Fulminant myocarditis induced by SARS-CoV-2 infection without severe lung involvement:insights into COvID-19 pathogenesis

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection often leads to pulmonary complications.Cardiovascular sequelae,including myocarditis and heart failure,have also been reported.Here,the study presents two fulminant myocarditis cases infected by SARS-CoV-2 exhibiting remarkable elevation of cardiac biomarkers without significant pulmonary injury,as determined by imaging examinations.Immunohistochemical staining reveals the viral antigen within cardiomyocytes,indicating that SARSCoV-2 could directly infect the myocardium.The full viral genomes from respiratory,anal,and myocardial specimens are obtained via next-generation sequencing.Phylogenetic analyses of the whole genome and spike gene indicate that viruses in the myocardium/pericardial effusion and anal swabs are closely related and cluster together yet diverge from those in the respiratory samples.In addition,unique mutations are found in the anal/myocardial strains compared to the respiratory strains,suggesting tissue-specific virus mutation and adaptation.These findings indicate genetically distinct SARS-CoV-2 variants have infiltrated and disseminated within myocardial tissues,independent of pulmonary injury,and point to different infection routes between the myocardium and respiratory tract,with myocardial infections potentially arising from intestinal infection.These findings highlight the potential for systemic SARS-CoV-2 infection and the importance of a thorough multi-organ assessment in patients for a comprehensive understanding of thepathogenesisof COVID-19.

Expert consensus on the use of human serum albumin in adult cardiac surgery

Introduction Albumin,which is a 65-kDa liver-synthesized protein,accounts for nearly 50%of total plasma protein and contributes to approximately 80%of intravascular oncotic pressure.Albumin helps maintain microvascular integrity,functions as an antioxidant,and transports hormones,fatty acid,bile salts,bilirubin,electrolytes(e.g.,calcium,magnesium,copper,zinc,et al.),and drugs.[1–3]Human serum albumin(HSA)is a sterile,liquid albumin product derived from large pools of human plasma by fractionation and pasteurization.The medical use of HAS could date back to approximately the time of World War II.

Extracorporeal membrane oxygenation versus cardiopulmonary bypass during transcatheter aortic valve implantation: a meta-analysis of survival benefits

Since its approval by the Food and Drug Administration in 2011,transcatheter aortic valve implantation(TAVI)has rapidly evolved to become the preferred ultimate intervention for high-and intermediate-risk patients with severe symptomatic aortic stenosis.[1]This is due to its non-open-heart,minimally invasive and off-pump advantages.[1]Nevertheless,as a result of the frequent frailty and comorbidity profiles of patients undergoing TAVI,such as advanced cardiac dysfunction and extensive coronary artery disease,or technically difficult anatomy for the procedure itself,[2-4]it is common for these patients to experience critical circulatory collapse perioperatively.These factors are linked to elevated mortality rates,necessitating suitable mechanical circulatory support(MCS)to reverse the disastrous situations.[5]

Visible-blind short-wavelength infrared photodetector with high responsivity based on hyperdoped silicon

Developing a low-cost, room-temperature operated and complementary metal-oxide-semiconductor(CMOS)compatible visible-blind short-wavelength infrared(SWIR) silicon photodetector is of interest for security,telecommunications, and environmental sensing. Here, we present a silver-supersaturated silicon(Si:Ag)-based photodetector that exhibits a visible-blind and highly enhanced sub-bandgap photoresponse. The visible-blind response is caused by the strong surface-recombination-induced quenching of charge collection for short-wavelength excitation, and the enhanced sub-bandgap response is attributed to the deep-level electrontraps-induced band-bending and two-stage carrier excitation. The responsivity of the Si:Ag photodetector reaches 504 mA · W^(-1) at 1310 nm and 65 m A · W^(-1) at 1550 nm under-3 V bias, which stands on the stage as the highest level in the hyperdoped silicon devices previously reported. The high performance and mechanism understanding clearly demonstrate that the hyperdoped silicon shows great potential for use in optical interconnect and power-monitoring applications.

Current situation,efficacy,and safety of extracorporeal cardiopulmonary resuscitation in China

To the Editor:The survival rate from conventional cardiopulmonary resuscitation(CCPR)of out-of-hospital and in-hospital cardiac arrest ranges from 9%to 20%.[1]Without returning of spontaneous circulation(ROSC)after CCPR,the chance of recovery is very poor.Initiating venoarterial extracorporeal membrane oxygenation in those patients may provide adequate organ perfusion that allows for longer organ viability and permit time for therapies seeking to correct the inciting pathologic event,which is termed extracorporeal cardiopulmonary resuscitation(ECPR).[2]Time to treatment,ECPR-related complications,as well as etiology,have been recognized as the main predictors of survival for ECPR patients.[3]ECPR has been carried out more and more in China,but the information on ECPR application remains unknown.Therefore,we conducted a retrospective survey about the usage of ECPR in China,including patient selection,initiation and management of extracorporeal mechanical ventilation(ECMO),patient outcome,and compared the status during 2017 and 2020.

Clinical application and management of temporary mechanical circulatory support:A clinical consensus

Temporary mechanical circulatory support(tMCS)plays a pivotal role in managing severe or refractory cardiogenic shock(CS),furnishing essential hemodynamic support,and sustaining organ perfusion from hours to weeks,or to even months.In the past decade,the utilization of tMCS has witnessed a signi cant increase in American and European countries.Meanwhile in Asia,the newly developed concepts and devices constituting tMCS have also made rapid progress.Nevertheless,the absence of a consensus or standardized guidelines,especially for the Asian population considering inherited polymorphism,is evident.To address this knowledge gap,eight associations/societies and experts in this eld came up with the present consensus after repeated discussions,more speci cally for the Asian population.It comprehensively elucidates the commonly employed tMCS devices,criteria for patient selection,indications and contraindications,clinical management,and the optimal timing for implantation and weaning.The goal of this statement is to promote the standardized application of tMCS and make reasonable decisions in clinical practice.Full-length version of the consensus can be seen in Supplementary File,http://links.lww.com/CM9/B883.