Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia
Aims: Thromboembolic events, including stroke, are typical complications of COVID-19. Whether arrhythmias, frequently described in severe COVID-19, are disease-specific and thus promote strokes is unclear. We investigated the occurrence of arrhythmias and stroke during rhythm monitoring in criticall...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Frontiers Media S.A.
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/0316fba39378471e9e5a784d47c7ab7c |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:0316fba39378471e9e5a784d47c7ab7c |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:0316fba39378471e9e5a784d47c7ab7c2021-11-30T17:57:22ZHigher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia2297-055X10.3389/fcvm.2021.763827https://doaj.org/article/0316fba39378471e9e5a784d47c7ab7c2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.763827/fullhttps://doaj.org/toc/2297-055XAims: Thromboembolic events, including stroke, are typical complications of COVID-19. Whether arrhythmias, frequently described in severe COVID-19, are disease-specific and thus promote strokes is unclear. We investigated the occurrence of arrhythmias and stroke during rhythm monitoring in critically ill patients with COVID-19, compared with severe pneumonia of other origins.Methods and Results: This retrospective study included 120 critically ill patients requiring mechanical ventilation in three European tertiary hospitals, including n =60 COVID-19, matched according to risk factors for the occurrence of arrhythmias in n = 60 patients from a retrospective consecutive cohort of severe pneumonia of other origins. Arrhythmias, mainly atrial fibrillation (AF), were frequent in COVID-19. However, when compared with non-COVID-19, no difference was observed with respect to ventricular tachycardias (VT) and relevant bradyarrhythmias (VT 10.0 vs. 8.4 %, p = ns and asystole 5.0 vs. 3.3%, p = ns) with consequent similar rates of cardiopulmonary resuscitation (6.7 vs. 10.0%, p = ns). AF was even more common in non-COVID-19 (AF 18.3 vs. 43.3%, p = 0.003; newly onset AF 10.0 vs. 30.0%, p = 0.006), which resulted in a higher need for electrical cardioversion (6.7 vs. 20.0%, p = 0.029). Despite these findings and comparable rates of therapeutic anticoagulation (TAC), the incidence of stroke was higher in COVID-19 (6.7.% vs. 0.0, p = 0.042). These events also happened in the absence of AF (50%) and with TAC (50%).Conclusions: Arrhythmias were common in severe COVID-19, consisting mainly of AF, yet less frequent than in matched pneumonia of other origins. A contrasting higher incidence of stroke independent of arrhythmias also observed with TAC, seems to be an arrhythmia-unrelated disease-specific feature of COVID-19.Peter JirakZornitsa ShomanovaRobert LarbigRobert LarbigDaniel DanklNino FrankClemens SeelmaierDominyka ButkieneMichael LichtenauerMoritz MirnaBernhard StrohmerJan SackarndUta C. HoppeJürgen SindermannHolger ReineckeGerrit FrommeyerLukas J. MotlochRudin PistulliFrontiers Media S.A.articleCOVID-19arrhythmiasatrial fibrillationstrokepneumoniaventricular tachycardiaDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
COVID-19 arrhythmias atrial fibrillation stroke pneumonia ventricular tachycardia Diseases of the circulatory (Cardiovascular) system RC666-701 |
| spellingShingle |
COVID-19 arrhythmias atrial fibrillation stroke pneumonia ventricular tachycardia Diseases of the circulatory (Cardiovascular) system RC666-701 Peter Jirak Zornitsa Shomanova Robert Larbig Robert Larbig Daniel Dankl Nino Frank Clemens Seelmaier Dominyka Butkiene Michael Lichtenauer Moritz Mirna Bernhard Strohmer Jan Sackarnd Uta C. Hoppe Jürgen Sindermann Holger Reinecke Gerrit Frommeyer Lukas J. Motloch Rudin Pistulli Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
| description |
Aims: Thromboembolic events, including stroke, are typical complications of COVID-19. Whether arrhythmias, frequently described in severe COVID-19, are disease-specific and thus promote strokes is unclear. We investigated the occurrence of arrhythmias and stroke during rhythm monitoring in critically ill patients with COVID-19, compared with severe pneumonia of other origins.Methods and Results: This retrospective study included 120 critically ill patients requiring mechanical ventilation in three European tertiary hospitals, including n =60 COVID-19, matched according to risk factors for the occurrence of arrhythmias in n = 60 patients from a retrospective consecutive cohort of severe pneumonia of other origins. Arrhythmias, mainly atrial fibrillation (AF), were frequent in COVID-19. However, when compared with non-COVID-19, no difference was observed with respect to ventricular tachycardias (VT) and relevant bradyarrhythmias (VT 10.0 vs. 8.4 %, p = ns and asystole 5.0 vs. 3.3%, p = ns) with consequent similar rates of cardiopulmonary resuscitation (6.7 vs. 10.0%, p = ns). AF was even more common in non-COVID-19 (AF 18.3 vs. 43.3%, p = 0.003; newly onset AF 10.0 vs. 30.0%, p = 0.006), which resulted in a higher need for electrical cardioversion (6.7 vs. 20.0%, p = 0.029). Despite these findings and comparable rates of therapeutic anticoagulation (TAC), the incidence of stroke was higher in COVID-19 (6.7.% vs. 0.0, p = 0.042). These events also happened in the absence of AF (50%) and with TAC (50%).Conclusions: Arrhythmias were common in severe COVID-19, consisting mainly of AF, yet less frequent than in matched pneumonia of other origins. A contrasting higher incidence of stroke independent of arrhythmias also observed with TAC, seems to be an arrhythmia-unrelated disease-specific feature of COVID-19. |
| format |
article |
| author |
Peter Jirak Zornitsa Shomanova Robert Larbig Robert Larbig Daniel Dankl Nino Frank Clemens Seelmaier Dominyka Butkiene Michael Lichtenauer Moritz Mirna Bernhard Strohmer Jan Sackarnd Uta C. Hoppe Jürgen Sindermann Holger Reinecke Gerrit Frommeyer Lukas J. Motloch Rudin Pistulli |
| author_facet |
Peter Jirak Zornitsa Shomanova Robert Larbig Robert Larbig Daniel Dankl Nino Frank Clemens Seelmaier Dominyka Butkiene Michael Lichtenauer Moritz Mirna Bernhard Strohmer Jan Sackarnd Uta C. Hoppe Jürgen Sindermann Holger Reinecke Gerrit Frommeyer Lukas J. Motloch Rudin Pistulli |
| author_sort |
Peter Jirak |
| title |
Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
| title_short |
Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
| title_full |
Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
| title_fullStr |
Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
| title_full_unstemmed |
Higher Incidence of Stroke in Severe COVID-19 Is Not Associated With a Higher Burden of Arrhythmias: Comparison With Other Types of Severe Pneumonia |
| title_sort |
higher incidence of stroke in severe covid-19 is not associated with a higher burden of arrhythmias: comparison with other types of severe pneumonia |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/0316fba39378471e9e5a784d47c7ab7c |
| work_keys_str_mv |
AT peterjirak higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT zornitsashomanova higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT robertlarbig higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT robertlarbig higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT danieldankl higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT ninofrank higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT clemensseelmaier higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT dominykabutkiene higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT michaellichtenauer higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT moritzmirna higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT bernhardstrohmer higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT jansackarnd higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT utachoppe higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT jurgensindermann higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT holgerreinecke higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT gerritfrommeyer higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT lukasjmotloch higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia AT rudinpistulli higherincidenceofstrokeinseverecovid19isnotassociatedwithahigherburdenofarrhythmiascomparisonwithothertypesofseverepneumonia |
| _version_ |
1718406361517129728 |