Clinical and cardiac characteristics of COVID-19 mortalities in a diverse New York City Cohort.
Aged
Aged, 80 and over
Arrhythmias, Cardiac
/ diagnosis
COVID-19
/ diagnosis
Cause of Death
Comorbidity
Electrocardiography
Female
Heart Disease Risk Factors
Hospital Mortality
/ ethnology
Hospitalization
Humans
Male
Middle Aged
New York City
/ epidemiology
Prognosis
Race Factors
Retrospective Studies
Risk Assessment
Time Factors
COVID-19
arrhythmia
cardiac death
electrocardiography
epidemiology
sudden death
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
02
06
2020
revised:
14
08
2020
accepted:
22
09
2020
pubmed:
7
10
2020
medline:
7
1
2021
entrez:
6
10
2020
Statut:
ppublish
Résumé
Electrocardiographic characteristics in COVID-19-related mortality have not yet been reported, particularly in racial/ethnic minorities. We reviewed demographics, laboratory and cardiac tests, medications, and cardiac rhythm proximate to death or initiation of comfort care for patients hospitalized with a positive SARS-CoV-2 reverse-transcriptase polymerase chain reaction in three New York City hospitals between March 1 and April 3, 2020 who died. We described clinical characteristics and compared factors contributing toward arrhythmic versus nonarrhythmic death. Of 1258 patients screened, 133 died and were enrolled. Of these, 55.6% (74/133) were male, 69.9% (93/133) were racial/ethnic minorities, and 88.0% (117/133) had cardiovascular disease. The last cardiac rhythm recorded was VT or fibrillation in 5.3% (7/133), pulseless electrical activity in 7.5% (10/133), unspecified bradycardia in 0.8% (1/133), and asystole in 26.3% (35/133). Most 74.4% (99/133) died receiving comfort measures only. The most common abnormalities on admission electrocardiogram included abnormal QRS axis (25.8%), atrial fibrillation/flutter (14.3%), atrial ectopy (12.0%), and right bundle branch block (11.9%). During hospitalization, an additional 17.6% developed atrial ectopy, 14.7% ventricular ectopy, 10.1% atrial fibrillation/flutter, and 7.8% a right ventricular abnormality. Arrhythmic death was confirmed or suspected in 8.3% (11/133) associated with age, coronary artery disease, asthma, vasopressor use, longer admission corrected QT interval, and left bundle branch block (LBBB). Conduction, rhythm, and electrocardiographic abnormalities were common during COVID-19-related hospitalization. Arrhythmic death was associated with age, coronary artery disease, asthma, longer admission corrected QT interval, LBBB, ventricular ectopy, and usage of vasopressors. Most died receiving comfort measures.
Identifiants
pubmed: 33022765
doi: 10.1111/jce.14772
pmc: PMC7675758
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
3086-3096Informations de copyright
© 2020 Wiley Periodicals LLC.
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