Cardiac arrhythmias in hospitalized patients with COVID-19: A prospective observational study in the western United States.
Aged
Arrhythmias, Cardiac
/ etiology
COVID-19
/ complications
Electrocardiography
/ mortality
Female
Heart Rate
/ physiology
Hospital Mortality
Hospitalization
Humans
Incidence
Male
Monitoring, Physiologic
Prospective Studies
Risk Assessment
Risk Factors
Tachycardia, Ventricular
/ etiology
Telemetry
/ mortality
United States
Ventricular Fibrillation
/ etiology
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
12
08
2020
accepted:
12
12
2020
entrez:
28
12
2020
pubmed:
29
12
2020
medline:
12
1
2021
Statut:
epublish
Résumé
Arrhythmias have been reported frequently in COVID-19 patients, but the incidence and nature have not been well characterized. Patients admitted with COVID-19 and monitored by telemetry were prospectively enrolled in the study. Baseline characteristics, hospital course, treatment and complications were collected from the patients' medical records. Telemetry was monitored to detect the incidence of cardiac arrhythmias. The incidence and types of cardiac arrhythmias were analyzed and compared between survivors and non-survivors. Among 143 patients admitted with telemetry monitoring, overall in-hospital mortality was 25.2% (36/143 patients) during the period of observation (mean follow-up 23.7 days). Survivors were less tachycardic on initial presentation (heart rate 90.6 ± 19.6 vs. 99.3 ± 23.1 bpm, p = 0.030) and had lower troponin (peak troponin 0.03 vs. 0.18 ng/ml. p = 0.004), C-reactive protein (peak C-reactive protein 97 vs. 181 mg/dl, p = 0.029), and interleukin-6 levels (peak interleukin-6 30 vs. 246 pg/ml, p = 0.003). Sinus tachycardia, the most common arrhythmia (detected in 39.9% [57/143] of patients), occurred more frequently in non-survivors (58.3% vs. 33.6% in survivors, p = 0.009). Premature ventricular complexes occurred in 28.7% (41/143), and non-sustained ventricular tachycardia in 15.4% (22/143) of patients, with no difference between survivors and non-survivors. Sustained ventricular tachycardia and ventricular fibrillation were not frequent (seen only in 1.4% and 0.7% of patients, respectively). Contrary to reports from other regions, overall mortality was higher and ventricular arrhythmias were infrequent in this hospitalized and monitored COVID-19 population. Either disease or management-related factors could explain this divergence of clinical outcomes, and should be urgently investigated.
Identifiants
pubmed: 33370347
doi: 10.1371/journal.pone.0244533
pii: PONE-D-20-25283
pmc: PMC7769280
doi:
Types de publication
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0244533Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL135866
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Circ Res. 2020 May 8;126(10):1443-1455
pubmed: 32252591
N Engl J Med. 2009 Apr 9;360(15):1526-38
pubmed: 19357408
Heart Rhythm. 2019 May;16(5):793-801
pubmed: 30476544
JAMA Cardiol. 2020 Jul 1;5(7):802-810
pubmed: 32211816
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Heart Rhythm. 2020 Sep;17(9):1439-1444
pubmed: 32585191
Resuscitation. 2020 Jun;151:18-23
pubmed: 32283117
J Am Coll Cardiol. 2020 Mar 10;75(9):1046-1057
pubmed: 32138965
Lancet Public Health. 2020 Oct;5(10):e536-e542
pubmed: 32950075
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
JAMA Cardiol. 2020 Jul 1;5(7):811-818
pubmed: 32219356
Card Electrophysiol Clin. 2015 Jun;7(2):269-81
pubmed: 26002391
Intensive Care Med. 2020 May;46(5):846-848
pubmed: 32125452