COVID-19’s Hidden Shield: How Post-Infection Hearts Safeguard Against Atrial Contractions (preprint)

Background: Ectopic atrial contractions, also known as premature atrial contractions (PACs), are abnormal heart rhythms originating from the atria (the upper chambers of the heart). These contractions occur earlier than expected during the cardiac cycle and can disrupt the normal rhythm. While they are generally benign, their presence can sometimes cause symptoms such as palpitations. The exact mechanisms linking COVID-19 and EACs are not fully understood, and some evidence suggests that COVID-19 infection can increase the risk of developing EACs or other types of arrhythmias.Objectives: Effects of the EAC on post-COVID-19 patientsMaterials and Methods: This is a case‒control study of middle-aged individuals of either sex involving 50 adult patients with post-COVID-19 infection (eight were excluded from the study because they were not cooperative), 23 females and 19 males with a mean age of 36.98 ± 12.2 years who were not vaccinated against COVID-19 after one month to two years of an acute episode of COVID-19 (confirmed by positive real-time reverse-transcription polymerase chain reaction (RT‒PCR)) according to the World Health Organization (WHO) selected randomly from those attending to the adult Holter and Echocardiography Laboratory in Al-Zahraa Hospital/Al-Hussein Medical City/Karbala Province after being referred by an internist during the period from the 12th of October 2022 to the end of January 2024 and divided into three groups: nonhospitalize, hospitalize and admitted to intensive care. The control group consisted of 40 healthy persons, 23 females and 17 males with a mean age of 33.28 ± 9.58 years, who were referred by an internist for ECG and echocardiography with no Hx of the previous infection of COVID-19. All of them underwent electrocardiographic evaluation via ECG and Holter ECG for 24 hours.Conclusion: Post-COVID-19 patients had a lower risk of EAC than control patients, indicating that it may have a protective effect on EAC and reduce the risk of cardiac arrhythmias.

Changes in dynamic electrocardiogram after COVID-19 infection: a self-controlled study (preprint)

Background: Coronavirus disease 2019 (COVID-19) not only causes respiratory system damage, but also cardiovascular system. Previous studies had shown that COVID-19 can cause abnormal changes in ECG, however few studies reported changes in dynamic electrocardiogram before and after COVID-19 infection. Methods: A retrospective review of patients who were first diagnosed with COVID-19 and underwent dynamic electrocardiogram from Fujian Provincial Hospital between January 1, 2023 and April 30, 2023.In which who had received at least once dynamic electrocardiogram between January 1, 2018 and December 20, 2022 were included in our study. The differences of dynamic electrocardiogram before and after COVID-19 infection were compared and analyzed. Results: A total of 144 COVID-19 patients were included(67 males，mean age 56±14.3). After COVID-19, the mean heart rate and minimum heart rate increased, the total number of atrial premature, atrial tachycardia and ventricular premature  contractions bigeminy，the incidence of T wave changes were increased, SDNN, SDNN index, PNN50, HF and LF were decreased(all p< 0.05). Conclusion:Dynamic electrocardiogram showed increased arrhythmia and decreased heart rate variability  after-COVID-19 , indicating that COVID-19 has damage to the cardiovascular system, which can provide reference for clinical diagnosis, treatment and prevention.

Changes in childhood stroke mortality from 1990 to 2019 in Brazil and its federative units.

This research analyzed the temporal trend of stroke mortality in children aged 0-14 years, from 1990 to 2019, in Brazil and its federative units. This ecological study used data from the Global Burden of Disease, a study led by the Institute for Health Metrics and Evaluation. Stroke definition considered the International Classification of Diseases according to codes G45, G46, and I60-I69. Age-standardized mortality rates and the mean annual percentage change (APC) in mortality rates were estimated. Stroke mortality trends decreased, with an APC of - 3.9% (95% CI - 4.5; - 3.3; p < 0.001). Reducing trends were found in all but two states, where they were stationary. Maranhão (- 6.5%; 95% CI - 7.6; - 5.4; p < 0.001) had the greatest reduction and Rondônia, the smallest (- 1.2%; 95% CI - 2.3; - 0.1, p = 0.027). Decrease was more important in children < 5 (- 5.8%; 95% CI - 6.3; - 5.2; p < 0.001) compared to 5-14 years old (- 2.1%; 95% CI - 2.9; - 1.3; p < 0.001); additionally, it was greater in girls (- 4.1%; 95% CI - 4.6; - 3.5; p < 0.001) than in boys (- 3.8%; 95% IC - 4.5; - 3.1; p < 0.001). Ischemic stroke had the highest APC (- 6.1%; 95% CI - 6.8; - 5.3; p < 0.001), followed by intracranial hemorrhage (- 5.3%; 95% CI - 6.1; - 4.5; p < 0.001) and subarachnoid hemorrhage (- 2.7%; 95% CI - 3.3; - 2.1; p < 0.001). Largest reductions were seen in states with more vulnerable socioeconomic contexts. The stationary trends and lowest APCs were concentrated in the northern region, which had greater impact of diseases and less favorable outcomes.

12-lead Electrocardiogram in Hospitalized COVID 19 Patients (preprint)

COVID-19 pandemic resulted in considerable morbidity and mortality. We analyzed 345 Electrocardiograms of 100 COVID-19 patients admitted to our tertiary care center in Detroit, during the initial month of Covid-19. Findings were correlated with mortality, cardiac injury and inflammatory markers. Our cohort included 61% males and 77% African Americans. The median age and BMI were 66 years (57-74) and 31 kg/m2 (26.1-39), respectively. We observed atrial arrhythmias in 29% of the patients (17% new onset), First degree heart block in 12%, ST-T segment changes in 17%, S1Q3T3 pattern in 19%, premature ventricular complexes in 23%, premature atrial complexes in 13%, Q waves in 27%, T wave inversion in 42% of the cases. While presence of premature atrial complexes or left atrial abnormality correlated with mortality (P = 0.02 & 0.03, respectively), other findings did not show significant correlation in this small cohort of patients.