tetano
Editor, Senior Moderator
Acta Anaesthesiol Scand
. 2021 Feb 27.
doi: 10.1111/aas.13806. Online ahead of print.
Cardiac arrhythmias in critically ill patients with coronavirus disease 2019: a retrospective population-based cohort study
Mik Wetterslev[SUP] 1 [/SUP], Peter Karl Jacobsen[SUP] 2 [/SUP], Christian Hassager[SUP] 2 [/SUP], Christian J?ns[SUP] 2 [/SUP], Niels Risum[SUP] 2 [/SUP], Steen Pehrson[SUP] 2 [/SUP], Anders Bastiansen[SUP] 3 [/SUP], Anne Sofie Andreasen[SUP] 4 [/SUP], Klaus Tjelle Kristiansen[SUP] 5 [/SUP], Morten H Bestle[SUP] 6 [/SUP], Thomas Mohr[SUP] 7 [/SUP], Hasse M?ller-S?rensen[SUP] 8 [/SUP], Anders Perner[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) may be associated with cardiac arrhythmias in hospitalised patients, but data from the ICU setting are limited. We aimed to describe the epidemiology of cardiac arrhythmias in ICU patients with COVID-19.
Methods: We conducted a multicenter, retrospective cohort study including all ICU patients with an airway sample positive for severe acute respiratory syndrome corona-virus 2 from March 1[SUP]st[/SUP] to June 1[SUP]st[/SUP] in the Capital Region of Denmark (1.8 million inhabitants). We registered cardiac arrhythmias in ICU, potential risk factors, interventions used in ICU and outcomes.
Results: From the 7 ICUs we included 155 patients with COVID-19. The incidence of cardiac arrhythmias in the ICU was 57/155 (37%, 95% confidence interval 30-45), and 39/57 (68%) of these patients had this as new-onset arrhythmia. Previous history of tachyarrhythmias and higher disease severity at ICU admission were associated with cardiac arrhythmias in the adjusted analysis. Fifty-four of the 57 (95%) patients had supraventricular origin of the arrhythmia, 39/57 (68%) received at least one intervention against arrhythmia (e.g. amiodarone, IV fluid or magnesium) and 38/57 (67%) had recurrent episodes of arrhythmia in ICU. Patients with arrhythmias in ICU had higher 60-day mortality (63%) as compared to those without arrhythmias (39%).
Conclusion: New-onset supraventricular arrhythmias were frequent in ICU patients with COVID-19 and related to previous history of tachyarrhythmias and severity of the acute disease. The mortality was high in these patients despite the frequent use of interventions against arrhythmias.
Keywords: Atrial fibrillation; COVID-19; Cardiac arrhythmias; Critical illness; ICU.
. 2021 Feb 27.
doi: 10.1111/aas.13806. Online ahead of print.
Cardiac arrhythmias in critically ill patients with coronavirus disease 2019: a retrospective population-based cohort study
Mik Wetterslev[SUP] 1 [/SUP], Peter Karl Jacobsen[SUP] 2 [/SUP], Christian Hassager[SUP] 2 [/SUP], Christian J?ns[SUP] 2 [/SUP], Niels Risum[SUP] 2 [/SUP], Steen Pehrson[SUP] 2 [/SUP], Anders Bastiansen[SUP] 3 [/SUP], Anne Sofie Andreasen[SUP] 4 [/SUP], Klaus Tjelle Kristiansen[SUP] 5 [/SUP], Morten H Bestle[SUP] 6 [/SUP], Thomas Mohr[SUP] 7 [/SUP], Hasse M?ller-S?rensen[SUP] 8 [/SUP], Anders Perner[SUP] 1 [/SUP]
Affiliations
- PMID: 33638870
- DOI: 10.1111/aas.13806
Abstract
Background: Coronavirus disease 2019 (COVID-19) may be associated with cardiac arrhythmias in hospitalised patients, but data from the ICU setting are limited. We aimed to describe the epidemiology of cardiac arrhythmias in ICU patients with COVID-19.
Methods: We conducted a multicenter, retrospective cohort study including all ICU patients with an airway sample positive for severe acute respiratory syndrome corona-virus 2 from March 1[SUP]st[/SUP] to June 1[SUP]st[/SUP] in the Capital Region of Denmark (1.8 million inhabitants). We registered cardiac arrhythmias in ICU, potential risk factors, interventions used in ICU and outcomes.
Results: From the 7 ICUs we included 155 patients with COVID-19. The incidence of cardiac arrhythmias in the ICU was 57/155 (37%, 95% confidence interval 30-45), and 39/57 (68%) of these patients had this as new-onset arrhythmia. Previous history of tachyarrhythmias and higher disease severity at ICU admission were associated with cardiac arrhythmias in the adjusted analysis. Fifty-four of the 57 (95%) patients had supraventricular origin of the arrhythmia, 39/57 (68%) received at least one intervention against arrhythmia (e.g. amiodarone, IV fluid or magnesium) and 38/57 (67%) had recurrent episodes of arrhythmia in ICU. Patients with arrhythmias in ICU had higher 60-day mortality (63%) as compared to those without arrhythmias (39%).
Conclusion: New-onset supraventricular arrhythmias were frequent in ICU patients with COVID-19 and related to previous history of tachyarrhythmias and severity of the acute disease. The mortality was high in these patients despite the frequent use of interventions against arrhythmias.
Keywords: Atrial fibrillation; COVID-19; Cardiac arrhythmias; Critical illness; ICU.