Subject(s)
Arrhythmias, Cardiac , COVID-19 , Cardiology Service, Hospital , Electrocardiography, Ambulatory , Electrophysiologic Techniques, Cardiac/methods , Telemedicine , Antiviral Agents/pharmacology , Arrhythmias, Cardiac/epidemiology , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/therapy , COVID-19/epidemiology , COVID-19/therapy , Cardiology Service, Hospital/organization & administration , Cardiology Service, Hospital/trends , Electrocardiography, Ambulatory/instrumentation , Electrocardiography, Ambulatory/methods , Forecasting , Humans , International Cooperation , Organizational Innovation , SARS-CoV-2 , Societies, Medical/trends , Telemedicine/methods , Telemedicine/organization & administration , Telemedicine/trendsSubject(s)
Arrhythmias, Cardiac/diagnosis , Betacoronavirus , Coronavirus Infections/complications , Electrocardiography , Pneumonia, Viral/complications , Telemedicine/organization & administration , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/therapy , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Humans , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , SARS-CoV-2Subject(s)
Arrhythmias, Cardiac , Coronavirus Infections , Pandemics , Pneumonia, Viral , Remote Consultation/methods , Telemedicine/organization & administration , Telemetry , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/epidemiology , Betacoronavirus , COVID-19 , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Electrophysiologic Techniques, Cardiac/methods , Electrophysiologic Techniques, Cardiac/trends , Humans , International Cooperation , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Telemetry/instrumentation , Telemetry/methodsABSTRACT
AIMS: The novel coronavirus SARS-CoV-2 has shown the potential to significantly affect the cardiovascular system. Cardiac arrhythmias are commonly reported complications in COVID-19 hospitalized patients. METHODS AND RESULTS: While tachyarrhythmias seem most common, we describe four cases of COVID-19 patients who developed a transient high-degree atrioventricular (AV) block during the course of their hospitalization. All four patients who developed a high-degree AV block during their hospitalization with COVID-19 did not require permanent pacing. CONCLUSION: Similarly to most AV blocks associated with infectious organisms and given its transient nature, this case series suggests that conservative management strategies should be preferred in COVID-19 patients who develop complete heart block.
Subject(s)
Atrioventricular Block/etiology , Atrioventricular Node/physiopathology , COVID-19/complications , Heart Rate , Hospitalization , Action Potentials , Adult , Atrioventricular Block/diagnosis , Atrioventricular Block/physiopathology , Atrioventricular Block/therapy , COVID-19/diagnosis , COVID-19/therapy , Conservative Treatment , Electrocardiography , Female , Humans , Male , Middle Aged , Risk Factors , Treatment OutcomeSubject(s)
Arrhythmias, Cardiac/epidemiology , Coronavirus Infections/epidemiology , Global Health , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Subacute Care/organization & administration , Telemedicine/organization & administration , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/therapy , COVID-19 , Cause of Death , Comorbidity , Coronavirus Infections/prevention & control , Female , Humans , Inpatients/statistics & numerical data , Long-Term Care/organization & administration , Male , Monitoring, Physiologic/methods , Outpatients/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Program Evaluation , Risk Assessment , Survival AnalysisABSTRACT
OBJECTIVE: Coronavirus disease 2019 (COVID-19) mortality is high in patients with hypertension, obesity, and diabetes. We examined the association between hypertension, obesity, and diabetes, individually and clustered as metabolic syndrome (MetS), and COVID-19 outcomes in patients hospitalized in New Orleans during the peak of the outbreak. RESEARCH DESIGN AND METHODS: Data were collected from 287 consecutive patients with COVID-19 hospitalized at two hospitals in New Orleans, LA from 30 March to 5 April 2020. MetS was identified per World Health Organization criteria. RESULTS: Among 287 patients (mean age 61.5 years; female, 56.8%; non-Hispanic black, 85.4%), MetS was present in 188 (66%). MetS was significantly associated with mortality (adjusted odds ratio [aOR] 3.42 [95% CI 1.52-7.69]), intensive care unit (ICU) (aOR 4.59 [CI 2.53-8.32]), invasive mechanical ventilation (IMV) (aOR 4.71 [CI 2.50-8.87]), and acute respiratory distress syndrome (ARDS) (aOR 4.70 [CI 2.25-9.82]) compared with non-MetS. Multivariable analyses of hypertension, obesity, and diabetes individually showed no association with mortality. Obesity was associated with ICU (aOR 2.18 [CI, 1.25-3.81]), ARDS (aOR 2.44 [CI 1.28-4.65]), and IMV (aOR 2.36 [CI 1.33-4.21]). Diabetes was associated with ICU (aOR 2.22 [CI 1.24-3.98]) and IMV (aOR 2.12 [CI 1.16-3.89]). Hypertension was not significantly associated with any outcome. Inflammatory biomarkers associated with MetS, CRP, and lactate dehydrogenase (LDH) were associated with mortality (CRP [aOR 3.66] [CI 1.22-10.97] and LDH [aOR 3.49] [CI 1.78-6.83]). CONCLUSIONS: In predominantly black patients hospitalized for COVID-19, the clustering of hypertension, obesity, and diabetes as MetS increased the odds of mortality compared with these comorbidities individually.