Influence of Yb3+/Ho3+codoping on optical and thermal properties of TeO2-ZnO glass

This paper reports the effect of incorporation of Yb3+ions on the frequency downconversion luminescence and thermal properties of triply ionised Ho3+doped zinc tellurite (TZ) glasses. The photoluminescence spectra of both the Ho3+/Yb3+doped and codoped glasses have been recorded and observed a green emission band corresponding to the5F4,5S2→5I8(∼550 nm) transition upon various excitations. In the downconversion (DC) emission process, the back energy transfer (BET) mechanism from Ho3+ions to Yb3+ions has also been explored. The colour emitted in the downconversion process is found to be non-tunable at different excitations. Thus, the Ho3+:TZ glass can be utilised for non-colour tunable optical devices under various UV excitations. Also the glass transition (Tg) and crystallisation (Tc) temperatures have been measured for both the doped and codoped glasses and found to be increased in the codoped glass. The singly Ho3+ions doped TZ glass shows better optical downconversion and glass forming ability.

Silver nanoparticles induces apoptosis of cancer stem cells in head and neck cancer

Background

Several nano formulations of silver nanoparticles with bioconjugates, herbal extracts and anti-cancerous drug coating have been vividly studied to target cancer. Despite of such extensive studies, AgNPs (silver nanoparticles) have not reached the stage of clinical use. Out of all possible reasons for this failure, the unexplored effect on Cancer Stem Cell (CSC) population and mechanism of action of AgNPs, are the most plausible ones and are worked upon in this study.

Methods

AgNPs were synthesized by chemical reduction method using sodium citrate and characterized by UV, FTIR, XRD and electron microscopy. CSC population was isolated from Cal33 cell line by MACS technique. MTT assay, trypan blue exclusion assay, Annexin V and PI based apoptosis assay and cell cycle assay were performed.

Results

The results showed that synthesized AgNPs have cytotoxic activity on all cancer cell lines tested with the IC50 value of a wide range (1.5-49.21 µg/ml for cell lines and 0.0643-0.1211 µg/ml for splenocytes and thymocytes). CSCs Cal33 showed higher resistance to AgNP treatment and arrest in G1/G0 phase upon cell cycle analysis.

Conclusion

AgNPs as an anti-cancer agent although have great potential but is limited by its off-target effects on normal cells and less effective on cancer stem cells at lower concentrations.

Emergence of Long-Range Angular Correlations in Low-Multiplicity Proton-Proton Collisions

This Letter presents the measurement of near-side associated per-trigger yields, denoted ridge yields, from the analysis of angular correlations of charged hadrons in proton-proton collisions at sqrt[s]=13  TeV. Long-range ridge yields are extracted for pairs of charged particles with a pseudorapidity difference of 1.4<|Δη|<1.8 and a transverse momentum of 1 Collapse

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First Measurement of the |t| Dependence of Incoherent J/ψ Photonuclear Production

The first measurement of the cross section for incoherent photonuclear production of J/ψ vector mesons as a function of the Mandelstam |t| variable is presented. The measurement was carried out with the ALICE detector at midrapidity, |y|<0.8, using ultraperipheral collisions of Pb nuclei at a center-of-mass energy per nucleon pair of sqrt[s_{NN}]=5.02  TeV. This rapidity interval corresponds to a Bjorken-x range (0.3-1.4)×10^{-3}. Cross sections are given in five |t| intervals in the range 0.04<|t|<1  GeV^{2} and compared to the predictions by different models. Models that ignore quantum fluctuations of the gluon density in the colliding hadron predict a |t| dependence of the cross section much steeper than in data. The inclusion of such fluctuations in the same models provides a better description of the data.

Recycling air conditioner-generated condensate water for microalgal biomass production and carbon dioxide sequestration

Air conditioners alleviate the discomfort of human beings from heat waves that are consequences of climate change caused by anthropogenic activities. With each passing year, the effects of global warming worsen, increasing the growth of air conditioning industry. Air conditioning units produce substantial amounts of non-nutritive and (generally) neglected condensate water and greenhouse gases. Considering this, the study explored the potential of using air conditioner condensate water (ACW) to cultivate Chlorella sorokiniana, producing biomass, and sequestering carbon dioxide (CO2). The maximum biomass production was obtained in the BG11 medium (1.45 g L-1), followed by ACW-50 (1.3 g L-1). Similarly, the highest chlorophyll-a content was observed in the BG11 medium (11 μg mL-1), followed by ACW-50 (9.11 μg mL-1). The ACW-50 cultures proved to be better adapted to physiological stress (Fv/Fm > 0.5) and can be suitable for achieving maximum biomass with adequate lipid, protein, and carbohydrate production. Moreover, C. sorokiniana demonstrated higher lipid and carbohydrate yields in the ACW-50 medium, while biomass production and protein yields were comparable to the BG11 medium. The lipid, protein, and carbohydrate productivity were 23.43, 32.9, and 23.19 mg L-1 d-1, respectively for ACW-50. Estimation of carbon capture potential through this approach equals to 9.5% of the total emissions which is an added advantage The results indicated that ACW could be effectively utilized for microalgae cultivation, reducing the reliance on freshwater for large-scale microalgal biomass production and reduce the carbon footprints of the air conditioning industry.

Next Generation Sequencing, and Development of a Pipeline as a Tool for the Detection and Discovery of Citrus Pathogens to Facilitate Safer Germplasm Exchange

Citrus is affected by many diseases, and hence, the movement of citrus propagative materials is highly regulated in the USA. Currently used regulatory pathogen detection methods include biological and laboratory-based technologies, which are time-consuming, expensive, and have many limitations. There is an urgent need to develop alternate, rapid, economical, and reliable testing methods for safe germplasm exchange. Citrus huanglongbing (HLB) has devastated citrus industries leading to an increased need for germplasm exchanges between citrus growing regions for evaluating many potentially valuable hybrids for both HLB resistance and multilocational performance. In the present study, Next-Generation Sequencing (NGS) methods were used to sequence the transcriptomes of 21 test samples, including 15 well-characterized pathogen-positive plants. A workflow was designed in the CLC Genomics Workbench software, v 21.0.5 for bioinformatics analysis of the sequence data for the detection of pathogens. NGS was rapid and found to be a valuable technique for the detection of viral and bacterial pathogens, and for the discovery of new citrus viruses, complementary to the existing array of biological and laboratory assays. Using NGS methods, we detected beet western yellows virus, a newly reported citrus virus, and a variant of the citrus yellow vein-associated virus associated with the "fatal yellows" disease.

Macrophage infiltration in 3D cancer spheroids to recapitulate the TME and unveil interactions within cancer cells and macrophages to modulate chemotherapeutic drug efficacy

BACKGROUND

Recapitulating the tumor microenvironment (TME) in vitro remains a major hurdle in cancer research. In recent years, there have been significant strides in this area, particularly with the emergence of 3D spheroids as a model system for drug screening and therapeutics development for solid tumors. However, incorporating macrophages into these spheroid cultures poses specific challenges due to the intricate interactions between macrophages and cancer cells.

METHODS

To address this issue, in this study, we established a reproducible healthy multicellular 3D spheroid culture with macrophage infiltrates in order to mimic the TME and modulate the drug's efficacy on cancer cells in the presence of macrophages. A 3D spheroid was established using the human cancer cell line CAL33 and THP1 cell derived M0 macrophages were used as a source of macrophages. Cellular parameters including tumour metabolism, health, and mitochondrial mass were analysed in order to establish ideal conditions. To modulate the interaction of cancer cells with macrophage the ROS, NO, and H2O2 levels, in addition to M1 and M2 macrophage phenotypic markers, were analyzed. To understand the crosstalk between cancer cells and macrophages for ECM degradation, HSP70, HIF1α and cysteine proteases were examined in spheroids using western blotting and qPCR.

RESULTS

The spheroids with macrophage infiltrates exhibited key features of solid tumors, including cellular heterogeneity, metabolic changes, nutrient gradients, ROS emission, and the interplay between HIF1α and HSP70 for upregulation of ECM degradading enzymes. Our results demonstrate that tumor cells exhibit a metabolic shift in the presence of macrophages. Additionally, we have observed a shift in the polarity of M0 macrophages towards tumor-associated macrophages (TAMs) in response to cancer cells in spheroids. Results also demonstrate the involvement of macrophages in regulating HIF-1α, HSP70, and ECM degradation cysteine proteases enzymes.

CONCLUSIONS

This study has significant implications for cancer therapy as it sheds light on the intricate interaction between tumor cells and their surrounding macrophages. Additionally, our 3D spheroid model can aid in drug screening and enhance the predictive accuracy of preclinical studies. The strength of our study lies in the comprehensive characterization of the multicellular 3D spheroid model, which closely mimics the TME.

Oncogenic Activities of Tribbles1 (TRIB1) Pseudokinase Overexpressed in GBM are Mediated by Protein-Protein Interactions

PURPOSE/OBJECTIVE(S)

Glioblastoma (GBM) is the most aggressive form of glioma with a low 5-year survival rate. The current treatments are inadequate and crippled by therapy resistance. Therefore, there is an unmet need to identify druggable therapeutic targets in GBM. In this study we identified TRIB1, a Ser/Thr pseudokinase that acts as a scaffold to initiate Ubiquitin Proteasome System-mediated degradation of its substrates. We and others have found that TRIB1 activates the canonical MAPK and Akt signaling cascades. Previous reports also suggest that TRIB1 contributes to chemotherapy resistance in various cancers. Therefore, we evaluated oncogenic roles of TRIB1 in GBM cells and its contribution to therapy resistance.

MATERIALS/METHODS

Patient-centered reverse translational approach was utilized to identify novel therapeutic targets. To this end, TRIB1 was identified by statistical association (Cox regression analysis) of the patient-derived gene expression profiling data publicly available from TCGA GBM cohort. TRIB1 was functionally validated in vitro by generating stable overexpression cell lines (patient-derived) by antibiotic selection. Conditional knockdown of TRIB1 was achieved by doxycycline induction. Protein-protein interactions were evaluated by co-immunoprecipitation. Protein levels were detected by western blotting. Changes in tumor volume and overall survival (OS) were calculated.

RESULTS

The mRNA profiling of TCGA GBM cohort revealed that increased TRIB1 gene expression was associated with worse OS of GBM patients [HR = 1.3 (1.0-1.5); P = 0.019]. The same analyses in our institutional cohort revealed a similar association. Mice bearing TRIB1 transgene overexpressing tumors had the increased tumor volume and shorter OS compared to empty vector control at the end of experiment. Overexpression of TRIB1 increased the phosphorylation/activation of ERK and Akt in patient-derived primary cell lines. Akt but not ERK activation was decreased after TRIB1 knockdown. TRIB1 bound directly to ERK and Akt in these cells. TRIB1 also formed a complex with p53, COP1 and HDAC1 in patient-derived primary cell lines. This protein-protein interaction was independent of TP53 mutation status.

CONCLUSION

Our data suggest that TRIB1 overexpressed in GBM executes various oncogenic functions through interaction with different proteins. Activating ERK signaling, can induce cell proliferation. Similarly, by activating Akt it can cause prosurvival effects. Finally, by associating with HDAC1 and COP1, TRIB1 can modulate p53 function. All these protein-protein interactions ultimately contribute to chemoradiotherapy resistance in GBM cells. We are currently developing small molecule inhibitors targeting the above-mentioned interactions of TRIB1 to overcome therapeutic resistance.

Role of pinch in Argon impurity transport in ohmic discharges of Aditya-U Tokamak

We present experimental results of the trace argon impurity puffing in the ohmic plasmas of Aditya-U tokamak performed to study the argon transport behaviour. Argon line emissions in visible and Vacuum Ultra Violet (VUV) spectral ranges arising from the plasma edge and core respectively are measured simultaneously. During the experiments, space resolved brightness profile of Ar1+ line emissions at 472.69 nm (3p44s 2P3/2-3p44p 2D3/2), 473.59 nm (3p44s 4P5/2-3p44p 4P3/2), 476.49 nm (3p44s 2P1/2-3p44p 2P3/2), 480.60 nm (3p44s 4P5/2-3p44p 4P5/2) are recorded using a high resolution visible spectrometer. Also, a VUV spectrometer has been used to simultaneously observe Ar13+ line emission at 18.79 nm (2s22p 2P3/2-2s2p2 2P3/2) and Ar14+ line emission at 22.11 nm (2s2 1S0-2s2p 1P1). The diffusivity and convective velocity of Ar are obtained by comparing the measured radial emissivity profile of Ar1+ emission and the line intensity ratio of Ar13+ and Ar14+ ions, with those simulated using the impurity transport code, STRAHL. Argon diffusivities ~ 12 m2/s and ~ 0.3 m2/s have been observed in the edge (ρ > 0.85) and core region of the Aditya-U, respectively. The diffusivity values both in the edge and core region are found to be higher than the neo-classical values suggesting that the argon impurity transport is mainly anomalous in the Aditya-U tokamak. Also, an inward pinch of ~ 10 m/s mainly driven by Ware pinch is required to match the measured and simulated data. The measured peaked profile of Ar density suggests impurity accumulation in these discharges.

Universal DNA methylation age across mammalian tissues

Aging, often considered a result of random cellular damage, can be accurately estimated using DNA methylation profiles, the foundation of pan-tissue epigenetic clocks. Here, we demonstrate the development of universal pan-mammalian clocks, using 11,754 methylation arrays from our Mammalian Methylation Consortium, which encompass 59 tissue types across 185 mammalian species. These predictive models estimate mammalian tissue age with high accuracy (r > 0.96). Age deviations correlate with human mortality risk, mouse somatotropic axis mutations and caloric restriction. We identified specific cytosines with methylation levels that change with age across numerous species. These sites, highly enriched in polycomb repressive complex 2-binding locations, are near genes implicated in mammalian development, cancer, obesity and longevity. Our findings offer new evidence suggesting that aging is evolutionarily conserved and intertwined with developmental processes across all mammals.

Milder Autumns May Increase Risk for Infection of Crops with Turnip Yellows Virus

Climate change has increased the risk for infection of crops with insect-transmitted viruses. Mild autumns provide prolonged active periods to insects, which may spread viruses to winter crops. In autumn 2018, green peach aphids (Myzus persicae) were found in suction traps in southern Sweden that presented infection risk for winter oilseed rape (OSR; Brassica napus) with turnip yellows virus (TuYV). A survey was carried out in spring 2019 with random leaf samples from 46 OSR fields in southern and central Sweden using DAS-ELISA, and TuYV was detected in all fields except one. In the counties of Skåne, Kalmar, and Östergötland, the average incidence of TuYV-infected plants was 75%, and the incidence reached 100% for nine fields. Sequence analyses of the coat protein gene revealed a close relationship between TuYV isolates from Sweden and other parts of the world. High-throughput sequencing for one of the OSR samples confirmed the presence of TuYV and revealed coinfection with TuYV-associated RNA. Molecular analyses of seven sugar beet (Beta vulgaris) plants with yellowing, collected in 2019, revealed that two of them were infected by TuYV, together with two other poleroviruses: beet mild yellowing virus and beet chlorosis virus. The presence of TuYV in sugar beet suggests a spillover from other hosts. Poleroviruses are prone to recombination, and mixed infection with three poleroviruses in the same plant poses a risk for the emergence of new polerovirus genotypes. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

Iron pill aspiration syndrome: A case report and literature review

Aspiration of iron pill containing ferrous sulfate into the airway can induce fulminant chemical burn and necrosis of the airway mucosa. Acute chemical burn and inflammatory response can result in life-threatening airway compromise. It can also result in long-term sequelae including but not limited to fibrosis and airway stenosis. Considering the common use of iron supplements, and the potential severity of aspiration related airway injury, clinicians should be fully cognizant of the interaction between aspirated iron and airway passages. Herein, we present a case report with pertinent review of the literature.

In vitro comparative evaluation of physical and chemical properties of surface enamel after using APF and SDF with or without laser activation

PURPOSE

To evaluate and compare the changes in physical and chemical properties of the enamel surface after application of Silver Diamine Fluoride (SDF), Acidulated Phosphate Fluoride (APF), LASER activated SDF and LASER activated APF.

METHODS

Sample consisted of 72 freshly extracted healthy human premolar teeth, extracted for orthodontic purpose, free from caries, fracture or any anomalies. The selected samples were randomly divided into four groups (n = 18): Group 1 (SDF); Group 2 (APF); Group 3 (LASER activated SDF) and Group 4 (LASER activated APF). All samples were evaluated for values of DIAGNOdent at baseline, after demineralisation and after remineralisation. They were further divided and assessed for colour changes, surface alterations and fluoride content of surface enamel using Spectrophotometer, Scanning Electron Microscopy and Energy Dispersive X-ray Spectrometry respectively. The statistical analysis was done using One-Way ANOVA, Tukey's HSD test, Mann-Whitney U test and Kruskal-Wallis Test.

RESULTS

Highest remineralising potential and maximum colour changes of surface enamel was exhibited by Group 3. Scanning Electron Micrographs of Group 3 and Group 4 exhibited regular globular structures of enamel whereas Group 1 and Group 2 showed irregular globular surface of the enamel at 2000× and 5000× magnification. Maximum fluoride uptake on the surface enamel was seen in Group 4 followed by Group 3.

CONCLUSION

Use of LASER activated topical fluorides helps to achieve superior caries prevention. LASER activated APF can be used as an aesthetic alternative to SDF, as LASER activated APF showed higher uptake of fluoride on the enamel surface without discoloration effect.

Mid-circuit correction of correlated phase errors using an array of spectator qubits

Scaling up invariably error-prone quantum processors is a formidable challenge. Although quantum error correction ultimately promises fault-tolerant operation, the required qubit overhead and error thresholds are daunting. In a complementary proposal, co-located, auxiliary 'spectator' qubits act as in-situ probes of noise, and enable real-time, coherent corrections of data qubit errors. We use an array of cesium spectator qubits to correct correlated phase errors on an array of rubidium data qubits. By combining in-sequence readout, data processing, and feed-forward operations, these correlated errors are suppressed within the execution of the quantum circuit. The protocol is broadly applicable to quantum information platforms, and establishes key tools for scaling neutral-atom quantum processors: mid-circuit readout of atom arrays, real-time processing and feed-forward, and coherent mid-circuit reloading of atomic qubits.

Extended minimal enteral feeding and time to regain birth weight in extremely low-birth-weight infants

BACKGROUND

Minimal enteral feeding after birth has been developed as a strategy to enhance the functional maturation of the gastrointestinal tract. This study aimed to examine the relationship between the duration of minimal enteral feeding and time to regain birth weight in extremely low-birth-weight infants.

METHODS

This retrospective study included all extremely low-birth-weight infants born between January 2018 and December 2020. Infants with major congenital anomalies and conditions requiring surgery and those who died or received palliative care in the first 10 days of life were excluded from the analysis. Minimal enteral feeding courses were categorized as extended if the feeding was continued for >  72 hours and short if the feeding was <  72 hours. The primary measured outcome was the time taken to regain birth weight.

RESULTS

Of 217 study infants, 180 received an extended minimal enteral feeding for >  72 h. The median time to regain birth weight was not significantly different between the extended and short minimal enteral feeding groups, median (IQR) was 10 (7-13) versus 8 (6-11), respectively (p = 0.15). Extended minimal enteral feeding is associated with a significant increase in the mean duration of the total parenteral nutrition, (21.3±10 versus 17.2±9.3 days; p = 0.021). Infants with prolonged minimal enteral feeding courses experienced non-significantly higher levels of necrotizing enterocolitis, late-onset sepsis, and retinopathy of prematurity.

CONCLUSIONS

Extended minimal enteral feeding in extremely low-birth-weight infants may not affect the time taken to regain birth weight.

Aberrant right subclavian artery: a case of vertebrobasilar insufficiency

Aberrant right subclavian artery (ARSA) is a rare congenital malformation, wherein the aorta gives rise to the right subclavian artery as a branch off the aortic arch distal to the takeoff of the left subclavian artery. We presented a case of a patient with ARSA that manifested vertebrobasilar symptoms. PubMed search was preformed using keywords 'aberrant right subclavian artery', 'right subclavian steal' and 'vertebrobasilar', which generated nine articles. We found only seven case reports through a PubMed search that discuss ARSA in association with Subclavian steal syndrome. Approximately 71% (n = 5) of the patients in our literature review manifested with signs and symptoms of vertebrobasilar insufficiency. Given the complex anatomy in this condition, treatment should be aimed at symptom resolution. Carotid-subclavian bypass ultimately resolved the symptoms in our patient. Management in symptomatic patient is surgical. In addition to open technique, endovascular interventions can be an option.

Leptomeningeal disease as a presenting feature of gestational trophoblastic neoplasia: A review and recommendations for management

OBJECTIVES

Gestational Trophoblastic Neoplasia (GTN) is a rare group of malignant placental-related tumours requiring systemic anti-cancer treatment. Leptomeningeal disease (LMD) related to GTN is not well reported with no consensus in optimal treatment. We offer recommendations for management of these patients.

METHODS

We discuss five patients with GTN who presented with features of LMD and were diagnosed with gadolinium-enhanced MRI brain, all of whom received low dose induction etoposide-cisplatin (EP) followed by either EP-etoposide, methotrexate (CNS) and actinomycin-D (EMA) or EMA(CNS)-cyclophosphamide and vincristine (CO).

RESULTS

Four out of the five patients additionally received intrathecal methotrexate. Four patients had complete hCG response to first line multi-agent chemotherapy, one patient required second line paclitaxel, cisplatin alternating with paclitaxel, etoposide (TP/TE), where paclitaxel was substituted with nab-paclitaxel due to anaphylaxis, followed by hysterectomy. One of the four initial complete hCG responders relapsed in the lung requiring further systemic treatment with subsequent lobectomy. Patient reported outcomes indicate persistent neurological symptoms are mild and do not affect functionality and quality of life.

CONCLUSION

With a follow-up range of 2-6 years, all five patients remain cured demonstrating excellent survival outcomes with the avoidance of whole-brain radiotherapy in all cases.

Seasonal variation in diagnosis of cutaneous invasive melanoma and cutaneous squamous cell carcinoma: A nationwide study in the Netherlands

BACKGROUND

Currently, there is no study that has reported on the seasonal trends of skin cancer in the Netherlands. This study aimed to investigate seasonal variation in diagnosis of cutaneous melanoma (CM) and cutaneous squamous cell carcinoma (cSCC) focusing on different subgroups.

METHODS

CM diagnosed from 2001 till 2019 and cSCCs from 2001 till 2015 were selected from the Netherlands Cancer Registry. The monthly distribution of CM and cSCC diagnoses were evaluated. Summer-to-winter ratios (SWRs) were calculated overall and stratified by patient and tumour characteristics.

RESULTS

Significant increases in melanoma incidence were noted over the summer months (SWR 1.39 (CI 1.37-1.40)). This increase was less apparent for cSCCs, as higher incidence rates were observed in the months September-November (SWR 1.13 (CI 1.12-1.14)). The seasonal variation of CM was greater in women and younger people, in superficial spreading melanoma and lentigo maligna melanoma, for the extremities, in thinner lesions, and for stage I at diagnosis. The seasonal variation of cSCC was similar for both sexes, most marked in patients 45-69 and ≥ 70, and for the extremities.

CONCLUSIONS

Our findings showed a pronounced seasonal variation in the diagnosis of CM with a peak in the summer months. For cSCC, no evident peak was observed, but an increase in diagnosis was noted in fall. Both CM and cSCC showed strong seasonal effects for the extremities.

Undernutrition and associated factors among lactating mothers in Dehradun, Uttarakhand, India

Undernutrition was one of the most widespread public health problems that affected both developed and developing countries. In India, it was one of the factors which lead to unacceptably high morbidity and mortality among women. However, little was documented on undernutrition among lactating women, particularly in the urban community. This study aimed to evaluate the nutritional status and its related factors among lactating mothers in the urban areas of the Dehradun region, Uttarakhand, India. A structured, pre-tested, and validated questionnaire was used to capture the sociodemographic information including the economical and medical conditions of 150 lactating women in Dehradun, India. Pearson correlation coefficient and association of various factors determined that 31.33% of women were in the age bracket of 20-25 years and the low-income group (72%). The prevalence of underweight was 7.33%, and the mean and standard deviation of the body mass index of mothers were 20.59±2.96 and 21.70±3.18 for sedentary and moderate workers respectively. There were significant correlations found between BMI, energy, carbohydrates, and fat intake (p<0.05). A multivariate regression model was used to associate the nutritional status of the participant’s income group, education, type of work, age of mothers, and frequency of meals. Based on the results, intervention programs for dietary correction and the effect of nutrition on the body were emphasized to lactating mothers for better health and nutritional outcomes.

ECG abnormalities and their relation to COVID-19 outcomes – a WHF study

Introduction

COVID-19 is a respiratory tract infection caused by the Coronavirus (SARS-CoV-2) and its main clinical manifestations are respiratory. The cardiovascular system can also be affected, especially in patients with severe acute respiratory syndrome [1].

On the other hand, cardiovascular disease (CVD) and risk factors have been shown to be predictors of poor outcomes in COVID-19 [2]. Diverse electrocardiographic abnormalities can be found in this condition [3], although their value as a prognostic predictor have not been properly established due to heterogeneity in abnormalities evaluation and small sample sizes in related studies [4].

Purpose

The aim of the present study is to evaluate the association of electrocardiogram (ECG) findings to poor COVID-19 outcomes

Methods

This is a multicentric cohort study that followed hospitalized adults due to COVID-19, from low-middle and high-income countries as part of the World Heart Federation (WHF) Global Study on CVD and COVID-19 initiative [5]. Participants were followed up from hospital admission until 30 days post discharge. For the present study, participants with a valid ECG were included. ECG findings were described according to standardized measurements [heart rate, PR interval, QRS duration and axis, corrected QT interval (QTc)] and abnormalities (according to the Minnesota code system). Abnormalities utilized were grouped into ischemic abnormalities (q waves and ST-T abnormalities), atrial fibrillation (AF), prolonged QTc, sinus tachycardia (defined for the study as above 120 bpm), right and left bundle branch block and presence of any major abnormality. The primary outcome was defined as death from any cause. The secondary outcomes were intensive care unit (ICU) admission and cardiovascular events (myocarditis, pericarditis, myocardial infarction, acute heart failure, ischemic and hemorrhagic stroke). Multiple logistic regression was used to evaluate the association of ECG abnormalities to the outcomes of interest. Adjustments were made in a step by step fashion including gender, age, country of residence, cardiovascular risk factors (diabetes, hypertension, tobacco use) and presence of comorbidities (CVD, asthma, cancer, immunosuppression and chronic kidney disease).

Results

The clinical characteristics of the cohort are described in table 1. Figure 1 represents the odds ratio and its 95% confidence interval of having the defined outcomes when presenting a ECG abnormality for the final regression model.

Conclusion

ECG abnormalities were independently related to poor outcomes in COVID-19 after accounting for multiple confounders. Significant associations were more frequently found for ischemic abnormalities, heart rate above 120 bpm, atrial fibrillation and having at least one major electrocardiographic abnormality.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): Pfizer and Sanofi PasteurWorld Heart Federation