealCruzHenry @corinne8154

#ESCCongress Covid & Heart Thread /7

And what did the Yale group find from their initial 400 covid19 patients?
HTN, Obesity, Lipids, DM and CKD were risk factors

@mancunianmedic @Lpa_Doc @BSHeartFailure @dr_benoy_n_shah @AskDrShashank @SachinGoelMD @duanepinto
#echofirst

#ESCCongress Covid & Heart Thread /8

And the conclusions from the Yale Cohort?

Women had better outcomes
Atrial arrhytmias, diuretic, O2 therapy, high trop, low albumin all associated with worse outcomes

@EilidhPinkChic @KTamirisaMD @dr_manisty @arjunkg @Dr_Stig #cardioed

#ESCCongress Covid & Heart Thread /9

And then, what sort of research do we need in Covid? Are observational studies good enough? Or not? The Answer is not... Only RCT are GOLD and can change practice! See the RECOVERY study and DEXAMETHASONE https://www.nejm.org/doi/full/10.1056/NEJMoa2021436

@ShrillaB

#ESCCongress Covid & Heart Thread /10

Hydroxychloroquine and Loinavir-ritonavir- not much help
Dexamethasone- YES = we hit "Bulls eye" 25% reduction in mortality in ventilated patients and 20% in those needing oxygen. A simple and cheap drug reducing mortality!

@duanepinto

#ESCCongress Covid & Heart Thread / THE END

And what did we learn from studies in Covid?

We need RCT! And we need Good RCT!
They are critical 4 identifying effective treatments!
We need streamline in making RCTs possible.

What we learned from Covid also applicable to Hearts!