Klinik Araştırma
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Analyzing Electrocardiography Abnormalities in COVID-19 Patients Admitting to Emergency Department

Yıl 2021, Cilt 2, Sayı 3, 193 - 197, 22.09.2021

Öz

Background: One of the groups affected at the highest level by the outbreak with the highest mortality rate is individuals with known cardiovascular diseases. Proinflammatory mediators play an important role in the pathophysiology of the disease cause cardiac and arrhythmic complications. This article aims to provide practical recommendations by evaluating ECG data in the follow-up and management of the disease to the Emergency Medicine workers to whom patients affected by COVID-19 first apply. Methods: We randomly collected the ECG data of the patients applying to our Hospital Emergency Medicine Clinic green, yellow and red areas who were positive for viral RNA in throat swabs were carried out. Results: The ECGs of 502 patients diagnosed with COVID-19 were collected in the 2-week period between June 15, 2020, and July 15, 2020. The study included 287 males (57.17%) and 215 females (42.83%). Normal sinus rhythm was detected in 241 patients (48.01%) at ECG. A total of 3 ECG patterns, which suggested ST elevation, and 11 ECG patterns, which suggested ST depression, were decisive in terms of emergency intervention. The number of patients with atrial fibrillation was 17 (3.39%). Conclusions: This infection was associated with multiple, direct, and indirect cardiovascular complications, including acute myocardial damage, myocarditis, arrhythmias. Sinus tachycardia was determined to be 30.08%, LVH 5.38%, and VES 4.18% in our study. As a result, we believe that our initial ECG recommendation is that cardiac monitoring will play an important role in treatment planning.

Kaynakça

  • 1- American College of Cardiology. Troponin and BNP use in COVID-19. Available at: https://www.acc.org/latest-in-cardiology/ articles/2020/03/18/15/25/troponin-and-bnp-use-in-covid19?utm_ source=accupdate&utm_medium=email_newsletter&utm_ content=20200320&utm_campaign=accupdate. Accessed March 23, 2020
  • 2- Azevedo RB, Botelho BG, Hollanda JVG, Ferreira LVL, Junqueira de Andrade LZ, et al. Covid-19 and the cardiovascular system: a comprehensive review. J Hum Hypertens. 2021;35(1):4-11.
  • 3- Kochi AN, Tagliari AP, Forleo GB, Fassini GM, Tondo C. Cardiac and arrhythmic complications in patients with COVID-19. J Cardiovasc Electrophysiol. 2020;31(5):1003-1008.
  • 4- Jankelson L, Karam G, Becker ML, Chinitz LA, Tsai MC. QT prolongation, torsades de pointes, and sudden death with short courses of chloroquine or hydroxychloroquine as used in COVID-19: A systematic review. Heart Rhythm. 2020;17(9):1472-1479.
  • 5- Chorin E, Wadhwani L, Magnani S, Dai M, Shulman E, Nadeau- Routhier C, et al. QT interval prolongation and torsade de pointes in patients with COVID-19 treated with hydroxychloroquine/ azithromycin. Heart Rhythm. 2020;17(9):1425-1433.
  • 6- van den Broek MPH, Möhlmann JE, Abeln BGS, Liebregts M, van Dijk VF, van de Garde EMW. Chloroquine-induced QTc prolongation in COVID-19 patients. Neth Heart J. 2020;28(78):406-409.
  • 7- Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nat Med. 2020;26(4):450-452.
  • 8- Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, Azman AS, Reich NG, Lessler J. The incubation period of Coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application. Ann Intern Med. 2020;172(9):577-582.
  • 9- Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of Coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720.
  • 10- Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323(20):2052-2059.
  • 11- Sutton D, Fuchs K, D’Alton M, Goffman D. Universal screening for SARS-CoV-2 in women admitted for delivery. N Engl J Med. 2020; 382:2163.
  • 12- Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med. 2020;382(22):2081-2090.
  • 13- Campbell KH, Tornatore JM, Lawrence KE, Illuzzi JL, Sussman LS, Lipkind HS, et al. Prevalence of SARS-CoV-2 among patients admitted for childbirth in southern Connecticut. JAMA. 2020;323(24):2520-2522.
  • 14- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069.
  • 15- Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513.
  • 16- Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl). 2020;133(9):1025-1031.
  • 17- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
  • 18- Zeng J, Huang J, Pan L. How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital. Intensive Care Med. 2020;46(6):1111-1113.
  • 19- Erganiş S, Bozdayı G. Virology, immunity and vaccine development of SARS-CoV-2. Arch Curr Med Res 2021;2(1):05-13
  • 20- Gandhi RT, Lynch JB, Del Rio C. Mild or moderate Covid-19. N Engl J Med. 2020;383(18):1757-1766.
  • 21- Cheung CC, Davies B, Gibbs K, Laksman ZW, Krahn AD. Multilead QT Screening is decessary for QT measurement: Implications for management of patients in the COVID-19 era. JACC Clin Electrophysiol. 2020;6(7):878-880.
  • 22- Ceyhan MA, Tümer M, Gürü S, Kadı G, Demir GG. Mean platelet volume and red cell distribution width values in patients with COVID-19 admitted to intensive care units or wards from emergency department. Arch Curr Med Res. 2021;2(2):88-92.
  • 23- Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with Coronavirus disease2019 (COVID-19). JAMA Cardiol. 2020;5(7):811-818.
  • 24- Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7):802-810.
  • 25- Inciardi RM, Lupi L, Zaccone G, Italia L, Raffo M, Tomasoni D, et al. Cardiac involvement in a patient with Coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(7):819-824.
  • 26- Hu H, Ma F, Wei X, Fang Y. Coronavirus fulminant myocarditis treated with glucocorticoid and human immunoglobulin. Eur Heart J. 2021;42(2):206.
  • 27- Bangalore S, Sharma A, Slotwiner A, Yatskar L, Harari R, Shah B, et al. ST-segment elevation in patients with Covid-19 - A case series. N Engl J Med. 2020;382(25):2478-2480.

Yıl 2021, Cilt 2, Sayı 3, 193 - 197, 22.09.2021

Öz

Kaynakça

  • 1- American College of Cardiology. Troponin and BNP use in COVID-19. Available at: https://www.acc.org/latest-in-cardiology/ articles/2020/03/18/15/25/troponin-and-bnp-use-in-covid19?utm_ source=accupdate&utm_medium=email_newsletter&utm_ content=20200320&utm_campaign=accupdate. Accessed March 23, 2020
  • 2- Azevedo RB, Botelho BG, Hollanda JVG, Ferreira LVL, Junqueira de Andrade LZ, et al. Covid-19 and the cardiovascular system: a comprehensive review. J Hum Hypertens. 2021;35(1):4-11.
  • 3- Kochi AN, Tagliari AP, Forleo GB, Fassini GM, Tondo C. Cardiac and arrhythmic complications in patients with COVID-19. J Cardiovasc Electrophysiol. 2020;31(5):1003-1008.
  • 4- Jankelson L, Karam G, Becker ML, Chinitz LA, Tsai MC. QT prolongation, torsades de pointes, and sudden death with short courses of chloroquine or hydroxychloroquine as used in COVID-19: A systematic review. Heart Rhythm. 2020;17(9):1472-1479.
  • 5- Chorin E, Wadhwani L, Magnani S, Dai M, Shulman E, Nadeau- Routhier C, et al. QT interval prolongation and torsade de pointes in patients with COVID-19 treated with hydroxychloroquine/ azithromycin. Heart Rhythm. 2020;17(9):1425-1433.
  • 6- van den Broek MPH, Möhlmann JE, Abeln BGS, Liebregts M, van Dijk VF, van de Garde EMW. Chloroquine-induced QTc prolongation in COVID-19 patients. Neth Heart J. 2020;28(78):406-409.
  • 7- Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nat Med. 2020;26(4):450-452.
  • 8- Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, Azman AS, Reich NG, Lessler J. The incubation period of Coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application. Ann Intern Med. 2020;172(9):577-582.
  • 9- Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of Coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720.
  • 10- Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323(20):2052-2059.
  • 11- Sutton D, Fuchs K, D’Alton M, Goffman D. Universal screening for SARS-CoV-2 in women admitted for delivery. N Engl J Med. 2020; 382:2163.
  • 12- Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med. 2020;382(22):2081-2090.
  • 13- Campbell KH, Tornatore JM, Lawrence KE, Illuzzi JL, Sussman LS, Lipkind HS, et al. Prevalence of SARS-CoV-2 among patients admitted for childbirth in southern Connecticut. JAMA. 2020;323(24):2520-2522.
  • 14- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069.
  • 15- Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513.
  • 16- Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl). 2020;133(9):1025-1031.
  • 17- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
  • 18- Zeng J, Huang J, Pan L. How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital. Intensive Care Med. 2020;46(6):1111-1113.
  • 19- Erganiş S, Bozdayı G. Virology, immunity and vaccine development of SARS-CoV-2. Arch Curr Med Res 2021;2(1):05-13
  • 20- Gandhi RT, Lynch JB, Del Rio C. Mild or moderate Covid-19. N Engl J Med. 2020;383(18):1757-1766.
  • 21- Cheung CC, Davies B, Gibbs K, Laksman ZW, Krahn AD. Multilead QT Screening is decessary for QT measurement: Implications for management of patients in the COVID-19 era. JACC Clin Electrophysiol. 2020;6(7):878-880.
  • 22- Ceyhan MA, Tümer M, Gürü S, Kadı G, Demir GG. Mean platelet volume and red cell distribution width values in patients with COVID-19 admitted to intensive care units or wards from emergency department. Arch Curr Med Res. 2021;2(2):88-92.
  • 23- Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with Coronavirus disease2019 (COVID-19). JAMA Cardiol. 2020;5(7):811-818.
  • 24- Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7):802-810.
  • 25- Inciardi RM, Lupi L, Zaccone G, Italia L, Raffo M, Tomasoni D, et al. Cardiac involvement in a patient with Coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(7):819-824.
  • 26- Hu H, Ma F, Wei X, Fang Y. Coronavirus fulminant myocarditis treated with glucocorticoid and human immunoglobulin. Eur Heart J. 2021;42(2):206.
  • 27- Bangalore S, Sharma A, Slotwiner A, Yatskar L, Harari R, Shah B, et al. ST-segment elevation in patients with Covid-19 - A case series. N Engl J Med. 2020;382(25):2478-2480.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıp
Bölüm ORIGINAL ARTICLE
Yazarlar

Miray TÜMER (Sorumlu Yazar)
Ankara City Hospital Department of Emergency Medicine
0000-0002-3917-0213
Türkiye


Ahmet Burak ERDEM
Ankara City Hospital, Department of Emergency Medicine
0000-0002-3618-6252
Türkiye


Hakan OĞUZTÜRK
Ankara City Hospital, Department of Emergency Medicine
0000-0002-9800-1428
Türkiye


Selahattin GÜRÜ
Ankara City Hospital, Department of Emergency Medicine
0000-0002-0299-1691
Türkiye


Gulhan KURTOGLU CELİK
Ankara City Hospital, Department of Emergency Medicine
0000-0003-1259-3694
Türkiye


Afşin Emre KAYIPMAZ
Ankara City Hospital, Department of Emergency Medicine
0000-0002-3578-4015
Türkiye

Yayımlanma Tarihi 22 Eylül 2021
Başvuru Tarihi 17 Temmuz 2021
Kabul Tarihi 5 Eylül 2021
Yayınlandığı Sayı Yıl 2021, Cilt 2, Sayı 3

Kaynak Göster

APA Tümer, M. , Erdem, A. B. , Oğuztürk, H. , Gürü, S. , Kurtoglu Celik, G. & Kayıpmaz, A. E. (2021). Analyzing Electrocardiography Abnormalities in COVID-19 Patients Admitting to Emergency Department . Archives of Current Medical Research , 2 (3) , 193-197 . Retrieved from https://dergipark.org.tr/tr/pub/acmr/issue/64942/997197

Archives of Current Medical Research (ACMR) provides instant open access to all content, bearing in mind the fact that presenting research

free to the public supports a greater global exchange of knowledge.

http://www.acmronline.org/