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J Glob Health ; 11: 05006, 2021 Mar 27.
Article in English | MEDLINE | ID: covidwho-1173056


BACKGROUND: In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan city and rapidly spread throughout China. So far, it has caused ~ 4000 deaths in this country. We aimed to systematically characterize clinical features and determine risk factors of sudden death for COVID-19 patients. METHODS: Deceased patients with COVID-19 in Tongji hospital from January 22 to March 23, 2020 were extracted. Patients who died within 24 hours after admission were identified as sudden deaths, and the others formed non-sudden deaths. The differences in clinical characteristics between the two groups were estimated. Risk factors associated with sudden deaths were explored by logistic regression. RESULTS: 281 deceased patients were enrolled in this study. Sudden death occurred in 28 (10.0%) patients, including 4 (14.3%) admitted to the intensive care unit. Fatigue was more common in sudden deaths (11, 47.8%) than in non-sudden deaths (40, 17.2%). Both the count and percentage of eosinophils were lower in sudden deaths than that in non-sudden deaths (P = 0.006 and P = 0.004). Compared with non-sudden deaths, sudden deaths had higher plasma levels of procalcitonin, C-reactive protein, D-dimer, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, lactate dehydrogenase, alkaline phosphatase and N-terminal pro-brain natriuretic peptide. There were not significant differences in gender, age, chest CT image features and comorbidities observed. CONCLUSIONS: The differences between the two groups suggested more severe systemic inflammation, multi-organ dysfunction, especially impaired liver and heart function in COVID-19 patients who died suddenly after admission. More researches are needed to verify these points.

COVID-19/mortality , Death, Sudden/epidemiology , Patient Admission/statistics & numerical data , SARS-CoV-2 , Aged , Cause of Death , China/epidemiology , Death, Sudden/etiology , Female , Hospital Mortality , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors
Heart Rhythm ; 18(2): 215-218, 2021 02.
Article in English | MEDLINE | ID: covidwho-1118446


BACKGROUND: Increased incidence of out-of-hospital sudden death (OHSD) has been reported during the coronavirus 2019 (COVID-19) pandemic. New York City (NYC) represents a unique opportunity to examine the epidemiologic association between the two given the variable regional distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in its highly diverse neighborhoods. OBJECTIVE: The purpose of this study was to examine the association between OHSD and SARS-CoV-2 epidemiologic burden during the first COVID-19 pandemic across the highly diverse neighborhoods of NYC. METHODS: The incidences of OHSD between March 20 and April 22, 2019, and between March 20 and April 22, 2020, as reported by the Fire Department of New York were obtained. As a surrogate for viral epidemiologic burden, we used percentage of positive SARS-CoV-2 antibody tests performed between March 3 and August 20, 2020. Data were reported separately for the 176 zip codes of NYC. Correlation analysis and regression analysis were performed between the 2 measures to examine association. RESULTS: Incidence of OHSD per 10,000 inhabitants and percentage of SARS-CoV-2 seroconversion were highly variable across NYC neighborhoods, varying from 0.0 to 22.9 and 12.4% to 50.9%, respectively. Correlation analysis showed a moderate positive correlation between neighborhood data on OHSD and percentage of positive antibody tests to SARS-CoV-2 (Spearman ρ 0.506; P <.001). Regression analysis showed that seroconversion to SARS-CoV-2 and OHSD in 2019 were independent predictors for OHSD during the first epidemic surge in NYC (R2 = 0.645). CONCLUSION: The association in geographic distribution between OHSD and SARS-CoV-2 epidemiologic burden suggests either a causality between the 2 syndromes or the presence of local determinants affecting both measures in a similar fashion.

COVID-19/immunology , Death, Sudden/epidemiology , Seroconversion , COVID-19/epidemiology , Female , Humans , Incidence , Male , New York City/epidemiology , Pandemics , SARS-CoV-2