Connect with us

Government

Heart Damage is Prevalent Among Patients Hospitalized By COVID-19

Heart injury among hospitalized COVID-19 patients associated with higher risk of death

Published

on

This article was originally published by BioEngineering.

IMAGE

Credit: Mount Sinai Health System

Mount Sinai researchers have found that myocardial injury (heart damage) is prevalent among patients hospitalized with COVID-19 and is associated with higher risk of mortality. More specifically, a serious myocardial injury can triple the risk of death. The results were published in the June 5 issue of the Journal of the American College of Cardiology.

“There has been a lot of speculation about how COVID-19 affects the heart and blood vessels, and with what frequency. Our observational study may help to shed some light on this. We found that 36 percent of patients who were hospitalized with COVID-19 had elevated troponin levels–which represents heart injury–and were at higher risk of death,” says lead author Anu Lala, MD, Assistant Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai. “These findings, which are consistent with reports from China and Europe, are important for clinicians. If COVID-19-positive patients arrive in the emergency room and their initial test results show troponin levels are elevated, doctors may be able to better triage these patients and watch over them more closely, but this remains a testable hypothesis.”

A team of investigators analyzed electronic health records of nearly 3,000 adult patients with confirmed positive COVID-19 admitted to five New York City hospitals within the Mount Sinai Health System between February 27 and April 12, 2020 (The Mount Sinai Hospital, Mount Sinai West, Mount Sinai Morningside, Mount Sinai Queens, and Mount Sinai Brooklyn). The median age for patients analyzed was 66, and roughly 60 percent were male. One-quarter of all patients self-identified as African American, and 27 percent self-identified as Hispanic or Latino. Roughly 25 percent of the patients had a history of heart disease (including coronary artery disease, atrial fibrillation and heart failure) and roughly 25 percent had cardiovascular disease risk factors (including diabetes or hypertension).

Mount Sinai researchers found that 36 percent of hospitalized COVID-19 patients had myocardial injury. For those with substantial injury, their risk of death was three times higher than COVID-19-positive patients without myocardial injury.

To get this information, researchers focused on the patients’ levels of troponin–proteins that are released when the heart muscle becomes damaged–and their outcomes. (Higher troponin levels mean greater heart damage.) All patients had a blood test for this within 24 hours of admission and were grouped into three categories: 64 percent were in the normal range (0.00-0.03 ng/mL); 17 percent had mild elevation (between one and three times the upper limit of normal, or >0.03-0.09 ng/mL), and 19 percent had higher elevation (more than three times the upper limit of normal, or >0.09 ng/mL). Higher troponin levels were more prevalent in patients who were over 70 years old and had previously known conditions including diabetes, high blood pressure, atrial fibrillation, coronary artery disease and heart failure. Researchers made adjustments for these factors in the analysis.

Then, they analyzed the associated risk of death after adjusting for factors including age, sex, body mass index, history of cardiovascular disease, medication, and illness at hospital admission. They found patients with milder forms of myocardial injury were associated with lower likelihood of hospital discharge and a 75 percent higher risk of death compared to patients with normal levels. Patients with higher troponin concentrations were associated with a three times higher risk of death compared to those with normal levels. Additionally, when adjusting for relevant factors including heart disease, diabetes and high blood pressure, troponin was independently associated with risk of death. More specifically, heart injury seems to be a more important indicator in predicting risk of death than a history of heart disease.

“The study concludes that myocardial injury is common among patients hospitalized with COVID -19 but is more often mild and associated with low-level troponin elevation. Despite low levels, even small amounts of heart injury could be linked to a pronounced risk of death, and COVID-19 patients with a history of cardiovascular disease are more likely to have myocardial injury when compared to patients without heart disease,” explains Dr. Lala.

“Myocardial injury is frequent in COVID-19 patients, but the question is what is the main etiology? Is this by direct effect of the virus into the myocardium, or is it an indirect effect of the cytokine storm also into the myocardium, or a procoagulant causing coronary thrombotic ischemia? These are questions that need to be addressed in future studies,” says senior author Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital. “Additionally, we now need to follow COVID-19 patients with myocardial injury to learn more about the consequences.”

###

About the Mount Sinai Health System

The Mount Sinai Health System is New York City’s largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai is a national and international source of unrivaled education, translational research and discovery, and collaborative clinical leadership ensuring that we deliver the highest quality care–from prevention to treatment of the most serious and complex human diseases. The Health System includes more than 7,200 physicians and features a robust and continually expanding network of multispecialty services, including more than 400 ambulatory practice locations throughout the five boroughs of New York City, Westchester, and Long Island. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report’s “Honor Roll” of the Top 20 Best Hospitals in the country and the Icahn School of Medicine as one of the Top 20 Best Medical Schools in country. Mount Sinai Health System hospitals are consistently ranked regionally by specialty by U.S. News & World Report.

For more information, visit https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.mountsinai.org%2F&data=01%7C01%7Ceurekalert%40aaas.org%7Ca9fc8dfcc2be43a23cde08d80bc64481%7C2eebd8ff9ed140f0a15638e5dfb3bc56%7C0&sdata=HwR%2F1VjNAvJkBjOne%2F2zgUFl3t%2FFn%2B45oGssG%2B%2F%2FQd8%3D&reserved=0 or find Mount Sinai on Facebook, Twitter and YouTube.

Media Contact
ilana nikravesh
newsmedia@mssm.edu

Read More

Continue Reading

Spread & Containment

“That 70s Show”

The hit TV series "That 70s Show" aired from 1998 to 2006 and focused on six teenage friends living in Wisconsin in the late 70s. The irony was that the…

Published

on

The hit TV series “That 70s Show” aired from 1998 to 2006 and focused on six teenage friends living in Wisconsin in the late 70s. The irony was that the actors playing the teenagers were not born in the late 70s and had never experienced life during that period. Many alive today cannot fathom a lifestyle devoid of the internet, cable television, mobile phones, and social media. Oh…the horrors.

Yet, today, almost 50 years later, financial commentators, many of whom were not alive at the time, suggest that inflation and yields will repeat “That 70s Show.” Understandably, the increase in inflation and interest rates from their historic lows is cause for concern. As James Bullard noted, “Inflation is a pernicious problem,” which is why the Federal Reserve lept into action.

“When the US Federal Reserve embarked on an aggressive campaign to quash inflation last year, it did so with the goal of avoiding a painful repeat of the 1970s, when inflation spun out of control and economic malaise set in.” – CNN

That concern of “spiraling inflation” remains the key concern of the Federal Reserve in its current monetary policy decisions. It has also pushed many economists to point back at history, using “That 70s Show” period as the yardstick for justifying their concerns about a resurgence of inflation.

“The chair of the Federal Reserve at the time, Arthur Burns, hiked interest rates dramatically between 1972 and 1974. Then, as the economy contracted, he changed course and started cutting rates.

Inflation later roared back, forcing the hand of Paul Volcker, who took over at the Fed in 1979, Richardson said. Volcker brought double-digit inflation to heel — but only by raising borrowing costs high enough to trigger back-to-back recessions in the early 1980s that at one point pushed unemployment above 10%.

‘If they don’t stop inflation now, the historical analogy [indicates] it’s not going to stop, and it’s going to get worse,’ said Richardson, an economics professor at the University of California, Irvine.”

However, such may be an oversimplification to suggest Burns was wrong and Volker was right. The reason is the economy today is vastly different than during “That 70s Show.”

Today Is Very Different Than The 1970s

During the 70s, the Federal Reserve was entrenched in an inflation fight. The end of the Bretton Woods and the failure of wage/price controls combined with an oil embargo sent inflation surging. That surge sent markets crumbling under the weight of rising interest rates. Ongoing oil price shocks, spiking food costs, wages, and budgetary pressures led to stagflation through the end of that decade.

What was most notable was the Fed’s inflation fight. Like today, the Fed is hiking rates to quell inflationary pressures from exogenous factors. In the late 70s, the oil crisis led to inflationary pressures as oil prices fed through a manufacturing-intensive economy. Today, inflation resulted from monetary interventions that created demand against a supply-constrained economy.

Such is a critical point. During “That 70s Show,” the economy was primarily manufacturing-based, providing a high multiplier effect on economic growth. Today, the mix has reversed, with services making up the bulk of economic activity. While services are essential, they have a very low multiplier effect on economic activity.

One of the primary reasons is that services require lower wage growth than manufacturing.

Wages vs Inflation

While wages did rise sharply over the last couple of years, such was a function of the economic shutdown, which created a supply/demand gap in the employment matrix. As shown, full-time employment as a percentage of the population fell sharply during the pandemic lockdown. However, with full employment back to pre-pandemic levels, wage growth declines as employers regain control over the labor balance.

Full Time Employees To Population

Furthermore, the economic composite of wages, interest rates, and economic growth remain highly correlated between “That 70s Show” and today. Such suggests that while inflation rose with the supply/demand imbalance created by the shutdown, the return to normalcy will lower inflation as economic activity slows.

Economic composite index vs Inflation

With a correlation of 85%, the inflationary decline will be coincident with economic growth, interest rates, and wages.

Economic composite correlation to inflation

Unlike “That 70s Show,” where economic growth and wages were rising steadily, which allowed for higher levels of interest rates and inflation, There is a singular reason why a repeat of that period is quite impossible.

Ad for SimpleVisor, the do-it-yourself investing tool by RIA Advisors. Don't invest alone. Tap into the power of SimpleVisor. Click to sign up now.

The Debt Burden And Economic Weakness

What is notable about “That 70s Show” is that it was the culmination of events following World War II.

Following World War II, America became the “last man standing.” France, England, Russia, Germany, Poland, Japan, and others were devastated, with little ability to produce for themselves. America found its most substantial economic growth as the “boys of war” returned home to start rebuilding a war-ravaged globe.

But that was just the start of it.

In the late ’50s, America stepped into the abyss as humankind took its first steps into space. The space race, which lasted nearly two decades, led to leaps in innovation and technology that paved the wave for the future of America.

These advances, combined with the industrial and manufacturing backdrop, fostered high levels of economic growth, increased savings rates, and capital investment, which supported higher interest rates.

Furthermore, the Government ran no deficit, and household debt to net worth was about 60%. So, while inflation increased and interest rates rose in tandem, the average household could sustain its living standard. The chart shows the difference between household debt versus incomes in the pre- and post-financialization eras.

income vs debt ratios

With the Government running a deep deficit with debt exceeding $32 trillion, consumer debt at record levels, and economic growth rates fragile, consumers’ ability to withstand higher inflation and interest rates is limited. As noted previously, the “gap” between income and savings to sustain the standard of living is at record levels. The chart shows the gap between the inflation-adjusted cost of living and the spread between incomes and savings. It currently requires more than $6500 of debt annually to fill the “gap.

Consumer Spending Gap

It Is Not The Same

While the Fed is currently engaged “in the fight of its life,” trying to quell inflation, The economic differences are vastly different today. Due to the heavy debt burden, the economy requires lower interest rates to sustain even meager economic growth rates of 2%. Such levels were historically seen as “pre-recessionary,” but today, they are something economists hope to maintain.

Graph showing Economic growth by cycle with data from 1790 to 2020.

This is one of the primary reasons why economic growth will continue to run at lower levels. Such suggests we will witness an economy:

  • Subject to more frequent recessionary spats,
  • Lower equity market returns, and
  • A stagflationary environment as wage growth remains suppressed while the cost of living rises.

Changes in structural employment, demographics, and deflationary pressures derived from changes in productivity will magnify these problems.

While many want to suggest that the Federal Reserve is worried about “That 70s Show,” we would be lucky to have the economic strength to support such a concern.

The Fed’s bigger worry should be when the impact of higher rates causes a financial break in a debt-dependent financial system.

The post “That 70s Show” appeared first on RIA.

Read More

Continue Reading

International

Federal Reserve trails global counterparts in balance sheet reductions, data reveals

Quick Take The Federal Reserve’s balance sheet of total assets has seen a reduction of an additional $75 billion in the past week, with total assets…

Published

on

Quick Take

The Federal Reserve’s balance sheet of total assets has seen a reduction of an additional $75 billion in the past week, with total assets now slightly surpassing the 8 trillion mark. For context, prior to the COVID-19 pandemic, the Fed’s balance sheet was approximately $3.5 trillion.

Despite the considerable distance yet to be covered, substantial efforts have been made to reduce the balance sheet via quantitative tightening, achieving a reduction of about 5.5% year to date.

It is interesting, however, to juxtapose this with other leading global central banks. The Bank of England (BOE) has surpassed the Fed’s reduction rate with a 6.5% decrease, the People’s Bank of China (PBoC) at 7.5%, and both the Bank of Japan (BOJ) and the European Central Bank (ECB) have outpaced with reductions exceeding 10%.

This continuation of quantitative tightening will put further pressure on bond yields, with the U.S. 10-year treasury yield rising to 4.5%.

This data underscores the concerted global effort by central banks to rebalance their respective financial territories, navigating the delicate path of recovery in the post-pandemic world.

Fed Balance Sheet: (Source: FRED)

The post Federal Reserve trails global counterparts in balance sheet reductions, data reveals appeared first on CryptoSlate.

Read More

Continue Reading

International

Britain’s Parliament Demands That Rumble, X Deplatform Russell Brand

Britain’s Parliament Demands That Rumble, X Deplatform Russell Brand

Authored by Andrea Widburg via American Thinker (emphasis ours),

Two…

Published

on

Britain's Parliament Demands That Rumble, X Deplatform Russell Brand

Authored by Andrea Widburg via American Thinker (emphasis ours),

Two hundred and fifty years ago, Great Britain bequeathed to us our notions of due process and free speech. That country, however, no longer exists. Instead, we have a country that is demanding that Russell Brand, who has been accused of alleged sexual wrongdoing that occurred decades ago (charges he denies), must be deplatformed from Rumble, a site built upon free speech. Fortunately, Rumble is standing strong.

Image: Russell Brand. YouTube screen grab.

Russell Brand has admitted that he was a sex and drug addict. Then, he cleaned up his act. I don’t doubt that he did regrettable things during his years of debauchery, although whether he did anything illegal or even outside the bell curve of a sex-saturated society has never been examined in a law court of law.

During those same years of debauchery, Brand was an out-and-proud leftist, as well as an edgy (very edgy) comedian. Now, though, during his years of clean living, Brand has become something of a libertarian, talking to people like Tucker Carlson and Ben Shapiro because he stood against COVID and vaccine madness.

Given that Brand has been red-pilled and is becoming redder by the day, many conservatives think it’s not a coincidence that he has suddenly been accused of sexual wrongdoing dating back a couple of decades. Regarding the specific accusations, I haven’t read the details and, frankly, I’m not interested.

The fact is that I’m very suspicious of charges floating up after decades. The “he said-she said” dynamic that bedevils many sex crimes is multiplied by the passage of time. That’s why we have statutes of limitations. Indeed, much as I think Joe Biden is capable of sex crimes, the only reason I believed Tara Reade’s allegations was because her mother called Larry King and discussed the issue when it happened.

[ZH: X received a letter as well...]

 The letter acknowledges in its opening sentence that there is no proof that Brand misbehaved. There are only “allegations.” The same letter, from Dame Caroline Dinenage, the Committee’s chair and, believe it or not, a conservative MP, says that the Committee is “concerned that he may be able to profit from his content on the platform.” In other words, based on allegations of long-past crimes, the British Parliament would like to see someone deprived of his income. (And yes, I assume Brand is rich, but it’s the principle of the thing.) The Committee’s sole concern is that “creators are not able to use the platform to undermine the welfare of victims of inappropriate and potentially illegal behaviour.” As far as I know, there aren’t victims. There are only accusers who have managed to survive for decades without talking. After a fair trial (something increasingly unlikely in the third decade of the 21st century), we can revisit whether there are actual victims. To his great credit, Pavlovski wrote a polite “stick it up your derriere” letter in response:

I especially love this bit:

We regard it as deeply inappropriate and dangerous that the UK Parliament would attempt to control who is allowed to speak on our platform or to earn a living from doing so. Singling out an individual and demanding his ban is even more disturbing given the absence of any connection between the allegations and his content on Rumble. We don’t agree with the behavior of many Rumble creators, but we refuse to penalize them for actions that have nothing to do with our platform.

That’s exactly right. The final sentence—“We emphatically reject the UK Parliament’s demands”—is something that would have made America’s Founders proud.

It’s deeply disturbing that a government would try to destroy an individual based on ancient allegations. What’s sad about this action is that it was Britain that bequeathed to us our fundamental concerns with free speech (the First Amendment) and due process (the Fifth Amendment). George Orwell saw it coming, but that doesn’t mean we have to be happy that it’s here.

[ZH reactions have been sharply critical of the UK government's move to deplatform someone who hasn't been convicted of anything. In particular, Elon Musk has had Brand's back]:

Tyler Durden Fri, 09/22/2023 - 05:00

Read More

Continue Reading

Trending