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Although cardiac involvement has prognostic significance in COVID-19 and is associated with severe presentations, few studies have explored the prognostic role of transthoracic echocardiography (TTE). We investigated the link between TTE parameters and prognosis in COVID-19. Consecutive patients with COVID-19 admitted in 24 French hospitals were retrospectively included. Comprehensive data, including clinical and biological parameters, were recorded at admission. Focused TTE was performed during hospitalization, according to clinical indication. Patients were followed-up for a primary composite outcome of death or transfer to intensive care unit (ICU) during hospitalization. Among 2878 patients, 445 (15%) underwent TTE. Most had cardiovascular risk factors, a history of cardiovascular disease, and were under cardiovascular medications. Dilatation and dysfunction were observed in12% (48/412) and 23% (102/442) of patients for the left ventricle, and in 12% (47/407) and 16% (65/402) for the right ventricle (RV), respectively. Primary composite outcome occurred in 44% (n = 196) of patients (9% n = 42] for death without ICU transfer and 35% n = 154] for admission to ICU). RV dilatation was the only TTE parameter associated with the primary outcome. After adjustment, male sex (hazard ratio [HR] 1.56, 95% CI 1.09 − 2.25; P = 0.02), higher body mass index (HR 1.10, 95% CI 1.02 − 1.18; P = 0.01), anticoagulation (HR 0.53, 95% CI 0.33 − 0.86; P = 0.01), and RV dilatation (HR 1.66, 95% CI 1.05 − 2.64; P = 0.03) remained independently associated with the primary outcome (Fig. 1). Echocardiographic evaluation of RV dilatation could be useful for assessing the risk of inhospital death or transfer to ICU in severe hospitalized COVID-19 patients. [ABSTRACT FROM AUTHOR]

Objective-To determine outcome of Standardbred racehorses with moderate to severe midbody suspensory ligament desmitis (MSD) treated by means of ultrasound-guided intralesional injection of a single dose of platelet-rich plasma (PAP) followed by a program of gradually increased exercise. Design-Nonrandomized clinical trial. Animals-9 Standardbred racehorses. Procedures-Following injection of PAP horses were allowed a controlled, gradual return to exercise. Race records for the year prior to injury and for 3 consecutive years after horses returned to racing were reviewed. For comparison purposes, race records of 9 Standard- bred racehorses with no history of MSD racing at the same time were also reviewed. Results-All 9 horses with MSD returned to racing after treatment; median time to return to racing was 32 weeks. All 9 horses raced at least once during the first and second years after returning to racing, but only 5 raced during the third year. When number of starts, total earnings, and earnings per start were compared between case and comparison horses, the only significant differences were number of starts during the third year after case horses returned to racing and earnings per start during the first year after case horses returned to racing, with values being significantly lower for case horses than for comparison horses. Conclusions and Clinical Relevance-Results suggested that horses with moderate to severe MSD treated by means of intralesional injection of a single dose of PAP followed by a program of gradually increased exercise had an excellent prognosis for returning to racing. (JAm Vet Med Assoc 2008;232:1515-1520) [ABSTRACT FROM AUTHOR]

While women account for 40-50 % of patients hospitalized for coronavirus disease 2019 (Covid-19), no specific data have been reported in this population. Assess the burden of cardiovascular comorbidities on outcomes in women hospitalized for Covid-19. We conducted a retrospective observational multicenter study from February 26 to April 20, 2020 in 24 French hospitals including all adults admitted for Covid-19. Primary composite outcome included transfer to intensive care unit (ICU) or in-hospital death. Among 2878 patients hospitalized for Covid-19, 1212 (42.1 %) were women. Women were significantly older (68.3 ± 18.0 vs. 65.4 ± 16.0 years, P < 0.001) but had less prevalent cardiovascular comorbidities than men. Among women, 276 (22.8 %) experienced the primary outcome, including 161 (13.3 %) transfer to ICU and 115 (9.5 %) deaths without transfer to ICU. The survival free from death or transfer to ICU was higher in women (HR 0.63, 95 %CI 0.53-0.73, P < 0.001), whereas the observed difference in in-hospital deaths did not reach statistical significance (P = 0.18). The proportion of women that experienced the primary outcome were 37.8 % in women with heart failure (n = 112), 30.9 % in women with coronary artery disease (n = 81), 29.1 % in women with diabetes (n = 254), 26.1 % in women with dyslipidemia (n = 315), and 26.0 % in women with hypertension (n = 632). Age (HR 1.05, 5 years increments, 95 %CI 1.01-1.10), body mass index (HR 1.06, 2 units increments, 95 %CI 1.02-1.10), chronic kidney disease (HR 1.57, 95 %CI 1.11-2.22), and heart failure (HR 1.52, 95 %CI 1.04-2.22) were independently associated with the primary outcome (Fig. 1). Women hospitalized for Covid-19 were older and had less prevalent cardiovascular comorbidities than men. While female sex was associated with a lower risk of transfer to ICU or in-hospital death, Covid-19 remains associated with considerable morbi-mortality in women, especially in those with cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Objective--To evaluate the buffy coat and apheresis methods for preparation of platelet concentrates from equine blood by comparing platelet and growth factor concentrations. Animals--15 mature mixed-breed geldings. Procedure--Whole blood samples were collected and processed by use of a buffy coat or apheresis method to obtain platelet poor and platelet concentrated fractions. The PCV, WBC count, and platelet count were compared among whole blood samples, platelet poor fractions, concentrates obtained by use of the apheresis method (ie, apheresis platelet concentrates), and concentrates obtained by use of the buffy coat method (ie, buffy coat platelet concentrates). Concentrations of transforming growth factor-β (ie, TGF-β1 and GF-β2) and insulin-like growth factor were compared between buffy coat and apheresis platelet concentrates. Results--Platelet concentrations were 8.9-fold and 5.2-fold greater in buffy coat and apheresis platelet concentrates, respectively, compared with whole blood. Platelet concentrations were 13.1-fold greater in filtered apheresis platelet concentrates, compared with whole blood. TGF-β1 concentrations were 2.8-old and 3.1-fold greater in buffy coat and apheresis platelet concentrates, respectively, and TGF-β1 concentrations were 10.5-fold greater in filtered apheresis platelet concentrates, compared with whole blood. TGF-β2 concentrations were 3.6-fold greater in apheresis platelet concentrates, compared with whole blood. Platelet concentrations correlated with growth factor concentrations across all blood and platelet fractions. White blood cell counts had a significant positive correlation with TGF-β1 concentration in buffy coat platelet concentrates. Conclusions and Clinical Relevance--Platelets and TGF-β1 can be concentrated reliably from equine blood by use of buffy coat or apheresis methods, without modification of the protocols used for humans. [ABSTRACT FROM AUTHOR]

While pulmonary embolism (PE) appears to be a major issue in Covid-19, data remain sparse. We aimed to describe the risk factors and baseline characteristics of patients with PE in a large cohort of Covid-19 patients. In a retrospective multicentric observational study, we included consecutive hospitalised patients for Covid-19. Patients without computed tomography pulmonary angiography (CTPA)-proven PE diagnosis, those who were directly admitted to an intensive care unit (ICU), and those still hospitalised without PE experience were excluded. Among 1240 patients (58.1% men, mean age 64 ± 17 years), 103 (8.3%) patients had PE confirmed by CTPA. The ICU transfer requirement and mechanical ventilation requirement were significantly higher in the PE group (P < 0.001 and P < 0.001, respectively). In an univariable analysis, traditional venous thromboembolic risk factors were not associated with PE (P > 0.05), while patients under therapeutic-dose anticoagulation before hospitalisation or prophylaxis-dose anticoagulation introduced during hospitalisation had lower PE occurrence (OR 0.40, 95%CI(0.14-0.91); P = 0.04 and OR 0.11, 95%CI(0.06-0.18); P < 0.001, respectively). In a multivariable analysis, the following variables (also statistically significant in univariable analysis) were associated with PE: male gender (OR 1.03, 95%CI(1.003-1.069); P = 0.04), anticoagulation with prophylaxis-dose (OR 0.83, 95%CI(0.79-0.85), P < 0.001) or therapeutic-dose (OR 0.87, 95%CI(0.82-0.92), P < 0.001), C-reactive protein (OR 1.03, 95%CI(1.01-1.04), P = 0.001) and time from symptom onset to hospitalisation (OR 1.02, 95%CI(1.006-1.038), P = 0.002) (Table 1). Pulmonary embolism risk factors in Covid-19 context do not include traditional thromboembolic risk factors but rather independent clinical and biological findings at admission, including a major contribution to inflammation. [ABSTRACT FROM AUTHOR]

Main features of COVID-19 patients have been reported in the literature. While young patients under 45 years old (y/o) account for a non-negligible part of hospitalized patients, data on this population remain sparse. To describe the characteristics and outcomes of hospitalized COVID-19 young patients (< 45 y/o). The Critical COVID France (CCF) study was an observational multicenter study including patients hospitalized for COVID-19. Primary composite outcome included transfer to ICU or in-hospital death. Secondary outcomes were cardiovascular complications diagnosed by the referring medical team according to available clinical, biological and radiological findings. Among 2,878 patients hospitalized for COVID-19 in 24 centers, 321 (11.2%) patients were under the age of 45 y/o. They had a higher body mass index (BMI) (28.9 ± 6.6 vs 27.7 ± 6.0, P = 0.004) but less other cardiovascular risk factors including hypertension (29 (9.2%) vs. 1422 (56.1%), P < 0.001), diabetes (20 (6.3%) vs. 656 (25.9%), P < 0.001) and dyslipidemia (15 (4.7%) vs. 783 (30.7%), P < 0.001). The primary outcome occurred in 54 (16.8%) patients under 45 y/o vs. 783 (30.7%) in patients aged > 45 y/o (P < 0.001), with a strong impact on the death rate (3 (0.9%) vs. 358 (14.0%), P < 0.001). The group under 45 y/o experienced more frequently related COVID-19 cardiovascular complications such as pericarditis (12 (0.5%) vs. 7 (2.2%), P = 0.003) and myocarditis (14 (0.6%) vs 8 (2.5%), P = 0.002). Conversely, acute heart failure occurred more frequently in patients aged > 45 y/o (183 (7.2%) vs. 3 (0.9%), P < 0.001). Acute coronary syndrome and stroke were similar between the two groups (Fig. 1). In this nationwide multicenter observational study of hospitalized COVID-19 patients, patients under the age of 45 y/o had less cardiovascular risk factors but more specific related COVID-19 cardiovascular complications such as pericarditis and myocarditis. [ABSTRACT FROM AUTHOR]

Objective—To determine clinical findings and outcome in horses treated by means of a balloon constant rate infusion system. Design—Retrospective case series. Animals—23 horses. Procedures—Medical records of horses examined at The Ohio State University veterinary teaching hospital from 2002 to 2005 that had septic arthritis, septic tenosynovitis, or penetration of a synovial structure and in which treatment involved a balloon constant rate infusion system were searched. Information pertaining to signalment, history, physical examination findings, clinicopathologic data, treatment, and duration of hospitalization was recorded. Results—Mean ± SD duration of hospitalization was 11.5 ± 5.26 days. No correlation between duration of clinical signs and duration of hospitalization or duration of infusion pump use was detected, but correlations between WBC count and duration of hospitalization and WBC and duration of infusion-pump use were observed. All horses survived to discharge. Follow-up information was obtained on 17 horses, 16 of which were alive at the time of follow-up. Twelve of 13 horses for which follow-up information was available for at least 5 months were alive 5 months or longer after discharge. Thirteen of the 16 horses alive at follow-up were reported by owners as not lame, whereas the remaining 3 were mildly lame or intermittently moderately lame or had developed angular limb deformity in the contralateral limb. Conclusions and Clinical Relevance—Balloon constant rate infusion systems may be used effectively in treatment of septic arthritis, septic tenosynovitis, and contaminated synovial wounds. Clinical response and long-term outcome appeared to be comparable to results obtained with other techniques. [ABSTRACT FROM AUTHOR]