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Risk factors and electrocardiogram characteristics for mortality in critical inpatients with COVID-19.
Li, Lingzhi; Zhang, Shudi; He, Bing; Chen, Xiaobei; Wang, Shihong; Zhao, Qingyan.
  • Li L; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
  • Zhang S; Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China.
  • He B; Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.
  • Chen X; Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China.
  • Wang S; Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, China.
  • Zhao Q; Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China.
Clin Cardiol ; 43(12): 1624-1630, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-888065
ABSTRACT

BACKGROUND:

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide.

HYPOTHESIS:

The possible risk factors that lead to death in critical inpatients with coronavirus disease 2019 (COVID-19) are not yet fully understood.

METHODS:

In this single-center, retrospective study, we enrolled 113 critical patients with COVID-19 from Renmin Hospital of Wuhan University between February 1, 2020 and March 15, 2020. Patients who survived or died were compared.

RESULTS:

A total of 113 critical patients with COVID-19 were recruited; 50 (44.3%) died, and 63 (55.7%) recovered. The proportion of patients with ventricular arrhythmia was higher in the death group than in the recovery group (P = .021) and was higher among patients with myocardial damage than patients without myocardial damage (P = .013). Multivariate analysis confirmed independent predictors of mortality from COVID-19 age > 70 years (HR 1.84, 95% CI 1.03-3.28), initial neutrophil count over 6.5 × 109 /L (HR 3.43, 95% CI 1.84-6.40), C-reactive protein greater than 100 mg/L (HR 1.93, 95% CI 1.04-3.59), and lactate dehydrogenase over 300 U/L (HR 2.90, 95% CI 1.26-6.67). Immunoglobulin treatment (HR 0.39, 95% CI 0.21-0.73) can reduce the risk of death. Sinus tachycardia (HR 2.94, 95% CI 1.16-7.46) and ventricular arrhythmia (HR 2.79, 95% CI 1.11-7.04) were independent ECG risk factors for mortality from COVID-19.

CONCLUSIONS:

Old age (>70 years), neutrophilia, C-reactive protein greater than 100 mg/L and lactate dehydrogenase over 300 U/L are high-risk factors for mortality in critical patients with COVID-19. Sinus tachycardia and ventricular arrhythmia are independent ECG risk factors for mortality from COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / COVID-19 / Inpatients Type of study: Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Clin Cardiol Year: 2020 Document Type: Article Affiliation country: Clc.23492

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / COVID-19 / Inpatients Type of study: Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Clin Cardiol Year: 2020 Document Type: Article Affiliation country: Clc.23492