Background: Cardiovasculareventshavebeenreportedinthesettingofcoronavirus disease-19(COVID-19).Ithasbeenhypothesizedthatsystemicinflammationmayaggravate arrhythmias or trigger new-onset conduction abnormalities. However, the specifictypeanddistributionofelectrocardiographicdisturbancesinCOVID-19as wellastheirinfluenceonmortalityremaintobefullycharacterized. Methods: Electrocardiograms (ECGs) were obtained from 186 COVID-19-positive patientsatalargetertiarycarehospitalinNorthernNevada.Thefollowingarrhythmiaswereidentifiedbycardiologists:sinusbradycardia,sinustachycardia,atrialfibrillation (A-Fib), atrial flutter, multifocal atrial tachycardia (MAT), premature atrial contraction (PAC), premature ventricular contraction (PVC), atrioventricular block (AVB),andrightbundlebranchblock(RBBB).ThemeanPRinterval,QRSduration, andcorrectedQTintervalweredocumented.Fisher'sexacttestwasusedtocompare the ECG features of patients who died during the hospitalization with those who survived.TheinfluenceofECGfeaturesonmortalitywasassessedwithmultivariable logistic regression analysis.Results: A-Fib,atrialflutter,andST-segmentdepressionwerepredictiveofmortality.In addition,themeanventricularratewashigheramongpatientswhodiedascompared to those who survived. The use of therapeutic anticoagulation was associated with reducedoddsofdeath;however,thisassociationdidnotreachstatisticalsignificance. Conclusion:The underlying pathogenesis of COVID-19-associated arrhythmias remains to be established, but we postulate that systemic inflammation and/or hypoxiamayinducepotentiallylethalconductionabnormalitiesinaffectedindividuals.ThisisanopenaccessarticleunderthetermsoftheCreativeCommonsAttribution-NonCommercial-NoDerivsLicense,whichpermitsuseanddistributionin anymedium,providedtheoriginalworkisproperlycited,theuseisnon-commercialandnomodificationsoradaptationsaremade. ©2021TheAuthors.Annals of Noninvasive ElectrocardiologypublishedbyWileyPeriodicalsLLC.
Myalgic encephalomyelitis (ME) is a complex, heterogeneous illness of unknown etiology. The search for biomarkers that can delineate cases from controls is one of the most active areas of ME research; however, little progress has been made in achieving this goal. In contrast to identifying biomarkers that are directly involved in the pathological process, an immunosignature identifies antibodies raised to proteins expressed during, and potentially involved in, the pathological process. Although these proteins might be unknown, it is possible to detect antibodies that react to these proteins using random peptide arrays. In the present study, we probe a custom 125,000 random 12-mer-peptide microarray with sera from 21 ME cases and 21 controls from the U.S. and Europe and used these data to develop a diagnostic signature. We further used these peptide sequences to potentially uncover the naturally occurring candidate antigens to which these antibodies may specifically react with in vivo. Our analysis revealed a subset of 25 peptides that distinguished cases and controls with high specificity and sensitivity. Additionally, BLAST (Basic Local Alignment Search Tool) searches suggest these peptides primarily represent human self-antigens and endogenous retroviral sequences and to a minor extent, viral and bacterial pathogens.
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