Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage.
B.1.1.7 variant
Bradycardia
COVID-19
Intensive care unit
Outcome
Journal
Toxicology reports
ISSN: 2214-7500
Titre abrégé: Toxicol Rep
Pays: Ireland
ID NLM: 101630272
Informations de publication
Date de publication:
2021
2021
Historique:
received:
19
05
2021
revised:
21
06
2021
accepted:
07
07
2021
entrez:
14
7
2021
pubmed:
15
7
2021
medline:
15
7
2021
Statut:
ppublish
Résumé
The progress of COVID-19 from moderate to severe may be precipitous, while the characteristics of the disease are heterogenous. The aim of this study was to describe the development of sinus bradycardia in critically ill patients with COVID-19 and its association with outcome in outbreak due to the SARS-CoV-2 B.1.1.7 Lineage. We leveraged the multi-center SuPAR in Adult Patients With COVID-19 (SPARCOL) study and identified patients who required admission to intensive care unit (ICU). Inclusion criteria were: (a) adult (≥18 years old) patients hospitalized primarily for COVID-19; (b) a confirmed SARS-CoV-2 infection diagnosed through reverse transcriptase polymerase chain reaction test of nasopharyngeal or oropharyngeal samples; and (c) at least one blood sample collected at admission and stored for suPAR, hs-CRP, and ferritin testing. All patients had continuous heart rate monitoring during hospitalization. In total, 81 patients were included. Of them, 17 (21 %) and 64 (79 %) were intubated and admitted to the ICU during the first and second wave, respectively. Two (12 %) and 62 (97 %) developed bradycardia before ICU admission, respectively (p < 0.001). Patients with bradycardia had increased suPAR (p < 0.001) and hs-CRP level (p < 0.001). Infusion of isoprenaline and/or noradrenaline was necessary to maintain an adequate rate and peripheral perfusion in all patients. Mortality was significantly higher in patients with bradycardia (p < 0.001). In conclusion, bradycardia was associated with poor outcome. As B.1.1.7 variant strain is spreading more rapidly in many countries, our findings help in the identification of patients who may require early admission to ICU.
Identifiants
pubmed: 34258235
doi: 10.1016/j.toxrep.2021.07.004
pii: S2214-7500(21)00131-1
pmc: PMC8265186
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1394-1398Informations de copyright
© 2021 Published by Elsevier B.V.
Déclaration de conflit d'intérêts
JEO is a co-founder, shareholder and CSO of ViroGates A/S and is mentioned inventor on patients on suPAR owned by Copenhagen University Hospital Hvidovre, Denmark. For the remaining authors none were declared.
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