Retired NYPD sergeant with coronavirus DROPS DEAD on Manhattan street hour after leaving hospital

[SBFNews]

Retired NYPD sergeant with coronavirus drops dead on Manhattan street hour after leaving hospital

By THOMAS TRACY, ROCCO PARASCANDOLA, KERRY BURKE and JOHN ANNESE
NEW YORK DAILY NEWS |
APR 07, 2020

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Retired NYPD Sergeant Yon Chang, pictured when he was still on the force.(Obtained by Daily News)

A retired NYPD sergeant left an Upper East Side hospital after he was diagnosed with COVID-19 — and was found dead about an hour later on the street outside, police sources said Tuesday

Yon Chang, 56, was at Lenox Hill Hospital early Tuesday and told an NYPD cop there he had just been diagnosed with the potentially deadly coronavirus.

He left a short time later only to collapse nearby, on the traffic island at Park Ave. and E. 77th St., about 6:05 a.m. He died at the scene.

Retired NYPD Sergeant Yon Chang and former Mayor Rudy Giuliani.(Obtained by Daily News)

Chang started feeling like he was coming down with a cold about five days ago, and worried relatives had urged him to stay home, his family said.

"We can’t speak. This is a very difficult time. Please respect our family’s privacy,”

Chang’s brother told the Daily News at the family’s Queens home Tuesday.

“It’s tragic. We extend our sympathy to his family,” said Ed Mullins, the president of the Sergeants Benevolent Association. “It’s almost like a science-fiction movie. This isn’t ending, and the impact of coronavirus is hitting the people who are closest to us.”

“This is a sergeant who was at the point where he was retired, and he should be enjoying himself,” Mullins added.

The city medical examiner will conduct an autopsy to determine the cause of death.

 

[bobby]

Such shocking news indeed...56yo can retire ?????

 

[Leongsam]

Could be myocarditis. It happens on a regular basis with those who catch the flu too. This poor guy was only 30.

You can find out more about this condition at https://www.myocarditisfoundation.org/



Tim’s Story
Sep 17, 2012

Discover How a Healthy 30-Year-Old Died within 15 Minutes
Tim’s Flu-Like Symptoms Led to Sudden Death
As told by Tim’s wife, Angela Burke

Tim and Angela Burke

On February 16, 2010 my life was suddenly forever changed. In the early morning hours I was woken up by my husband, Tim, struggling to breath. Approximately 15 minutes later he was gone. My wonderful, loving husband of only two years was gone. All of the hopes and dreams that we shared were gone. It was so hard to comprehend because he was not sick. He was active, exercised regularly and was in good shape. How was this possible?

The coroner called later that morning and explained that Tim’s death was a result of complications from myocarditis. At the time of his death, he had six weeks of scar tissue around his heart and he was three weeks into heart, liver and kidney failure. Also sometime in the recent past he had suffered a mild heart attack. Tim was only 30.
I was completely stunned by what the coroner had found. Myocarditis? What is myocarditis? That is what I and everyone else in my life began asking. It does not seem possible that there is a disease that can take someone’s life without presenting much more than flu-like symptoms.

The week prior to his death he told me that he was “not feeling right.” He had experienced occasional lightheadedness, nausea and had less of an appetite. We thought he may have been getting the flu but he had started to feel better.

Unfortunately, this disease does exist and though it’s considered rare, it effects far too many people and in many cases goes undetected until sudden death occurs. The fact that Tim lost his life will never make sense to me but I am committed to continuing to raise money for The Myocarditis Foundation.

Hopefully through the hard work of individuals to raise money and awareness for this cause, progress through research will be made in leaps and bounds. There needs to be a time when this disease is more often than not diagnosed before it is too late. Please educate yourself and others about this disease.

 

[Leongsam]

How Does Flu Cause Myocarditis?
Team ePainAssist

5-6 minutes


Influenza is one of the common causes of myocarditis. Myocarditis is the condition characterized by the infection of muscles of the heart. Flu causes myocarditis through various mechanisms.

How Does Flu Cause Myocarditis?

One of the major complications of influenza is acute myocarditis. The virus either attacks the cardiac muscles or it is the immune system and the inflammation in response to a viral infection that leads to cardiac muscle damage. The severity of myocarditis varies from patient to patient. In some patients, the condition goes asymptomatic while some patients develop severe complications to the tune that it may take away the lives though impairment in the cardiac function. It is essential that cardiac monitoring should be done in the cases of influenza infections to prevent the patient from developing complications. This would also include diagnosis and starting the treatment immediately. Viruses most commonly associated with developing myocarditis include Coronavirus, Epstein-Barr virus, Cytomegalovirus, Influenza (A, B), Coxsackie (A, B), and Adenovirus. The application of cellular and molecular biology, as well as the detailed knowledge of the viral structure and function, helps us in understanding the pathophysiology of the viral effects on the heart in greater detail. The understanding of cardiac damage, reducing the function of the heart and the progression of the disease helps physicians in providing high-quality treatment. (2) Following are the various mechanisms through which the viral infections affect the cardiac muscles leading to myocarditis:

Direct Viral Cause. The toxins secreted by the virus causes damage to the muscle cells of the heart. The duration of this damage is approximately within three days of the infection. The defense mechanism although slows the process of viral replication, but the replication of the virus in the heart muscles is sufficient enough to cause severe cardiac decompensation, and that too at a rapid rate. The factors that affect the rate of this damage are age, exercise, and nutrition. Although other factors such as pregnancy and status of sex hormone play their role in the development of myocarditis, the not important factors remain the immune system. If the immune system fails to control the initial phase of viral replication, then it may lead to cardiomyopathy. The research has concluded that the presence of viral genetic material is sufficient to cause damage of cardio muscles and is capable of disrupting the filamentous structure of the protein and this effect is independent of the myopathy caused by the immune system. (2)

Indirect Immune Cause. The prevention of viral replication by the immune system poses both the positive as well as negative consequences in context to myocardial health. As soon as the virus invades the body, the cells that response early are the Natural Killer (NK) cells. Studies indicate that low level of natural killer cells causes increased severity of myocarditis. However, along with the NK cells, the NK-like cells are also produced. These cells damage the cardiac muscles by releasing a substance known as perforin. After the production of NK cells, the cells produced by the immune system are T-cells. These cells kill the virus present in the myocytes, causing damage to the myocytes themselves. This is done due to molecular mimicry. Further, products from the damaged myocytes cause further damage to the other myocytes by T-cells. (2) (1)

Role Of Nitric Oxide. Nitric oxide is produced by the endothelial cells. Nitric oxide has a beneficial effect on the heart as well as the blood vessels as it causes cardiac muscle relaxation and manages diastolic function. However, during the severe inflammation, in the case of myocarditis, the expression of the inducible form of nitric oxide (iNOS) is increased and this result in the increased production of nitric oxide. Excessive production of nitric oxide increases oxidative stress resulting in necrosis and apoptosis of myocardial cells. (2)

Conclusion

Myocarditis caused due to viral infection through various mechanisms. This includes the direct attack of the flu virus on the muscle cells, damage to the muscle cells by the immune system and necrosis and apoptosis caused by the increased concentration of nitric oxide.
References:

 

[Rogue Trader]

Asian cop must have been assassinated by ninjas sent by triads

 

[Leongsam]

Myocarditis caused by Influenza can affect children too so remember annual flu shots are very important.

sciencedirect.com

Myocarditis associated with influenza infection in five children


Background
Myocarditis is an inflammatory condition located mainly in the myocardium. It is caused by a variety of bacterial and viral infections. Influenza is one of the most common relevant viruses that cause myocarditis.
Objectives
We attempted to share our experiences about clinical and laboratory findings, cardiac evaluation, and treatment of children with influenza myocarditis.
Methods
This retrospective study was performed by the Department of Pediatric Infectious Diseases at the Faculty of Medicine, Hacettepe University in Turkey. The medical records of patients diagnosed with myocarditis associated with an influenza infection between January 2014 and January 2017 were systematically reviewed.
Results
Vaccination seems likely to be an important protection strategy for both influenza infections and complications.

Introduction
Influenza occurs all over the world, with an annual global attack rate estimated at 5–10% in adults and 20–30% in children; unfortunately, annual epidemics are estimated to result in approximately 3–5 million cases of severe illness and approximately 250,000–500,000 deaths [1], [2]. In addition to such moderate complications as sinusitis and otitis, myocarditis is one possible serious complications of influenza [3]. Myocarditis in children is one of the most important causes of acute cardiovascular death and requires early diagnosis and aggressive treatment to save the patient [4]. It is caused primarily by numerous infection agents, but it may also accompany autoimmune disease, hypersensitivity reactions, and toxins [5]. Influenza is one of the common relevant viruses caused by myocarditis, as well as Coxsackie B, adenovirus, echovirus, and cytomegalovirus. The actual incidence of influenza myocarditis in the general population is unknown because of the variable clinical presentation in a wide range—from asymptomatic electrocardiographic changes to fulminant heart failure with fatal arrhythmias [6]. The prevalence of myocardial involvement in infections caused by influenza virus ranges from 0 to 11%, and the clinical appearance of influenza myocarditis is not common [7], [8], [9]. In the literature, few pediatric cases with influenza myocarditis were reported.

With this report, we attempted to share our experiences, which include a description of clinical findings, laboratory findings, and cardiac evaluation and treatment, with five children who had influenza myocarditis over three years.

Material and methods

This retrospective study was performed by the Department of Pediatric Infectious Diseases at the Faculty of Medicine, Hacettepe University in Turkey. The medical records of patients diagnosed with myocarditis associated with influenza infection between January 2014 and January 2017 were systematically reviewed. The diagnosis of acute myocarditis was confirmed according to criteria reported in “Guidelines for Diagnosis and Treatment of Myocarditis” as (1) a history of flu-like symptoms, (2) pathologic cardiac findings on physical examination, (3) abnormal electrocardiography (ECG), (4) abnormal ECHO findings, (5) elevated myocardial constitutive proteins, (6) changes in cardiac findings on physical examination within a few hours and myocardial constitutive proteins, (7) exclusion of acute myocardial infarction, (8) abnormal histological findings on endomyocardial biopsy, and (9) detection of a virus [10]. Relevant information, such as demographics, clinical laboratory findings, and cardiac findings, were recorded on prepared forms. All laboratory tests had been performed in our local laboratory, and echocardiography (ECHO) was performed on all patients. Respiratory viruses were isolated from nasopharyngeal specimens, and the samples were analyzed by multiplex reverse transcription polymerase chain reaction (RT-PCR) to detect viral pathogens. We tested samples for 15 viruses (IFV A-B, PIV 1-2-3, hAD, RSV A, RSV B, CoV, EV, hRV, hBoV, CoV 229/NL63, and CoV OC43/HKU1). Nucleic acid isolation was performed with a GeneAll Ribospin vRD II Isolation Kit (Seoul, Korea). A real-time PCR method was carried out using a Seegene RV16 Detection Kit (Seoul, Korea). The study was approved by the Ethical Committee of the Hacettepe University (number: GO 17/88).

Results
Demographic, epidemiological, and clinical features

During the period between January 2014 and January 2017, 5 patients (3 female, 2 male) with a median age of 5 years were diagnosed with myocarditis associated with influenza infection among 241 patients with influenza infection. Only 1 patient had no underlying disease; the others had metabolic disease, dilated cardiomyopathy, neurologic disease, and chronic granulomatous disease, respectively. The most frequently reported presenting symptoms were fever and cough (100%); vomiting was seen in 2 (40%) of the patients, and only 1 patient had dyspnea. None of these patients were previously vaccinated with influenza. The demographic, epidemiological, and clinical features of these 5 patients are summarized in Table 1.