Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients

Vandenberk, Bert; Engelen, Matthias M; Sijpe, Greet Van De; Vermeulen, Jeroen F.; Janssens, Stefan; Vanassche, Thomas; Verhamme, Peter; Munter, Paul De; Lorent, Natalie; Willems, Rik

doi:10.1016/j.ijcha.2021.100912

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…Repolarization abnormalities, contributed by the viral infection may happen during the natural course of COVID-19 progression, only to be noticeable at patient discharge from the hospital. Another study by Vandenberk et al corresponds to this finding that repolarization marker abnormalities at discharge may predict mortality and re-admission for up to 1-year follow-up [ 14 ]. Although TWA increment at discharge was evident in COVID-19 patients, our study did not find any significant difference in TWA levels between mild and moderate severity subgroups in patients with COVID-19, both during admission (46.95 ± 31.35 µV vs. 38.25 ± 22.1 µV, P = 0.45) and discharge (46.89 ± 32.98 µV vs. 69.90 ± 33.91 µV, P = 0.14).…”

Section: Discussionmentioning

confidence: 96%

“…Although COVID-19 also affects atrial repolarization, it seems that ventricular repolarization heterogeneity has a more obvious correlation with disease severity [ 5 , 11 , 12 ]. Repolarization parameters measured with a surface electrocardiogram (ECG) at admission may be able to predict 30-day and 1-year outcomes in COVID-19 patients, thus emphasizing their prognostic role [ 13 , 14 ]. Nevertheless, the optimal measurement and interpretation for manual ECG acquisition for some of these variables are still unknown and carry the risk of interobserver variability [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Is T-Wave Alternans a Repolarization Abnormality Marker in COVID-19? An Investigation on the Potentialities of Portable Electrocardiogram Device

Tondas¹,

Munawar

Marcantoni

et al. 2023

Cardiol Res

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Background: Cardiac arrhythmias are significantly associated with poor outcomes in coronavirus disease 2019 patients. Microvolt T-wave alternans (TWA) can be automatically quantified and has been recognized as a representation of repolarization heterogeneity and linked to arrhythmogenesis in various cardiovascular diseases. This study aimed to explore the correlation between microvolt TWA and COVID-19 pathology.Methods: Patients suspected of COVID-19 in Mohammad Hoesin General Hospital were consecutively evaluated using Alivecor ® Kardiamobile 6L™ portable electrocardiogram (ECG) device. Severe COVID-19 patients or those who are unable to cooperate in active ECG self-recording were excluded from the study. TWA was detected and its amplitude was quantified using the novel enhanced adaptive match filter (EAMF) method.Results: A total of 175 patients, 114 COVID-19 patients (polymerase chain reaction (PCR)-positive group), and 61 non-COVID-19 pa-tients (PCR-negative group) were enrolled in the study. PCR-positive group was subdivided according to the severity of COVID-19 pathology into mild and moderate severity subgroups. Baseline TWA levels were similar between both groups during admission (42.47 ± 26.52 µV vs. 44.72 ± 38.21 µV), but higher TWA levels were observed during discharge in the PCR-positive compared to the PCR-negative group (53.45 ± 34.42 µV vs. 25.15 ± 17.64 µV, P = 0.03). The correlation between PCR-positive result in COVID-19 and TWA value was significant, after adjustment of other confounding variables (R 2 = 0.081, P = 0.030). There was no significant difference in TWA levels between mild and moderate severity subgroups in patients with COVID-19, both during admission (44.29 ± 27.14 µV vs. 36.75 ± 24.46 µV, P = 0.34) and discharge (49.47 ± 33.62 µV vs. 61.09 ± 35.99 µV, P = 0.33). Conclusions:Higher TWA values can be observed on follow-up ECG obtained during discharge in the PCR-positive COVID-19 patients.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Is T-Wave Alternans a Repolarization Abnormality Marker in COVID-19? An Investigation on the Potentialities of Portable Electrocardiogram Device

Tondas¹,

Munawar

Marcantoni

et al. 2023

Cardiol Res

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“…Пандемія коронавірусної хвороби, спричинена вірусом SARS-CoV-2, характеризується високою летальністю та широким спектром ускладнень. Найпоширенішими ускладненнями, за даними Chen та співавторів (2022), які проаналізували 187 досліджень із загальним залученням 77 013 пацієнтів, були ураження печінки: 10,00 % (1,39-46,72), 23,04 % (14,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)13) і 43,48 % (39,88-47,15) у легких, середніх і тяжких випадках, а також гострий респіраторний дистрес-синдром 94,17 % (20,78-99,90) та дихальна недостатність 90,69 % (28,59). Ниркова недостатність (відношення шансів 17,43 (6,43)) і дихальна недостатність (відношення шансів 105, 12 (49,48-223,33)) при супутніх захворюваннях були тісно пов'язані з тяжкими/критичними формами захворювання [1].…”

Section: вступunclassified

“…Схожі результати ми бачимо й у повідомленнях інших авторів. Частота цих порушень коливається на рівні 26-45 % [29,33]. Існують дані, які свідчать про несприятливе прогностичне значення реполяризаційних порушень, виявлених при ЕКГ у пацієнтів з COVID-19, з короткостроковою та віддаленою летальністю [33].…”

Section: обговоренняunclassified

“…Частота цих порушень коливається на рівні 26-45 % [29,33]. Існують дані, які свідчать про несприятливе прогностичне значення реполяризаційних порушень, виявлених при ЕКГ у пацієнтів з COVID-19, з короткостроковою та віддаленою летальністю [33]. Наші дані також свідчать про асоціацію порушень реполяризації з летальним перебігом хвороби: ВШ 27,8 (95% ДІ 1,487-519,895).…”

Section: обговоренняunclassified

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Cardiovascular disorders in children with COVID-19

Yevtushenko,

Seriakova,

Kramarov

et al. 2023

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Background. The purpose of the work is to study the prevalence of cardiac disorders in hospitalized children with coronavirus disease (COVID-19). Materials and methods. A retrospective, cohort, monocenter study of the medical records of children who underwent inpatient treatment between September and December 2021 at the Kyiv City Children’s Clinical Infectious Disease Hospital was conducted. For our study, we selected the medical records of patients with polymerase chain reaction-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the presence of at least one result of cardiac activity examination by electrocardiography (ECG) and/or echocardiography. The first study of cardiac activity by ECG and/or echocardiography was carried out in the first three days of inpatient treatment. Standard methods of descriptive statistics were used for data processing. Non-parametric statistical methods (Mann-Whitney test, chi-square, Pearson’s exact test) were used for mathematical analysis. The research was carried out in accordance with the Declaration of Helsinki principles. The study was approved by the bioethics committee of the hospital. Results. Among 305 children hospitalized with a diagnosis of U07.1 (2019-nCoV acute respiratory disease), there were selected 195 medical histories of patients aged 15 days to 18 years (median of 5.37 years), who were examined for cardiac activity by ECG and/or echocardiography. The most common changes were rhythm disturbances in the form of sinus tachycardia (20.8 %), bradycardia (11.9 %) and sinus arrhythmia (7.9 %), ventricular conduction disorders (25.7 %), deviation of the electrical axis of the heart (10.9 %) and repolarization disorders (31.7 %). During echocardiographic examination, structural abnormalities in the form of myocardial hypertrophy were detected in 3.1 % of patients, dilated heart chambers in 2 %, and pericardial effusion in 9.2 %. Among the functional changes, we observed: a decrease in left ventricular contractility in 4.1 % of cases, in cardiac output in 28.6 %, and an increase in total peripheral resistance in 41.8 %. Heart rhythm disturbances in the form of sinus tachycardia, deviation of the electrical axis of the heart, a decrease in the amplitude of the ECG waves, repolarization disorders, and pericardial effusion were associated with an increased risk of death in children with COVID-19. Clinical cases of cardiovascular complications in the form of jugular vein thrombosis and infectious endocarditis illustrate the role of the cardiovascular system in the pathogenesis of coronavirus disease. Conclusions. SARS-CoV-2 infection is often associated with damage to the cardiovascular system. In most pediatric patients, this occurs in the form of subclinical changes registered during laboratory or instrumental studies, but the development of manifest forms such as myocarditis, endocarditis, pericarditis, heart attack, coronary disease, thrombotic complications, and heart failure is possible. Using simple non-invasive methods (ECG and echocardiography) during screening, it is possible to diagnose damage to the cardiovascular system, as well as to detect changes in the cardiovascular system, which are subclinical, but can have an important prognostic value regarding the adverse course of the disease in children, which are hospitalized with SARS-CoV-2 infection.

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Cardiac Registries During the COVID-19 Pandemic: Lessons Learned

et al. 2022

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Purpose of this Review We discuss the role of observational studies and cardiac registries during the COVID-19 pandemic. We focus on published cardiac registries and highlight contributions to the field that have had clinical implications. Recent Findings We included observational studies of COVID-19 patients published in peer-reviewed medical journals with defined inclusion and exclusion criteria, defined study design, and primary outcomes. A PubMed and MEDLINE literature review results in 437 articles, of which 52 include patients with COVID-19 with cardiac endpoints. From July 2020 to December 2021, the average time from last data collected to publication was 8.9 ± 4.1 months, with an increasing trend over time ( R = 0.9444, p < 0.0001). Of the 52 articles that met our inclusion criteria, we summarize main findings of 4 manuscripts on stroke, 14 on acute coronary syndrome, 4 on cardiac arrest, 7 on heart failure, 7 on venous thromboembolism, 5 on dysrhythmia, and 11 on different populations at risk for cardiovascular. Summary Registries are cost effective, not disruptive to essential health services, and can be rapidly disseminated with short intervals between last data point collected and publication. In less than 2 years, cardiac registries have filled important gaps in knowledge and informed the care of COVID-19 patients with cardiovascular conditions. Supplementary Information The online version contains supplementary material available at 10.1007/s11886-022-01686-5.

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Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients

Cited by 4 publications

References 24 publications

Is T-Wave Alternans a Repolarization Abnormality Marker in COVID-19? An Investigation on the Potentialities of Portable Electrocardiogram Device

Is T-Wave Alternans a Repolarization Abnormality Marker in COVID-19? An Investigation on the Potentialities of Portable Electrocardiogram Device

Cardiovascular disorders in children with COVID-19

Cardiac Registries During the COVID-19 Pandemic: Lessons Learned

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