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Nathala P, Salunkhe V, Samanapally H, Xu Q, Furmanek S, Fahmy OH, Deepti F, Glynn A, McGuffin T, Goldsmith DC, Petrey J, Ali T, Titus D, Carrico R, Ramirez J, Antimisiaris D, Clifford SP, Pahwa S, Roser L, Kong M, Huang J. Electrocardiographic Features and Outcome: Correlations in 124 Hospitalized Patients With COVID-19 and Cardiovascular Events. J Cardiothorac Vasc Anesth 2022; 36:2927-2934. [PMID: 35165040 PMCID: PMC8757653 DOI: 10.1053/j.jvca.2022.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Electrocardiographic (ECG) changes have been associated with coronavirus disease 2019 (COVID-19) severity. However, the progression of ECG findings in patients with COVID-19 has not been studied. The purpose of this study was to describe ECG features at different stages of COVID-19 cardiovascular (CV) events and to examine the effects of specific ECG parameters and cardiac-related biomarkers on clinical outcomes in COVID-19. DESIGN Retrospective, cohort study. SETTING Major tertiary-care medical centers and community hospitals in Louisville, KY. PARTICIPANTS A total of 124 patients with COVID-19 and CV events during hospitalization. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Twelve-lead ECG parameters, biomarkers of cardiac injuries, and clinical outcomes were analyzed with Spearman correlation coefficients and Kruskal-Wallis 1-way analysis of variance. Atrial fibrillation/atrial flutter was more frequent on the ECG obtained at the time of the CV event when compared with admission ECG (9.5% v 26.9%; p = 0.007). Sinus tachycardia was higher in the last available hospital ECG than the CV event ECG (37.5% v 20.4%; p = 0.031). Admission ECG-corrected QT interval was significantly associated with admission troponin levels (R = 0.52; p < 0.001). The last available hospital ECG showed nonsurvivors had longer QRS duration than survivors (114.6 v 91.2 ms; p = 0.026), and higher heart rate was associated with longer intensive care unit length of stay (Spearman ρ = 0.339; p = 0.032). CONCLUSIONS In hospitalized patients with COVID-19 and CV events, ECGs at various stages of COVID-19 hospitalization showed significantly different features with dissimilar clinical outcome correlations.
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Affiliation(s)
- Pavani Nathala
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY
| | - Vidyulata Salunkhe
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY
| | - Harideep Samanapally
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY
| | - Qian Xu
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY
| | - Stephen Furmanek
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY
| | - Omar H Fahmy
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY
| | - Fnu Deepti
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY
| | - Alex Glynn
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY
| | | | | | - Jessica Petrey
- Kornhauser Health Sciences Library, University of Louisville, Louisville, KY
| | - Tshura Ali
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY
| | - Derek Titus
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY
| | - Ruth Carrico
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY
| | - Julio Ramirez
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY
| | - Demetra Antimisiaris
- Department of Pharmacology & Toxicology, University of Louisville, Louisville, KY
| | - Sean P Clifford
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY
| | - Siddharth Pahwa
- Department of Cardiovascular & Thoracic Surgery, University of Louisville, Louisville, KY
| | - Lynn Roser
- School of Medicine, University of Louisville, Louisville, KY
| | - Maiying Kong
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY
| | - Jiapeng Huang
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases, University of Louisville, Louisville, KY; Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY; Department of Pharmacology & Toxicology, University of Louisville, Louisville, KY; Department of Cardiovascular & Thoracic Surgery, University of Louisville, Louisville, KY; Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY.
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Prescription Patterns of Drugs Given to Hospitalized COVID-19 Patients: A Cross-Sectional Study in Colombia. Antibiotics (Basel) 2022; 11:antibiotics11030333. [PMID: 35326796 PMCID: PMC8944754 DOI: 10.3390/antibiotics11030333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 02/04/2023] Open
Abstract
The impact of COVID-19 prompted a race to find a treatment that would reduce its mortality. Most studies have not shown favorable results for many of these drugs, but they are still used. The aim as to determine the differences and similarities in the hospital pharmacological management of patients with COVID-19 according to sex, age group, and geographical region of Colombia, 2020–2021. Descriptive cross-sectional study was conducted on the prescription patterns of the medications given to patients diagnosed with COVID-19 treated in eight clinics in Colombia between 6 March 2020 and 31 May 2021. We performed a descriptive analysis of the sociodemographic, clinical, and pharmacological variables of the patients. A total of 8596 patients from 170 cities were identified, with a median age of 53.0 years and 53.3% of them men. A total of 24.3% required care in the intensive care unit, and 18.7% required invasive mechanical ventilation. The most commonly used drugs for the treatment of COVID-19 were systemic corticosteroids (63.6%), followed by colchicine (12.8%), azithromycin (8.9%), and ivermectin (6.4%). Corticosteroids, anticoagulants, colchicine, azithromycin, ivermectin, and hydroxychloroquine were prescribed more frequently in men, and their overall use increased with age. There were differences in prescriptions between geographic regions. The majority of patients were managed with medications included in the management guidelines. There were differences between sexes, age groups, and geographical regions.
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