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Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage

The progress of COVID-19 from moderate to severe may be precipitous, while the characteristics of the disease are heterogenous. The aim of this study was to describe the development of sinus bradycardia in critically ill patients with COVID-19 and its association with outcome in outbreak due to the...

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Autores principales: Chalkias, Athanasios, Pantazopoulos, Ioannis, Papagiannakis, Nikolaos, Skoulakis, Anargyros, Laou, Eleni, Kolonia, Konstantina, Ntalarizou, Nicoletta, Tourlakopoulos, Konstantinos, Pagonis, Athanasios, Kampolis, Christos, De Guadiana Romualdo, Luis García, Ragias, Dimitrios, Eugen-Olsen, Jesper, Gourgoulianis, Konstantinos, Arnaoutoglou, Eleni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265186/
https://www.ncbi.nlm.nih.gov/pubmed/34258235
http://dx.doi.org/10.1016/j.toxrep.2021.07.004
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author Chalkias, Athanasios
Pantazopoulos, Ioannis
Papagiannakis, Nikolaos
Skoulakis, Anargyros
Laou, Eleni
Kolonia, Konstantina
Ntalarizou, Nicoletta
Tourlakopoulos, Konstantinos
Pagonis, Athanasios
Kampolis, Christos
De Guadiana Romualdo, Luis García
Ragias, Dimitrios
Eugen-Olsen, Jesper
Gourgoulianis, Konstantinos
Arnaoutoglou, Eleni
author_facet Chalkias, Athanasios
Pantazopoulos, Ioannis
Papagiannakis, Nikolaos
Skoulakis, Anargyros
Laou, Eleni
Kolonia, Konstantina
Ntalarizou, Nicoletta
Tourlakopoulos, Konstantinos
Pagonis, Athanasios
Kampolis, Christos
De Guadiana Romualdo, Luis García
Ragias, Dimitrios
Eugen-Olsen, Jesper
Gourgoulianis, Konstantinos
Arnaoutoglou, Eleni
author_sort Chalkias, Athanasios
collection PubMed
description The progress of COVID-19 from moderate to severe may be precipitous, while the characteristics of the disease are heterogenous. The aim of this study was to describe the development of sinus bradycardia in critically ill patients with COVID-19 and its association with outcome in outbreak due to the SARS-CoV-2 B.1.1.7 Lineage. We leveraged the multi-center SuPAR in Adult Patients With COVID-19 (SPARCOL) study and identified patients who required admission to intensive care unit (ICU). Inclusion criteria were: (a) adult (≥18 years old) patients hospitalized primarily for COVID-19; (b) a confirmed SARS-CoV-2 infection diagnosed through reverse transcriptase polymerase chain reaction test of nasopharyngeal or oropharyngeal samples; and (c) at least one blood sample collected at admission and stored for suPAR, hs-CRP, and ferritin testing. All patients had continuous heart rate monitoring during hospitalization. In total, 81 patients were included. Of them, 17 (21 %) and 64 (79 %) were intubated and admitted to the ICU during the first and second wave, respectively. Two (12 %) and 62 (97 %) developed bradycardia before ICU admission, respectively (p < 0.001). Patients with bradycardia had increased suPAR (p < 0.001) and hs-CRP level (p < 0.001). Infusion of isoprenaline and/or noradrenaline was necessary to maintain an adequate rate and peripheral perfusion in all patients. Mortality was significantly higher in patients with bradycardia (p < 0.001). In conclusion, bradycardia was associated with poor outcome. As B.1.1.7 variant strain is spreading more rapidly in many countries, our findings help in the identification of patients who may require early admission to ICU.
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spelling pubmed-82651862021-07-09 Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage Chalkias, Athanasios Pantazopoulos, Ioannis Papagiannakis, Nikolaos Skoulakis, Anargyros Laou, Eleni Kolonia, Konstantina Ntalarizou, Nicoletta Tourlakopoulos, Konstantinos Pagonis, Athanasios Kampolis, Christos De Guadiana Romualdo, Luis García Ragias, Dimitrios Eugen-Olsen, Jesper Gourgoulianis, Konstantinos Arnaoutoglou, Eleni Toxicol Rep Regular Article The progress of COVID-19 from moderate to severe may be precipitous, while the characteristics of the disease are heterogenous. The aim of this study was to describe the development of sinus bradycardia in critically ill patients with COVID-19 and its association with outcome in outbreak due to the SARS-CoV-2 B.1.1.7 Lineage. We leveraged the multi-center SuPAR in Adult Patients With COVID-19 (SPARCOL) study and identified patients who required admission to intensive care unit (ICU). Inclusion criteria were: (a) adult (≥18 years old) patients hospitalized primarily for COVID-19; (b) a confirmed SARS-CoV-2 infection diagnosed through reverse transcriptase polymerase chain reaction test of nasopharyngeal or oropharyngeal samples; and (c) at least one blood sample collected at admission and stored for suPAR, hs-CRP, and ferritin testing. All patients had continuous heart rate monitoring during hospitalization. In total, 81 patients were included. Of them, 17 (21 %) and 64 (79 %) were intubated and admitted to the ICU during the first and second wave, respectively. Two (12 %) and 62 (97 %) developed bradycardia before ICU admission, respectively (p < 0.001). Patients with bradycardia had increased suPAR (p < 0.001) and hs-CRP level (p < 0.001). Infusion of isoprenaline and/or noradrenaline was necessary to maintain an adequate rate and peripheral perfusion in all patients. Mortality was significantly higher in patients with bradycardia (p < 0.001). In conclusion, bradycardia was associated with poor outcome. As B.1.1.7 variant strain is spreading more rapidly in many countries, our findings help in the identification of patients who may require early admission to ICU. Elsevier 2021-07-08 /pmc/articles/PMC8265186/ /pubmed/34258235 http://dx.doi.org/10.1016/j.toxrep.2021.07.004 Text en © 2021 Published by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Regular Article
Chalkias, Athanasios
Pantazopoulos, Ioannis
Papagiannakis, Nikolaos
Skoulakis, Anargyros
Laou, Eleni
Kolonia, Konstantina
Ntalarizou, Nicoletta
Tourlakopoulos, Konstantinos
Pagonis, Athanasios
Kampolis, Christos
De Guadiana Romualdo, Luis García
Ragias, Dimitrios
Eugen-Olsen, Jesper
Gourgoulianis, Konstantinos
Arnaoutoglou, Eleni
Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage
title Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage
title_full Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage
title_fullStr Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage
title_full_unstemmed Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage
title_short Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage
title_sort sinus bradycardia is associated with poor outcome in critically ill patients with covid-19 due to the b.1.1.7 lineage
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265186/
https://www.ncbi.nlm.nih.gov/pubmed/34258235
http://dx.doi.org/10.1016/j.toxrep.2021.07.004
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