Prevalence, Characteristics, and Outcomes of COVID-19-Associated Acute Myocarditis

Background: Acute myocarditis (AM) is thought to be a rare cardiovascular complication of COVID-19, although minimal data are available beyond case reports. We aim to report the prevalence, baseline characteristics, in-hospital management, and outcomes for patients with COVID-19-associated AM on the basis of a retrospective cohort from 23 hospitals in the United States and Europe. Methods: A total of 112 patients with suspected AM from 56 963 hospitalized patients with COVID-19 were evaluated between February 1, 2020, and April 30, 2021. Inclusion criteria were hospitalization for COVID-19 and a diagnosis of AM on the basis of endomyocardial biopsy or increased troponin level plus typical signs of AM on cardiac magnetic resonance imaging. We identified 97 patients with possible AM, and among them, 54 patients with definite/probable AM supported by endomyocardial biopsy in 17 (31.5%) patients or magnetic resonance imaging in 50 (92.6%). We analyzed patient characteristics, treatments, and outcomes among all COVID-19-associated AM. Results: AM prevalence among hospitalized patients with COVID-19 was 2.4 per 1000 hospitalizations considering definite/probable and 4.1 per 1000 considering also possible AM. The median age of definite/probable cases was 38 years, and 38.9% were female. On admission, chest pain and dyspnea were the most frequent symptoms (55.5% and 53.7%, respectively). Thirty-one cases (57.4%) occurred in the absence of COVID-19-associated pneumonia. Twenty-one (38.9%) had a fulminant presentation requiring inotropic support or temporary mechanical circulatory support. The composite of in-hospital mortality or temporary mechanical circulatory support occurred in 20.4%. At 120 days, estimated mortality was 6.6%, 15.1% in patients with associated pneumonia versus 0% in patients without pneumonia (P=0.044). During hospitalization, left ventricular ejection fraction, assessed by echocardiography, improved from a median of 40% on admission to 55% at discharge (n=47; P<0.0001) similarly in patients with or without pneumonia. Corticosteroids were frequently administered (55.5%). Conclusions: AM occurrence is estimated between 2.4 and 4.1 out of 1000 patients hospitalized for COVID-19. The majority of AM occurs in the absence of pneumonia and is often complicated by hemodynamic instability. AM is a rare complication in patients hospitalized for COVID-19, with an outcome that differs on the basis of the presence of concomitant pneumonia

EARLINET observations related to volcanic eruptions (2000-2010)

A European Aerosol Research Lidar Network to Establish an Aerosol ClimatologyAerosols affect life on earth in several ways. They play an important role in the climate system; the effect of aerosols on the global climate system is one of the major uncertainties of present climate predictions. They play a major role in atmospheric chemistry and hence affect the concentrations of other potentially harmful atmospheric constituents, e.g. ozone. They are an important controlling factor for the radiation budget, in particular in the UV-B part of the spectrum. At ground level, they can be harmful, even toxic, to man, animals, and plants. Because of these adverse effects that aerosols can have on human life, it is necessary to achieve an advanced understanding of the processes that generate, redistribute, and remove aerosols in the atmosphere.A quantitative dataset describing the aerosol vertical, horizontal, and temporal distribution, including its variability on a continental scale, is necessary. The dataset is used to validate and improve models that predict the future state of the atmosphere and its dependence on different scenarios describing economic development, including those actions taken to preserve the quality of the environment. The EARLINET data set is the most comprehensive compilation of data available for this purpose.This project description is taken from: http://www.earlinet.org/index.php?id=earlinet_homepageSummary: Aerosols originating from volcanic emissions have an impact on the climate: sulfate and ash particles from volcanic emissions reflect solar radiation, act as cloud condensation and ice nuclei, and modify the radiative properties and lifetime of clouds, and therefore influence the precipitation cycle. These volcanic particles can also have an impact on environmental conditions and could be very dangerous for aircraft in flight. In addition to the routine measurements, further EARLINET observations are devoted to monitor volcano eruptions. The EARLINET volcanic dataset includes extended observations related to two different volcanoes in Europe Mt. Etna (2001 and 2002 eruptions), and the Eyjafjallajokull volcano in Iceland (April - May 2010 eruption). This dataset includes also recent events of volcanic eruptions in the North Pacific region (2008-2010) that emitted sulfuric acid droplets into the upper troposphere - lower stratosphere (UTLS) height region of the northern hemisphere. The EARLINET volcanic observations in the UTLS are complemented by the long-term stratospheric aerosol observations collected in the Stratosphere category

EARLINET correlative observations for CALIPSO (2006-2010)

A European Aerosol Research Lidar Network to Establish an Aerosol ClimatologyAerosols affect life on earth in several ways. They play an important role in the climate system; the effect of aerosols on the global climate system is one of the major uncertainties of present climate predictions. They play a major role in atmospheric chemistry and hence affect the concentrations of other potentially harmful atmospheric constituents, e.g. ozone. They are an important controlling factor for the radiation budget, in particular in the UV-B part of the spectrum. At ground level, they can be harmful, even toxic, to man, animals, and plants. Because of these adverse effects that aerosols can have on human life, it is necessary to achieve an advanced understanding of the processes that generate, redistribute, and remove aerosols in the atmosphere.A quantitative dataset describing the aerosol vertical, horizontal, and temporal distribution, including its variability on a continental scale, is necessary. The dataset is used to validate and improve models that predict the future state of the atmosphere and its dependence on different scenarios describing economic development, including those actions taken to preserve the quality of the environment. The EARLINET data set is the most comprehensive compilation of data available for this purpose.This project description is taken from: http://www.earlinet.org/index.php?id=earlinet_homepageSummary: Since the beginning of CALIPSO observations in June 2006 EARLINET has performed correlative measurements during nearby overpasses of the satellite at individual stations following a dedicated observational strategy. The EARLINET-CALIPSO correlative measurement plan considers the criteria established in the CALIPSO validation plan (http://calipsovalidation.hamptonu.edu). Participating EARLINET stations perform measurements, as close in time as possible and for a period of at least 30 min up to several hours, when CALIPSO overpasses their location within a horizontal radius of 100 km. Within the 16-day observational cycle of CALIPSO each station is overpassed within this distance 1-2 times during daytime (typically between 1100 and 1400 UTC) and 1-2 times during night time (typically between 0000 and 0300 UTC). Additional measurements are performed, mainly on a non-regular basis, when CALIPSO overpasses a neighboring station in order to study the horizontal variability of the aerosol distribution. The time schedule for correlative observations is calculated starting from the high-resolution ground-track data provided by NASA, and is updated and distributed to whole network weekly. The EARLINET-CALIPSO correlative dataset represents a statistically significant data set to be used for the validation and full exploitation of the CALIPSO mission, for studying the representativeness of cross sections along an orbit against network observations on a continental scale, and for supporting the continuous, harmonized observation of aerosol and clouds with remote-sensing techniques from space over long time periods

EARLINET all observations (2000-2010)

This collection contains all measurements that have been performed in the frame of the EARLINET project during the period April 2000 - December 2010. Some of these measurements are also part of the collections 'Calipso', 'Climatology', 'SaharanDust' or 'VolcanicEruption'. In addition this collection also contains measurements from the categories 'Cirrus', 'DiurnalCycles', 'ForrestFires', 'Photosmog', 'RuralUrban', and 'Stratosphere'. This collection also contains measurements not devoted to any of the above categories. More information about these categories and the contributing stations can be found in the file 'EARLINET_general_introduction.pdf' accompanying this dataset

EARLINET climatology (2000-2010)

A European Aerosol Research Lidar Network to Establish an Aerosol ClimatologyAerosols affect life on earth in several ways. They play an important role in the climate system; the effect of aerosols on the global climate system is one of the major uncertainties of present climate predictions. They play a major role in atmospheric chemistry and hence affect the concentrations of other potentially harmful atmospheric constituents, e.g. ozone. They are an important controlling factor for the radiation budget, in particular in the UV-B part of the spectrum. At ground level, they can be harmful, even toxic, to man, animals, and plants. Because of these adverse effects that aerosols can have on human life, it is necessary to achieve an advanced understanding of the processes that generate, redistribute, and remove aerosols in the atmosphere.A quantitative dataset describing the aerosol vertical, horizontal, and temporal distribution, including its variability on a continental scale, is necessary. The dataset is used to validate and improve models that predict the future state of the atmosphere and its dependence on different scenarios describing economic development, including those actions taken to preserve the quality of the environment. The EARLINET data set is the most comprehensive compilation of data available for this purpose.This project description is taken from: http://www.earlinet.org/index.php?id=earlinet_homepageSummary: EARLINET climatological lidar observations are performed on a regularschedule of one daytime measurement per week around noon (on Monday), when theboundary layer is usually well developed, and two night-time measurements per week(on Monday and Thursday), with low background light, in order to perform Ramanextinction measurements. This regular schedule for observations minimizes the biasin the dataset possibly related to specific measurement conditions. The resultingdataset is used to obtain unbiased data for climatological studies.This dataset contains profiles of aerosol extinction, backscatter and lidar ratio.Several aerosol extinction/backscatter datasets can be present for the sameclimatological measurement in order to provide profiles either with a better temporalresolution or with an extended height range by using a larger temporal average.This is by far the largest dataset on the aerosol vertical distribution, and it isthe only one which is collected systematically and is covering a whol

Publisher Correction: Thymus alterations and susceptibility to immune checkpoint inhibitor myocarditis

International audienc

Thymus alterations and susceptibility to immune checkpoint inhibitor myocarditis

International audienceImmune checkpoint inhibitors (ICI) have transformed the therapeutic landscape in oncology. However, ICI can induce uncommon life-threatening autoimmune T-cell-mediated myotoxicities, including myocarditis and myositis. The thymus plays a critical role in T cell maturation. Here we demonstrate that thymic alterations are associated with increased incidence and severity of ICI myotoxicities. First, using the international pharmacovigilance database VigiBase, the Assistance Publique Hôpitaux de Paris–Sorbonne University data warehouse (Paris, France) and a meta-analysis of clinical trials, we show that ICI treatment of thymic epithelial tumors (TET, and particularly thymoma) was more frequently associated with ICI myotoxicities than other ICI-treated cancers. Second, in an international ICI myocarditis registry, we established that myocarditis occurred earlier after ICI initiation in patients with TET (including active or prior history of TET) compared to other cancers and was more severe in terms of life-threatening arrythmias and concurrent myositis, leading to respiratory muscle failure and death. Lastly, we show that presence of anti-acetylcholine-receptor antibodies (a biological proxy of thymic-associated autoimmunity) was more prevalent in patients with ICI myocarditis than in ICI-treated control patients. Altogether, our results highlight that thymic alterations are associated with incidence and seriousness of ICI myotoxicities. Clinico-radio-biological workup evaluating the thymus may help in predicting ICI myotoxicities