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Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia
Aims: Thromboembolic events, including stroke, are typical complications of COVID-19. Whether arrhythmias, frequently described in severe COVID-19, are disease-specific and thus promote strokes is unclear. We investigated the occurrence of arrhythmias and stroke during rhythm monitoring in criticall...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652060/ https://www.ncbi.nlm.nih.gov/pubmed/34901224 http://dx.doi.org/10.3389/fcvm.2021.763827 |
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author | Jirak, Peter Shomanova, Zornitsa Larbig, Robert Dankl, Daniel Frank, Nino Seelmaier, Clemens Butkiene, Dominyka Lichtenauer, Michael Mirna, Moritz Strohmer, Bernhard Sackarnd, Jan Hoppe, Uta C. Sindermann, Jürgen Reinecke, Holger Frommeyer, Gerrit Motloch, Lukas J. Pistulli, Rudin |
author_facet | Jirak, Peter Shomanova, Zornitsa Larbig, Robert Dankl, Daniel Frank, Nino Seelmaier, Clemens Butkiene, Dominyka Lichtenauer, Michael Mirna, Moritz Strohmer, Bernhard Sackarnd, Jan Hoppe, Uta C. Sindermann, Jürgen Reinecke, Holger Frommeyer, Gerrit Motloch, Lukas J. Pistulli, Rudin |
author_sort | Jirak, Peter |
collection | PubMed |
description | Aims: Thromboembolic events, including stroke, are typical complications of COVID-19. Whether arrhythmias, frequently described in severe COVID-19, are disease-specific and thus promote strokes is unclear. We investigated the occurrence of arrhythmias and stroke during rhythm monitoring in critically ill patients with COVID-19, compared with severe pneumonia of other origins. Methods and Results: This retrospective study included 120 critically ill patients requiring mechanical ventilation in three European tertiary hospitals, including n =60 COVID-19, matched according to risk factors for the occurrence of arrhythmias in n = 60 patients from a retrospective consecutive cohort of severe pneumonia of other origins. Arrhythmias, mainly atrial fibrillation (AF), were frequent in COVID-19. However, when compared with non-COVID-19, no difference was observed with respect to ventricular tachycardias (VT) and relevant bradyarrhythmias (VT 10.0 vs. 8.4 %, p = ns and asystole 5.0 vs. 3.3%, p = ns) with consequent similar rates of cardiopulmonary resuscitation (6.7 vs. 10.0%, p = ns). AF was even more common in non-COVID-19 (AF 18.3 vs. 43.3%, p = 0.003; newly onset AF 10.0 vs. 30.0%, p = 0.006), which resulted in a higher need for electrical cardioversion (6.7 vs. 20.0%, p = 0.029). Despite these findings and comparable rates of therapeutic anticoagulation (TAC), the incidence of stroke was higher in COVID-19 (6.7.% vs. 0.0, p = 0.042). These events also happened in the absence of AF (50%) and with TAC (50%). Conclusions: Arrhythmias were common in severe COVID-19, consisting mainly of AF, yet less frequent than in matched pneumonia of other origins. A contrasting higher incidence of stroke independent of arrhythmias also observed with TAC, seems to be an arrhythmia-unrelated disease-specific feature of COVID-19. |
format | Online Article Text |
id | pubmed-8652060 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-86520602021-12-09 Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia Jirak, Peter Shomanova, Zornitsa Larbig, Robert Dankl, Daniel Frank, Nino Seelmaier, Clemens Butkiene, Dominyka Lichtenauer, Michael Mirna, Moritz Strohmer, Bernhard Sackarnd, Jan Hoppe, Uta C. Sindermann, Jürgen Reinecke, Holger Frommeyer, Gerrit Motloch, Lukas J. Pistulli, Rudin Front Cardiovasc Med Cardiovascular Medicine Aims: Thromboembolic events, including stroke, are typical complications of COVID-19. Whether arrhythmias, frequently described in severe COVID-19, are disease-specific and thus promote strokes is unclear. We investigated the occurrence of arrhythmias and stroke during rhythm monitoring in critically ill patients with COVID-19, compared with severe pneumonia of other origins. Methods and Results: This retrospective study included 120 critically ill patients requiring mechanical ventilation in three European tertiary hospitals, including n =60 COVID-19, matched according to risk factors for the occurrence of arrhythmias in n = 60 patients from a retrospective consecutive cohort of severe pneumonia of other origins. Arrhythmias, mainly atrial fibrillation (AF), were frequent in COVID-19. However, when compared with non-COVID-19, no difference was observed with respect to ventricular tachycardias (VT) and relevant bradyarrhythmias (VT 10.0 vs. 8.4 %, p = ns and asystole 5.0 vs. 3.3%, p = ns) with consequent similar rates of cardiopulmonary resuscitation (6.7 vs. 10.0%, p = ns). AF was even more common in non-COVID-19 (AF 18.3 vs. 43.3%, p = 0.003; newly onset AF 10.0 vs. 30.0%, p = 0.006), which resulted in a higher need for electrical cardioversion (6.7 vs. 20.0%, p = 0.029). Despite these findings and comparable rates of therapeutic anticoagulation (TAC), the incidence of stroke was higher in COVID-19 (6.7.% vs. 0.0, p = 0.042). These events also happened in the absence of AF (50%) and with TAC (50%). Conclusions: Arrhythmias were common in severe COVID-19, consisting mainly of AF, yet less frequent than in matched pneumonia of other origins. A contrasting higher incidence of stroke independent of arrhythmias also observed with TAC, seems to be an arrhythmia-unrelated disease-specific feature of COVID-19. Frontiers Media S.A. 2021-11-24 /pmc/articles/PMC8652060/ /pubmed/34901224 http://dx.doi.org/10.3389/fcvm.2021.763827 Text en Copyright © 2021 Jirak, Shomanova, Larbig, Dankl, Frank, Seelmaier, Butkiene, Lichtenauer, Mirna, Strohmer, Sackarnd, Hoppe, Sindermann, Reinecke, Frommeyer, Motloch and Pistulli. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Jirak, Peter Shomanova, Zornitsa Larbig, Robert Dankl, Daniel Frank, Nino Seelmaier, Clemens Butkiene, Dominyka Lichtenauer, Michael Mirna, Moritz Strohmer, Bernhard Sackarnd, Jan Hoppe, Uta C. Sindermann, Jürgen Reinecke, Holger Frommeyer, Gerrit Motloch, Lukas J. Pistulli, Rudin Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
title | Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
title_full | Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
title_fullStr | Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
title_full_unstemmed | Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
title_short | Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
title_sort | higher incidence of stroke in severe covid-19 is not associated with a higher burden of arrhythmias: comparison with other types of severe pneumonia |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652060/ https://www.ncbi.nlm.nih.gov/pubmed/34901224 http://dx.doi.org/10.3389/fcvm.2021.763827 |
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