Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
1.
J Clin Med ; 11(10)2022 May 22.
Article in English | MEDLINE | ID: covidwho-1862830

ABSTRACT

BACKGROUND: The COVID-19 pandemic increased the complexity of the clinical management and pharmacological treatment of patients presenting with an Acute Coronary Syndrome (ACS). AIM: to explore the incidence and prognostic impact of in-hospital bleeding in patients presenting with ACS before and during the COVID-19 pandemic. METHODS: We evaluated in-hospital Thrombolysis In Myocardial Infarction (TIMI) major and minor bleeding among 2851 patients with ACS from 17 Italian centers during the first wave of the COVID-19 pandemic (i.e., March-April 2020) and in the same period in the previous two years. RESULTS: The incidence of in-hospital TIMI major and minor bleeding was similar before and during the COVID-19 pandemic. TIMI major or minor bleeding was associated with a significant threefold increase in all-cause mortality, with a similar prognostic impact before and during the COVID-19 pandemic. CONCLUSIONS: the incidence and clinical impact of in-hospital bleeding in ACS patients was similar before and during the COVID-19 pandemic. We confirmed a significant and sizable negative prognostic impact of in-hospital bleeding in ACS patients.

2.
Eur J Clin Invest ; 52(8): e13781, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1764910

ABSTRACT

INTRODUCTION: Some abnormal electrocardiographic findings were independently associated with increased mortality in patients admitted for COVID-19; however, no studies have focussed on the prognosis impact of the interatrial block (IAB) in this clinical setting. The aim of our study was to assess the prevalence and clinical implications of IAB, both partial and advanced, in hospitalized COVID-19 patients. MATERIALS: We retrospectively evaluated 300 consecutive COVID-19 patients (63.22 ± 15.16 years; 70% males) admitted to eight Italian Hospitals from February 2020 to April 2020 who underwent twelve lead electrocardiographic recording at admission. The study population has been dichotomized into two groups according to the evidence of IAB at admission, both partial and advanced. The differences in terms of ARDS in need of intubation, in-hospital mortality and thromboembolic events (a composite of myocardial infarction, stroke and transient ischaemic attack) have been evaluated. RESULTS: The presence of IAB was noticed in 64 patients (21%). In the adjusted logistic regression model, the partial interatrial block was found to be an independent predictor of ARDS in need of intubation (HR: 1.92; p: .04) and in-hospital mortality (HR: 2.65; p: .02); moreover, the advanced interatrial block was an independent predictor of thrombotic events (HR: 7.14; p < .001). CONCLUSIONS: Among COVID-19 patients hospitalized in medical wards, the presence of interatrial block is more frequent than in the general population and it might be useful as an early predictor for increased risk of incident thrombotic events, ARDS in need of intubation and in-hospital mortality.


Subject(s)
Atrial Fibrillation , COVID-19 , Respiratory Distress Syndrome , Atrial Fibrillation/epidemiology , COVID-19/epidemiology , Electrocardiography , Female , Hospitals , Humans , Interatrial Block/epidemiology , Male , Prognosis , Retrospective Studies
3.
Medicina (Kaunas) ; 58(3)2022 Mar 07.
Article in English | MEDLINE | ID: covidwho-1732122

ABSTRACT

Background and objectives: Pre-existing atrial fibrillation (AF) is a frequent comorbidity in hospitalized patients with COVID-19; however, little is still known about its prognostic role in infected patients. The aim of our study was to evaluate whether the pre-existing AF as comorbidity would contribute to increase the risk for severe forms of COVID-19, worse prognosis, or even higher mortality. Materials and Methods: We retrospectively evaluated all consecutive COVID-19 patients admitted to the emergency department of nine Italian Hospitals from 1 March to 30 April 2020.The prevalence and the type of pre-existing AF have been collected. The correlation between the history and type of AF and the development of severe ARDS and in-hospital mortality has been evaluated. Results: In total, 467 patients (66.88 ± 14.55 years; 63% males) with COVID-19 were included in the present study. The history of AF was noticed in 122 cases (26.1%), of which 12 (2.6%) with paroxysmal, 57 (12.2%) with persistent and 53 (11.3%) with permanent AF. Among our study population, COVID-19 patients with AF history were older compared to those without AF history (71.25 ± 12.39 vs. 65.34 ± 14.95 years; p < 0.001); however, they did not show a statistically significant difference in cardiovascular comorbidities or treatments. Pre-existing AF resulted in being independently associated with an increased risk of developing severe ARDS during the hospitalization; in contrast, it did not increase the risk of in-hospital mortality. Among patients with AF history, no significant differences were detected in severe ARDS and in-hospital mortality between patients with permanent and non-permanent AF history. Conclusions: Pre-existing AF is a frequent among COVID-19 patients admitted to hospital, accounting up to 25% of cases. It is independently associated with an increased risk of severe ARDS in hospitalized COVID-19 patients; in contrast, it did not affect the risk of death. The type of pre-existing AF (permanent or non-permanent) did not impact the clinical outcome.


Subject(s)
Atrial Fibrillation , COVID-19 , Atrial Fibrillation/complications , Atrial Fibrillation/epidemiology , COVID-19/complications , Female , Humans , Male , Prognosis , Retrospective Studies , Risk Factors
4.
European heart journal supplements : journal of the European Society of Cardiology ; 23(Suppl G), 2021.
Article in English | EuropePMC | ID: covidwho-1602665

ABSTRACT

Aims Coronavirus disease 19 (COVID-19) pandemic has dramatically changed the management and the prognosis of patients experiencing acute coronary syndrome (ACS). Several scientific societies have highlighted the need for dedicated paths to deliver better and faster care to improve outcomes. Nevertheless, data depicting the impact of COVID-19 pandemic on ACS in Italy are still poor. To perform a propensity weighted analysis on a multicentre Italian registry involving patients with ACS managed before vs. during COVID-19 pandemic, taking into account baseline patients characteristics, clinical presentation, procedural aspects, and in-hospital outcomes (death, bleeding, stent thrombosis, myocardial infarction, stroke/transient ischaemic attack, mechanical complication, and arrhythmic complication). Methods and results We included all consecutive patients who have suffered from ACS during two periods before (March/April 2018, March/April 2019) vs. the period of COVID-19 pandemic (March/April 2020). A generalized boosted non-parsimonious regression was used to estimate the propensity scores of having an ACS in 2020 (year of COVID-19) vs. 2018/2019 using an average treatment effect and balancing for all baseline confounders. We included 2851 patients admitted to hospital with ACS in 17 Italian centres: 1079 (37.8%) during 2018, 1056 (37.0%) in 2019, and 716 (25.1%) during the first COVID-19 wave of 2020. Seventy (2.5%) patients had a positive swab for SARS-CoV-2 at admission. During 2020 there were higher time-to-emergency-call (P = 0.028) and less diagnosis of unstable angina (P = 0.029) and MINOCA (P = 0.004);none of the admission symptoms differ significantly across the years (P > 0.05) except for fever that was more prevalent in 2020 (P < 0.001). Patients suffering from ACS had lower admission EF (P = 0.006). After PS weighting, multivariate Cox regression analysis showed age (P < 0.001), night admission (P = 0.017), cardiocirculatory arrest before cath-lab (P = 0.041), worst Killip class (P = 0.039), admission EF (P = 0.026), and need for left-ventricle mechanical support (P = 0.011) as independent predictors of in-hospital death. After propensity weighted analysis none of the in-hospital outcomes differed significantly across the years of investigation (all P > 0.05). Conclusions During COVID-19 pandemic in Italy the characteristics and management of ACS was slightly different than the past. However, the rates of ‘hard’, in-hospital outcomes (e.g. deaths) are almost similar to the past, suggesting appropriate care and well-organized emergency-paths for ACS.

5.
J Cardiovasc Pharmacol ; 78(1): e94-e100, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1356725

ABSTRACT

ABSTRACT: Statin therapy has been recently suggested as possible adjuvant treatment to improve the clinical outcome in patients with coronavirus disease 2019 (COVID-19). The aim of this study was to describe the prevalence of preadmission statin therapy in hospitalized patients with COVID-19 and to investigate its potential association with acute distress respiratory syndrome (ARDS) at admission and in-hospital mortality. We retrospectively recruited 467 patients with laboratory-confirmed COVID-19 admitted to the emergency department of 10 Italian hospitals. The study population was divided in 2 groups according to the ARDS diagnosis at admission and in-hospital mortality. A multivariable regression analysis was performed to assess the risk of ARDS at admission and death during hospitalization among patients with COVID-19. A competing risk analysis in patients taking or not statins before admission was also performed. ARDS at admission was reported in 122 cases (26.1%). There was no statistically significant difference for clinical characteristics between patients presenting with and without ARDS. One hundred seven patients (18.5%) died during the hospitalization; they showed increased age (69.6 ± 13.1 vs. 66.1 ± 14.9; P = 0.001), coronary artery disease (23.4% vs. 12.8%; P = 0.012), and chronic kidney disease (20.6% vs. 11.1%; P = 0.018) prevalence; moreover, they presented more frequently ARDS at admission (48.6% vs. 19.4%; P < 0.001). At multivariable regression model, statin therapy was not associated neither with ARDS at admission nor with in-hospital mortality. Preadmission statin therapy does not seem to show a protective effect in severe forms of COVID-19 complicated by ARDS at presentation and rapidly evolving toward death.


Subject(s)
COVID-19/therapy , Dyslipidemias/drug therapy , Hospitalization , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/mortality , Comorbidity , Disease Progression , Dyslipidemias/diagnosis , Dyslipidemias/mortality , Female , Hospital Mortality , Humans , Italy , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Assessment , Risk Factors , Time Factors
6.
Indian Heart J ; 73(5): 647-649, 2021.
Article in English | MEDLINE | ID: covidwho-1293828

ABSTRACT

BACKGROUND: The rates of in-hospital mortality following percutaneous interventional procedures (PIP) during the COVID-19 pandemic period compared to the non-pandemic period has not been reported so far. METHODS: We retrospectively enrolled all consecutive patients admitted for PIP across five centers from February 2020 to May 2020. RESULTS: A total of 4092 PIP were performed during the reference periods. The total number of procedures dropped from 2380 to 1712 (28.0% reduction). Overall in-hospital mortality increased from 1.1% in 2019, to 2.6% in 2020 (63% relative increase). CONCLUSION: During the COVID-19 pandemic, in-hospital all-cause mortality significantly increased in patients admitted for cardiological PIP.


Subject(s)
COVID-19 , Cardiology , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
8.
Eur J Clin Invest ; 50(12): e13387, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-721128

ABSTRACT

INTRODUCTION: Little is still known about the prognostic impact of incident arrhythmias in hospitalized patients with COVID-19. The aim of this study was to evaluate the incidence and predictors of sustained tachyarrhythmias in hospitalized patients with COVID-19, and their potential association with disease severity and in-hospital mortality. MATERIALS AND METHODS: This was a retrospective multicenter observation study including consecutive patients with laboratory confirmed COVID-19 admitted to emergency department of ten Italian Hospitals from 15 February to 15 March 2020. The prevalence and the type of incident sustained arrhythmias have been collected. The correlation between the most prevalent arrhythmias and both baseline characteristics and the development of ARDS and in-hospital mortality has been evaluated. RESULTS: 414 hospitalized patients with COVID-19 (66.9 ± 15.0 years, 61.1% male) were included in the present study. During a median follow-up of 28 days (IQR: 12-45), the most frequent incident sustained arrhythmia was AF (N: 71; 17.1%), of which 50 (12.1%) were new-onset and 21 (5.1%) were recurrent, followed by VT (N: 14, 3.4%) and supraventricular arrhythmias (N: 5, 1.2%). Incident AF, both new-onset and recurrent, did not affect the risk of severe adverse events including ARDS and death during hospitalization; in contrast, incident VT significantly increased the risk of in-hospital mortality (RR: 2.55; P: .003). CONCLUSIONS: AF is the more frequent incident tachyarrhythmia; however, it not seems associated to ARDS development and death. On the other hand, incident VT is a not frequent but independent predictor of in-hospital mortality among hospitalized COVID-19 patients.


Subject(s)
Atrial Fibrillation/epidemiology , COVID-19/mortality , Hospital Mortality , Respiratory Distress Syndrome/epidemiology , Tachycardia, Supraventricular/epidemiology , Tachycardia, Ventricular/epidemiology , Age Factors , Aged , Aged, 80 and over , Arrhythmias, Cardiac/epidemiology , COVID-19/physiopathology , Female , Hospitalization , Humans , Incidence , Italy/epidemiology , Male , Middle Aged , Multivariate Analysis , Prognosis , Recurrence , Renal Insufficiency, Chronic/epidemiology , Respiratory Distress Syndrome/physiopathology , Retrospective Studies , Severity of Illness Index
SELECTION OF CITATIONS
SEARCH DETAIL