Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage
| Autor: | Luis Garcia de Guadiana Romualdo, Konstantinos I. Gourgoulianis, Sparcol Investigators, Jesper Eugen-Olsen, Konstantina Kolonia, Nicoletta Ntalarizou, Ioannis Pantazopoulos, Athanasios Chalkias, Dimitrios Ragias, Konstantinos Tourlakopoulos, Nikolaos Papagiannakis, Eleni Laou, Eleni Arnaoutoglou, Athanasios Pagonis, Anargyros Skoulakis, Christos F. Kampolis |
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| Rok vydání: | 2021 |
| Předmět: |
Bradycardia
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Health Toxicology and Mutagenesis Sinus bradycardia B.1.1.7 variant Disease Toxicology Early admission Article law.invention law RA1190-1270 Isoprenaline Internal medicine Medicine Intensive care unit ComputingMethodologies_COMPUTERGRAPHICS Outcome business.industry COVID-19 SuPAR Toxicology. Poisons medicine.symptom business medicine.drug |
| Zdroj: | Toxicology Reports Toxicology Reports, Vol 8, Iss, Pp 1394-1398 (2021) |
| ISSN: | 2214-7500 |
| Popis: | Graphical abstract 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. |
| Databáze: | OpenAIRE |
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