Key result
Among patients with Takotsubo syndrome, those with concurrent COVID-19 infection had an in-hospital mortality rate of 33.3%, compared to 2.3% in COVID-19-negative individuals.
Why the study?
Takotsubo syndrome has increased during the COVID-19 pandemic, prompting a systematic review of cases associated with COVID-19 infection, vaccination, and pandemic-related psychosocial stressors.
Systematic Review (n=102)
Takotsubo syndrome in the setting of COVID-19 infection is associated with a high in-hospital mortality rate of 33.3% and frequently presents with dyspnea, elevated cardiac biomarkers, and ST-T ECG abnormalities.
Answers are grounded in this paper and cite their sources.
Concurrent COVID-19 signals markedly higher mortality risk in Takotsubo syndrome; systematic review leaves open need for targeted management strategies.
Background and Aims: Takotsubo syndrome (TTS), also known as stress cardiomyopathy, is characterized by acute and transient left ventricular dysfunction and has increased during the COVID-19 pandemic. Herein, we aim to review studies on TTS that were associated with COVID-19 infection, vaccine, and other COVID-19-related etiologies including psychosocial stressors. Methods: We systematically searched PubMed, EMBASE, and Scopus up to May 12, 2022. We included case reports, case series, and original articles that reported at least one TTS case associated with COVID-19, or TTS cases after receiving COVID-19 vaccines, or TTS cases secondary to psychological stress due to the COVID-19 pandemic. The quality assessment was conducted using the Joanna Briggs Institute checklist. Results: = 67 [65.6%]) and the mean left ventricular ejection fraction was 36.5%. Among COVID-19 patients, the in-hospital mortality rate was 33.3%. On the other hand, only one COVID-19-negative individual expired (2.3%). The most common presenting clinical symptom was dyspnea in 42 (73.6%) patients. the mean time interval from the first symptom to admission was 7.2 days. The most common chest imaging finding was ground-glass opacity which was reported in 14 (31.1%) participants. The most common abnormalities were T-wave inversion in 35 (43.2%) and ST-segment elevation in 30 (37%). Brain natriuretic peptide and troponin were elevated in 94.7% and 95.9% of participants, respectively. Conclusion: The TTS in patients with COVID-19 is almost rare, whereas it could lead to a great mortality and morbidity. An individual with COVID-19, especially an elderly woman, presented with dyspnea in addition to a rise in brain natriuretic peptide and troponin should be evaluated for TTS.
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Ghasemi et al. (2022) conducted a systematic review in Takotsubo syndrome associated with COVID-19 (n=102). COVID-19 infection, vaccination, or pandemic-related stress vs. COVID-19-negative individuals with Takotsubo syndrome was evaluated on In-hospital mortality rate. Among patients with Takotsubo syndrome, those with concurrent COVID-19 infection had an in-hospital mortality rate of 33.3%, compared to 2.3% in COVID-19-negative individuals.
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