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COVİD-19 Hastalarında Başvuru Esnasında EKG’deki Özellikler Hastane içi Olayları Öngörebilir

Yıl 2021, Cilt 13, Sayı S1, 401 - 410, 30.08.2021
https://doi.org/10.18521/ktd.922646

Öz

Amaç: COVID-19 hastalarında başvuru esnasındaki elektrokardiyografi (EKG) özellikleri ile tüm nedenlere bağlı hastane-içi mortalite ile tedavi üniteleri arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: 15 Mart ile 17 Haziran 2020 tarihleri arasında gerçek zamanlı ters transkripsiyon polimeraz zincir reaksiyonu metodu ile şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2) tespit edilerek COVID-19 tanısı konulan ve hastaneye yatırılan toplam 172 ardışık hasta bu çalışmaya dahil edildi. Laboratuar parametleri ve EKG bulguları başvuru sırasında kaydedildi. Hastaneye ve yoğun bakım ünitesine (YBÜ) yatış kriterleri Türkiye Cumhuriyeti Sağlık Bakanlığı’nın geçici kılavuzuna göre belirlendi. Hastalar hastane içi mortalite durumlarına ve tedavi gördükleri birime göre gruplandırıldı. Bulgular: Ortanca yaş mortalite grubunda ve YBÜ'de tedavi edilen hastalarda önemli ölçüde daha yüksekti (her ikisi için, p <0.05). P dispersiyonu, QRS süresi, QTc süresi ve QT dispersiyonu YBÜ’de tedavi edilen hastalarda önemli ölçüde daha uzundu (hepsi için, p <0.001). PR süresi, P dispersiyonu, QRS süresi, QT dispersiyonu ve QTc süresi mortalite grubunda önemli ölçüde daha uzundu (hepsi için p <0.05). QT dispersiyonu YBÜ başvurularını öngörürken QRS süresi COVID-19 hastalarında tüm nedenlere bağlı hastane-içi mortaliteyi öngördü. Sonuç: Başvuru esnasındaki EKG bulguları, COVID-19 hastalarında tedavi birimleri ve tüm nedenlere bağlı hastane-içi mortalite ile bağımsız olarak ilişkilendirilebilir.

Kaynakça

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Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients

Yıl 2021, Cilt 13, Sayı S1, 401 - 410, 30.08.2021
https://doi.org/10.18521/ktd.922646

Öz

Objective: To evaluate the association of ECG features obtained on admission with treating units and in-hospital all-cause mortality in COVID-19 patients. Methods: A total of 172 consecutive hospitalized patients with COVID-19 diagnosed by detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with real-time reverse-transcription polymerase chain reaction (RT-PCR) method between 15 May and 17 June 2020 were enrolled in the study. Laboratory parameters and findings on ECG obtained during admission were recorded. Criteria for hospitalization and intensive care unit (ICU) admission were determined in accordance with interim guidance of the Republic of Turkey Ministry of Health and the World Health Organization. Patients were grouped according to their in-hospital mortality status, survivors and non-surviors and units where patients are treated, intensive care unit and in-patient room. Results: The median age was significantly higher in the non-survivors group and, in the patients treated in ICU (p<0.05, for both). PR duration, P dispersion, QRS duration, QTc duration, and QT dispersion were significantly longer in patients treated in the ICU (p <0.001, for all), whilst PR duration, P dispersion, QRS duration, QT dispersion and QTc interval were significantly longer in the non-survivors group (p<0.05, for all). QT dispersion (OR: 1.093, 95% Cl: 1.018 + 1.174, p = 0.014) predicted admission to ICU, whereas QRS duration (OR: 1.045, 95% Cl: 1.000-1.091, p = 0.049) predicted in-hospital all-cause mortality in patients with COVID-19. Conclusion: Findings on ECG during admission could be independently associated with treating units and in-hospital all-cause mortality in COVID-19 patients.

Kaynakça

  • 1. 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;395:497–506. https://doi.org/10.1016/S0140-6736 (20)30183-5.
  • 2. Eaaswarkhanth M, Al Madhoun A, Al-Mulla F. Could the D614G substitution in the SARS-CoV-2 spike(S) protein be associated with higher COVID-19 mortality? Int J Infect Dis 2020;96:459–60. https://doi.org/10.1016/j.ijid.2020.05.071.
  • 3. Lai CC, Liu YH, Wang CY, Wang YH, Hsueh SC, Yen MY, et al. Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV2): Facts and myths. J Microbiol Immunol Infect 2020;53:404-12. https://doi.org/10.1016/j.jmii.2020.02.012
  • 4. Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, et al. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA 2020;323:1406-7 https://doi.org/10.1001/jama.2020.2565.
  • 5. Garg S, Kim L, Whitaker M, O’Halloran A, Cummings C, Holstein R, et al. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 - COVID-NET, 14 States, March 1-30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:458-64.
  • 6. Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci 2020;12:8. doi: 10.1038/s41368-020-0074-x.
  • 7. Zhou R. Does SARS-CoV-2 cause viral myocarditis in COVID-19 patients? Eur Heart J 2020;41:2123. doi: 10.1093/eurheartj/ehaa392.
  • 8. IC Kim, JY Kim, HA Kim, S Han. COVID-19-related myocarditis in a 21-year-old female patient. Eur Heart J 2020;41:1859. doi: 10.1093/eurheartj/ehaa288.
  • 9. Inciardi RM, Adamo M, Lupi L, Cani DS, Di Pasquale M, Tomasoni D, et al. Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy. Eur Heart J 2020;41:1821-29. doi: 10.1093/eurheartj/ehaa388.
  • 10. Argenziano MG, Bruce SL, Slater CL, Tiao JR, Baldwin MR, Barr RG, et al. Characterization and clinical course of 1000 Patients with COVID-19 in New York: retrospective case series. medRxiv 2020;2020.04.20.20072116. doi: 10.1101/2020.04.20.20072116.
  • 11. Lanza GA, De Vita A, Ravenna SE, D’Aiello A, Covino M, Franceschi F, et al. Electrocardiographic findings at presentation and clinical outcome in patients with SARS-CoV-2 infection. Europace 2020;euaa245. doi: 10.1093/europace/euaa245.
  • 12. Rautaharju PM, Ge S, Nelson JC, Marino Larsen EK, Psaty BM, Furberg CD, et al. Comparison of mortality risk for electrocardiographic abnormalities in men and women with and without coronary heart disease (from the Cardiovascular Health Study). Am J Cardiol. 2006;97:309-15. doi: 10.1016/j.amjcard.2005.08.046.
  • 13. Lund LH, Jurga J, Edner M, Benson L, Dahlström U, Linde C, et al. Prevalence, correlates, and prognostic significance of QRS prolongation in heart failure with reduced and preserved ejection fraction. Eur Heart J 2013;34:529-39. doi: 10.1093/eurheartj/ehs305.
  • 14. Ogiso M, Suzuki A, Shiga T, Nakai K, Shoda M, Hagiwara N. Effect of intravenous amiodarone on QT and T peak-T end dispersions in patients with nonischemic heart failure treated with cardiac resynchronization-defibrillator therapy and electrical storm. J Arrhythm 2015;31:1-5. doi: 10.1016/j.joa.2014.01.006.
  • 15. Glancy JM, Garratt CJ, Woods KL, de Bono DP. QT dispersion and mortality after myocardial infarction. Lancet 1995;345:945-8. doi:10.1016/ S0140-6736(95)90697-5.
  • 16. Buja G, Miorelli M, Turrini P, Melacini P, Nava A. Comparison of QT dispersion in hypertrophic cardiomyopathy between patients with and without ventricular arrhythmias and sudden death. Am J Cardiol 1993;72:973-6. doi:10.1016/0002-9149(93)91118-2.
  • 17. World Health Organization. Clinical management of severe acute respiratory infection when Novel coronavirus (2019-nCoV) infection is suspected: Interim Guidance. https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected.
  • 18. Prigent A. Monitoring renal function and limitations of renal function tests. Semin Nucl Med 2008;38:32-46. doi: 10.1053/j.semnuclmed.2007.09.003. 19.Ministry of Health. COVID-19 algoritmalar [online]; 2020 Website: https:// covid19bilgi.saglik.gov.tr/tr/algoritmalar [accessed 17April 2020].
  • 20. Bazett HC. The time relations of the blood-pressure changes after excision of the adrenal glands, with some observations on blood volume changes. J Physiol 1920;53:320-39. doi: 10.1113/jphysiol.1920.sp001881.
  • 21 Priori SG, Napolitano C, Diehl L, Schwartz PJ. Dispersion of the QT interval. A marker of therapeutic efficacy in the idiopathic long QT syndrome. Circulation 1994;89:1681-9. doi: 10.1161/01.cir.89.4.1681.
  • 22. Dilaveris PE, Gialafos EJ, Sideris SK, Theopistou AM, Andrikopoulos GK, Kyriakidis M, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J. 1998;135:733-8. doi: 10.1016/s0002-8703(98)70030-4.
  • 23.Antzelevitch C, Shimizu W, Yan GX, Sicouri S. Cellular basis for QT dispersion. J Electrocardiol 1998;30 Suppl:168-75. doi: 10.1016/s0022-0736(98)80070-8.
  • 24. Bogun F, Chan KK, Harvey M, Goyal R, Castellani M, Niebauer M, et al. QT dispersion in nonsustained ventricular tachycardia and coronary artery disease. Am J Cardiol 1996;77:256-9. doi: 10.1016/s0002-9149(97)89389-7.
  • 25.Han J, Goel BG. Electrophysiologic precursors of ventricular tachyarrhythmias. Arch Intern Med. 1972;129:749–55.
  • 26.Mirvis DM. Spatial variation of QT intervals in normal persons and patients with acute myocardial infarction. J Am Coll Cardiol 1985;5:625-31. doi: 10.1016/s0735-1097(85)80387-9.
  • 27. Puljevic D, Smalcelj A, Durakovic Z, Goldner V. QT dispersion, daily variations, QT interval adaptation and late potentials as risk mark‐ ers for ventricular tachycardia. Eur Heart J 1997;18:1343-9. doi: 10.1093/oxfordjournals.eurheartj.a015448.
  • 28.Barr CS, Naas A, Freeman M, Lang CC, Struthers AD. QT dispersion and sudden unexpected death in chronic heart failure. Lancet 1994;343:327-9. doi: 10.1016/s0140-6736(94)91164-9.
  • 29 Bazoukis G, Yeung C, Wui Hang Ho R, Varrias D, Papadatos S, Lee S, et al. Association of QT dispersion with mortality and arrhythmic events-A meta-analysis of observational studies. J Arrhythm 2019;36:105-15. doi: 10.1002/joa3.12253.
  • 30. Glancy JM, Garratt CJ, de Bono DP. Dynamics of QT dispersion during myocardial infarction and ischaemia. Int J Cardiol 1996;57:55-60. doi: 10.1016/s0167-5273(96)02732-5.
  • 31. Shi S, Qin M, Shen Bo, 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;5:802-10. doi: 10.1001/jamacardio.2020.0950.
  • 32. Alabd AA, Fouad A, Abdel-Nasser R, Nammas W. QT interval dispersion pattern in patients with acute ischemic stroke: Does the site of infarction matter? Int J Angiol Winter 2009;18:177-81. doi: 10.1055/s-0031-1278349.
  • 33. Minisi AJ, Thames MD. Distribution of left ventricular sympathetic afferents demonstrated by reflex responses to transmural myocardial ischemia and to intracoronary and epicardial bradykinin. Circulation 1993;87:240-6. doi: 10.1161/01.cir.87.1.240.
  • 34. Kosmopoulos M, Roukoz H, Sebastian P, Kalra J, Goslar T, Bartos JA et al. Increased QT Dispersion Is Linked to Worse Outcomes in Patients Hospitalized for Out-of-Hospital Cardiac Arrest. J Am Heart Assoc 2020;9(16):e016485. doi: 10.1161/JAHA.120.016485.
  • 35. Rahar KK, Pahadiya HR, Barupal KG, Mathur CP, Lakhotia M. The QT dispersion and QTc dispersion in patients presenting with acute neurological events and its impact on early prognosis. J Neurosci Rural Pract 2016;7:61-6. doi: 10.4103/0976-3147.172173.
  • 36. Kelmanson IA. High anxiety in clinically healthy patients and increased QT dispersion: a meta-analysis. Eur J Prev Cardiol 2014;21:1568-74. doi:10.1177/2047487313501613.
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Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Makaleler
Yazarlar

Hazar HARBALIOĞLU (Sorumlu Yazar)
Duzce State Hospital, Department of Cardiology, Duzce/ Turkey
0000-0002-6694-814X
Türkiye


Omer GENC
Agri Training and Research Hospital, Department of Cardiology, Agri/ Turkey.
0000-0002-9097-5391
Türkiye


Gökhan ALICI
Adana City Training and Research Hospital, Department of Cardiology, Adana/ Turkey
0000-0002-4589-7566
Türkiye


Alaa QUİSİ
Medline Adana Hospital, Department of Cardiology. Adana, Turkey.
0000-0002-5862-5789
Türkiye


Abdullah YILDIRIM
Adana City Training and Research Hospital, Department of Cardiology, Adana/ Turkey
0000-0003-3175-0835
Türkiye

Yayımlanma Tarihi 30 Ağustos 2021
Yayınlandığı Sayı Yıl 2021, Cilt 13, Sayı S1

Kaynak Göster

Bibtex @araştırma makalesi { ktd922646, journal = {Konuralp Medical Journal}, issn = {1309-3878}, eissn = {1309-3878}, address = {}, publisher = {Düzce Üniversitesi}, year = {2021}, volume = {13}, pages = {401 - 410}, doi = {10.18521/ktd.922646}, title = {Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients}, key = {cite}, author = {Harbalıoğlu, Hazar and Genc, Omer and Alıcı, Gökhan and Quisi, Alaa and Yıldırım, Abdullah} }
APA Harbalıoğlu, H. , Genc, O. , Alıcı, G. , Quisi, A. & Yıldırım, A. (2021). Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients . Konuralp Medical Journal , COVID-19 , 401-410 . DOI: 10.18521/ktd.922646
MLA Harbalıoğlu, H. , Genc, O. , Alıcı, G. , Quisi, A. , Yıldırım, A. "Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients" . Konuralp Medical Journal 13 (2021 ): 401-410 <https://dergipark.org.tr/tr/pub/ktd/issue/64699/922646>
Chicago Harbalıoğlu, H. , Genc, O. , Alıcı, G. , Quisi, A. , Yıldırım, A. "Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients". Konuralp Medical Journal 13 (2021 ): 401-410
RIS TY - JOUR T1 - Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients AU - Hazar Harbalıoğlu , Omer Genc , Gökhan Alıcı , Alaa Quisi , Abdullah Yıldırım Y1 - 2021 PY - 2021 N1 - doi: 10.18521/ktd.922646 DO - 10.18521/ktd.922646 T2 - Konuralp Medical Journal JF - Journal JO - JOR SP - 401 EP - 410 VL - 13 IS - S1 SN - 1309-3878-1309-3878 M3 - doi: 10.18521/ktd.922646 UR - https://doi.org/10.18521/ktd.922646 Y2 - 2021 ER -
EndNote %0 Konuralp Tıp Dergisi Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients %A Hazar Harbalıoğlu , Omer Genc , Gökhan Alıcı , Alaa Quisi , Abdullah Yıldırım %T Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients %D 2021 %J Konuralp Medical Journal %P 1309-3878-1309-3878 %V 13 %N S1 %R doi: 10.18521/ktd.922646 %U 10.18521/ktd.922646
ISNAD Harbalıoğlu, Hazar , Genc, Omer , Alıcı, Gökhan , Quisi, Alaa , Yıldırım, Abdullah . "Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients". Konuralp Medical Journal 13 / S1 (Ağustos 2021): 401-410 . https://doi.org/10.18521/ktd.922646
AMA Harbalıoğlu H. , Genc O. , Alıcı G. , Quisi A. , Yıldırım A. Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients. Konuralp Medical Journal. 2021; 13(S1): 401-410.
Vancouver Harbalıoğlu H. , Genc O. , Alıcı G. , Quisi A. , Yıldırım A. Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients. Konuralp Medical Journal. 2021; 13(S1): 401-410.
IEEE H. Harbalıoğlu , O. Genc , G. Alıcı , A. Quisi ve A. Yıldırım , "Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients", Konuralp Medical Journal, c. 13, sayı. S1, ss. 401-410, Ağu. 2021, doi:10.18521/ktd.922646