Background Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitutes a major health burden worldwide due to high mortality rates and hospital bed shortages. SARS-CoV-2 infection is associated with several laboratory abnormalities. We aimed to develop and validate a risk score based on simple demographic and laboratory data that could be used on admission in patients with SARS-CoV-2 infection to predict in-hospital mortality. Methods Three cohorts of patients from different hospitals were studied consecutively (developing, validation, and prospective cohorts). The following demographic and laboratory data were obtained from medical records: sex, age, hemoglobin, mean corpuscular volume (MCV), platelets, leukocytes, sodium, potassium, creatinine, and C-reactive protein (CRP). For each variable, classification and regression tree analysis were used to establish the cut-off point(s) associated with in-hospital mortality outcome based on data from developing cohort and before they were used for analysis in the validation and prospective cohort. The covid-19 score was calculated as a sum of cut-off points associated with mortality outcome. Results The developing, validation, and prospective cohorts included 129, 239, and 497 patients, respectively (median age, 71, 67, and 70 years, respectively). The following cut of points associated with in-hospital mortality: age > 56 years, male sex, hemoglobin < 10.55 g/dL, MCV > 92.9 fL, leukocyte count > 9.635 or < 2.64 103/µL, platelet count, < 81.49 or > 315.5 103/µL, CRP > 51.14 mg/dL, creatinine > 1.115 mg/dL, sodium < 134.7 or > 145.4 mEq/L, and potassium < 3.65 or > 6.255 mEq/L. The AUC of the covid-19 score for predicting in-hospital mortality was 0.89 (0.84–0.95), 0.850 (0.75–0.88), and 0.773 (0.731–0.816) in the developing, validation, and prospective cohorts, respectively (P < 0.001The mortality of the prospective cohort stratified on the basis of the covid-19 score was as follows: 0–2 points,4.2%; 3 points, 15%; 4 points, 29%; 5 points, 38.2%; 6 and more points, 60%. Conclusion The covid-19 score based on simple demographic and laboratory parameters may become an easy-to-use, widely accessible, and objective tool for predicting mortality in hospitalized patients with SARS-CoV-2 infection.

Introduction: The epidemiology of Emergency Department (ED) visits provides important data regarding demand for the medical resources. The aim: To present changes in the visits to ED of University Hospital during the early stage of Covid-19 state of epidemic. Matrial and Methods: All ED visits during the 3 periods each lasting one weeks in 2018, 2019, and 2020 respectively were analysed. The data related to patients ’visits in the emergency department were gathered. Results: The percentage of patients admitted between 23-29.03 in 2020 year was 23.7% of the study group and constituted a significantly lower percentage than those admitted in 2028 who constituted 37.2% and 2019 who constituted 39.1% p<0.001. There was no significant differences between percentages of patients admitted to ED and brought by EMS among studied periods. The percentage of patients admitted to other ward of the hospital was higher in 2020 than in 2018 and 2019. Conclusions: 1. During early stage of COVID-19 epidemic state the number of ED significantly decreased both patients brought by EMS and non EMS pathway. 2. Patients admitted to ED are more often admitted to other ward of the hospital. 3. The mortality during ED stay is similar than in similar periods in previous years.

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Background: During the COVID-19 pandemic, the number of admissions to the emergency department (ED) due to a primary diagnosis of atrial fibrillation (AF) has decreased when compared to pre-pandemic times. The principal aim of the study was to assess the frequency of SARS-CoV-2 infections and sinus rhythm restoration among patients who arrived at the ED with AF. Secondary aims included determining whether patients arriving at the ED principally due to AF delayed their presentations and whether the frequency of successful cardioversion for AF was decreased during the pandemic period. Materials and Methods: A retrospective analysis of medical records of patients admitted to two hospital EDs due to AF during July–December 2019 (pre-pandemic period) versus July–December 2020 (pandemic period) was performed. Results: During the study periods, 601 ED visits by 497 patients were made due to the primary diagnosis of AF. The patients were aged 71.2+/−13.5 years and 51.3% were male. The duration of an AF episode before the ED admission was 10 h (4.5–30 h) during the pandemic period vs. 5 h (3–24 h) during the non-pandemic period (p = 0.001). A shorter duration of the AF episode before ED admission was associated with the successful restoration of the sinus rhythm. During the pandemic period, among patients with short-lasting AF who were not treated with Phenazolinum, the restoration of the sinus rhythm was more frequent in the Copernicus Memorial Hospital than in the University Hospital (p = 0.026). A positive SARS-CoV-2 test was found in 5 (1%) patients, while 2 other patients (0.5%) had a prior diagnosis of COVID-19 disease noted in their medical history. Conclusions: 1. The number of AF episodes treated in these two EDs was lower during the pandemic than non-pandemic period. 2. The patients with AF appeared at the ED later after AF onset in the pandemic period. 3. Successful cardioversion of atrial fibrillation was more frequent during the pre-pandemic period in one of the two hospitals. 4. A difference of approaches to the treatment of short-lasting AF episodes between EDs during the pandemic period may exist between these two EDs. 5. The patients with SARS-CoV-2 infection during the second wave of the COVID-19 pandemic constituted a small percentage of the patients admitted to EDs due to an AF episode.

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(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increases the risk of atrial fibrillation/flutter (AF/AFL) incident. The study aimed to present the characteristics of admissions to the emergency department (ED) due to AF/AFL incidents during the third COVID-19 pandemic wave. (2) Methods: A retrospective analysis of the medical records of the ED patients: 8399 during 3 months of the second and 11,144 during the 3 months of the third pandemic wave. (3) Results: SARS-CoV-2 positive patients there were 295 (3.5%) during the second wave and 692 (6.2%) during the third wave (p < 0.001). Among patients with SARS-CoV-2 infection, there were 44 (14.9%) patients with known AF/AFL during the second wave and 75 (10.8%) during the third wave, respectively (0.07). There were 116 visits with a diagnosis of AF/AFL incident during the third wave (study group) and 76 visits during the second wave (control group). The SARS-CoV-2 test was positive in 11 (9.5%) visits in the study group and in 1 (1.3%) visit in the control group p = 0.047. During the third wave, the patients with AF/AFL incidents with positive tests were older and more often had new-onset AF/AFL than those with negative tests: 76.3 (13.2) years vs. 71.8 (12.6) years; and 4 (36.4%) patients vs. 7 (7.6%) patients, respectively. (5) Conclusions: During the third pandemic wave, the number of patients with SARS-CoV-2 infection increased in comparison to the second wave. Additionally, among patients with AF/AFL incidents, the percentage of SARS-CoV-2-positive patients increased. During the third wave, the patients with positive tests and AF/AFL incident were older and more often had new-onset AF/AFL than those with AF/AFL incident and negative test which indicate the arrhythmogenic effect at the onset of the disease, especially in the older population.

Introduction: Inappropriate shocks in patients with an implantable cardioverter-defibrillator (ICD) are associated with significant psychological and physical consequences and increased long-term mortality. The aim: To assess predictors associated with inappropriate high-energy discharges of implantable cardioverter-defibrillators. Material and Methods: Retrospective data analysis of 150 patients aged 64.2±12.8 years (84.7% male) admitted to the Hospital Emergency Department due to at least one cardioverter-defibrillator discharge was performed. All of the discharges were inappropriate in the group of 33 patients, and in the group of 117 patients at least one discharge was appropriate. The following data: age, gender, concomitant diseases, type of ICD implantation (primary vs. secondary prevention), type of discharge, number of discharges, serum potassium, and sodium concentration were collected. Results: Patients with only inappropriate discharges were younger, significantly more often had chronic atrial fibrillation, a significantly higher number of discharges, and ischaemic cardiomyopathy. Logistic regression analysis revealed that the occurrence of only inappropriate discharges was related to the number of discharges over three, the age of patients below 60 years, the serum sodium concentration between 135 mEq/L and 142 mEq/L, and the primary type of prevention of sudden cardiac death. Conclusions: 1. Predictors of inappropriate discharges include: age, serum sodium concentration, and primary type of indications for cardioverter-defibrillator implantation. 2. Further research is necessary to determine the influence of disturbances in the sodium economy on the occurrence of appropriate and inappropriate interventions of implantable cardioverter-defibrillators.

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection could result in different laboratory abnormalities. The prediction of the outcome based on simple demographics and laboratory parameters could be useful for clinical purposes. The objective of the study is to develop and validate a score (Covid19-score) based on demographics and laboratory findings, performed at hospital admission in patients with a SARS-CoV-2 infection confirmed on a reverse transcriptase-polymerase chain reaction of the nasopharyngeal swab, to predict in-hospital mortality.Methods: Three cohorts of patients from three different hospitals were studied consecutively. The studied data came from patients’ electronic records. On the basis of the retrospective analysis of the mortality in the developing cohort from the first hospital the cut-off points predicting in-hospital mortality for gender, age, hemoglobin, mean corpuscular volume, platelet count, leukocyte count, sodium, potassium, creatinine level, C-reactive protein level were found and Covid19-score as a sum of points was calculated for each patient. The area under the receiver operating characteristic curve (AUC) of the Covid19-score for predicting survival to hospital discharge was counted. The Covid19-score was validated using data of patients from a second hospital. The significance of Covid19-score was confirmed on the prospective cohort of patients collected from a third hospital,Results: AUC of the Covid19-score for predicting survival to hospital discharge was 0.89 (0.84-0.95) p<0.001 in developing cohort, 0.850 (0.75-0.88) p<0.001 in validation cohort and 0.773 (0.731-0.816) p<0.001 in the prospective cohort.Conclusion: The Covid19-score is useful in predicting the clinical outcome for hospitalized patients with SARS-CoV-2 infection