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Winning the battle but losing the war: increased population-based mortality from aortic dissection
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  • Published on:
    Covid-19 -related aortitis as a risk factor for aortic dissection

    In their analysis of population-based mortality from dissecting aortic aneurysm(DAA), the authors drew attention to the need for further research to be undertaken to optimise earlier identification of those at risk[1]. Relevant to this task is the increasing awareness of the entity of COVID-19-related aortitis, and the documentation of increasing numbers of anecdotal reports of the association of COVID-19 infection and DAA.
    The report by Shergall et al was one of the first to show a persuasively valid causal relationship between COVID-19 infection and aortitis. In that example a 71 year old man presented with chest pain radiating to the scapula, within a few days of experiencing symptomatic COVID-19 infection. Although, by this time, the nasopharyngeal swab test was negative for COVID-19, he had serological evidence of recent COVID-19 infection. Computed tomography showed evidence of diffuse inflammatory aortitis. Following a course of prednisolone 40 mg/day, subsequent tomography showed partial resolution of the aortitis[2].
    In three subsequent reports, it was the occurrence of DAA(presumably as a complication of aortitis) , rather than aortitis per se, which was the issue of concern, especially because of the pain-free nature of the clinical presentation.
    In one of those patients , a 45 year old previously healthy non-smoker with no comorbidities, the only symptoms comprised a 3 days history of fever, cough, and dyspnoea. He had neither...

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    Conflict of Interest:
    None declared.