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To contain the spread of COVID-19, many countries imposed several restrictive measures, leading to radical changes in daily life behaviors. Healthcare workers experienced additional stress due to the increased risk of contagion, possibly causing an increase in unhealthy habits. We investigated changes in cardiovascular (CV) risk assessed by the SCORE-2 in a healthy population of healthcare workers during the COVID-19 pandemic; an analysis by subgroups was also conducted (sportspeople vs sedentary subjects). We compared medical examination and blood tests in a population of 264 workers aged over 40, performed yearly before (T0) and during the pandemic (T1, T2). We found a significant increase in the average CV risk, according to SCORE-2, during the follow-up in our healthy population, with a shift from a mean low-moderate risk profile at T0 (2.35%) to a mean high-risk profile at T2 (2.80%). Furthermore, in sedentary subjects was observed a greater and early increase in SCORE-2 compared to sportspeople. Since 2019, we observed an increase in CV risk profile in a healthy population of healthcare workers, particularly in sedentary subjects, highlighting the need to reassess SCORE-2 every year to promptly treat high-risk subjects, according to the latest Guidelines. • The spread of COVID-19 forced billions of people to remain at home, leading to radical changes in daily life behaviors. • Moreover, healthcare workers experienced additional stress due to the increased risk of contagion. • We found a significant increase in cardiovascular risk profile during the pandemic in healthy healthcare workers. • The increase in systolic blood pressure was independent predictor of the reported increasing in cardiovascular risk. [ABSTRACT FROM AUTHOR]

Background: Clinical studies suggest that testosterone (T) plays an important role in the male predominance of the clinical manifestations of the Brugada syndrome (BS). However, no statistically significant correlations have been observed between T levels and electrocardiogram (ECG) parameters in the BS patients. We investigated whether the hormonal pattern and the variation within CAG repeat polymorphism in exon 1 of the androgen receptor (AR) gene, affecting androgen sensitivity, are associated with the Brugada ECG phenotype in males. Methods and Results: 16 male patients with BS (mean age 45.06 ± 11.3 years) were studied. 12-lead ECG was recorded. Blood levels of follicle-stimulating hormone, luteinizing hormone, prolactin, testosterone, free-T, dihydrotestosterone, 17- β-estradiol, estrone, 3-alpha-androstanediol-glucuronide, delta-4-androstenedione, dehydroepiandrosterone sulphate, progesterone, 17- hydroxyprogesterone, and sex hormone binding globulin were assayed. Genotyping of CAG repeats on DNA extracted from leukocytes was carried out. No relationship was found between hormone values and ECG parameters of BS. BS patients showed the CAG length normally recognized in the human polymorphism range and the number of CAG repeats did not correlate with the ECG pattern of BS. Conclusions: The AR CAG repeat length does not correlate with the ECG features of the patients affected by BS. The search for genes downstream AR activation as possibly responsible for the increased risk of spontaneous arrhythmias in BS males after puberty is warranted. [ABSTRACT FROM AUTHOR]

Immune Checkpoint Inhibitors (ICIs) represent a major progress in cancer therapy. However, their mechanism of action may result in a spectrum of immune-related adverse events, among which neuromuscular and cardiac complications. Herein we report on a case of a 47-year-old woman with metastatic lung adenocarcinoma who received first line therapy with Nivolumab and Ipilimumab associated with Carboplatin and Pemetrexed. Two weeks after the first infusion she developed fluctuating ptosis, ophthalmoplegia with diplopia, dysphagia and dyspnea, associated with mild distal weakness of upper limbs. ECG, laboratory exams and echocardiography showed data suggestive of myocarditis with troponin over 13.000 pg/ml. CK levels were also elevated over 6000 UI/L. Extensor digitorum communis muscle biopsy revealed inflammatory findings consistent with myositis. Repetitive nerve stimulation, anti-AChR and anti-MuSK antibodies resulted negative. She started prednisone 1 mg/kg/day, IVIg (2 gr/kg) and pyridostigmine 60 mg tid with only mild reduction of CK levels. Because of persistently elevated troponin and poor clinical response, she received intravenous methylprednisolone 1 gr/day for 5 days followed by striking reduction of troponin levels and clinical improvement. At one month follow-up, no laboratory signs of myocarditis and myositis were detectable with regression of distal upper limb weakness and milder ophthalmoparesis and ptosis. myocarditis/myositis/myasthenia overlap syndrome is an increasingly reported life-threatening adverse event related to ICIs which must be promptly diagnosed and treated. Intravenous methylprednisolone could represent an effective first line therapy in case of severe ICIs-related myocarditis/myositis/myasthenia association. [ABSTRACT FROM AUTHOR]