Experience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 2019
Objectives:. Coronavirus disease 2019 is associated with high mortality rates and multiple organ damage. There is increasing evidence that these patients are at risk for various cardiovascular insults; however, there are currently no guidelines for the diagnosis and management of such cardiovascular...
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Wolters Kluwer
2020
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oai:doaj.org-article:a6206361b9f04169a224a5e6be8a86da2021-11-25T07:53:04ZExperience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 20192639-802810.1097/CCE.0000000000000288https://doaj.org/article/a6206361b9f04169a224a5e6be8a86da2020-12-01T00:00:00Zhttp://journals.lww.com/10.1097/CCE.0000000000000288https://doaj.org/toc/2639-8028Objectives:. Coronavirus disease 2019 is associated with high mortality rates and multiple organ damage. There is increasing evidence that these patients are at risk for various cardiovascular insults; however, there are currently no guidelines for the diagnosis and management of such cardiovascular complications in patients with coronavirus disease 2019. We share data and recommendations from a multidisciplinary team to highlight our institution’s clinical experiences and guidelines for managing cardiovascular complications of coronavirus disease 2019. Design, Setting, and Patients:. This was a retrospective cohort study of patients admitted to one of six ICUs dedicated to the care of patients with coronavirus disease 2019 located in three hospitals within one academic medical center in Atlanta, Georgia. Measurements/Interventions:. Chart review was conducted for sociodemographic, laboratory, and clinical data. Rates of specific cardiovascular complications were assessed, and data were analyzed using a chi-square or Wilcoxon rank-sum test for categorical and continuous variables. Additionally, certain cases are presented to demonstrate the sub committee’s recommendations. Main Results:. Two-hundred eighty-eight patients were admitted to the ICU with coronavirus disease 2019. Of these, 86 died (29.9%), 242 (84.03%) had troponin elevation, 70 (24.31%) had dysrhythmias, four (1.39%) had ST-elevation myocardial infarction, eight (2.78%) developed cor pulmonale, and 190 (65.97%) with shock. There was increased mortality risk in patients with greater degrees of troponin elevation (p < 0.001) and with the development of arrhythmias (p < 0.001), cor pulmonale (p < 0.001), and shock (p < 0.001). Conclusions:. While there are guidelines for the diagnosis and management of pulmonary complications of coronavirus disease 2019, there needs to be more information regarding the management of cardiovascular complications as well. These recommendations garnered from the coronavirus disease 2019 cardiology subcommittee from our institution will add to the existing knowledge of these potential cardiovascular insults as well as highlight suggestions for the diagnosis and management of the range of cardiovascular complications of coronavirus disease 2019. Additionally, with the spread of coronavirus disease 2019, our case-based recommendations provide a bedside resource for providers newly caring for patients with coronavirus disease 2019.Randi Connor-Schuler, MDA. Ian Wong, MDAnand Shah, MDBabar Fiza, MDMelissa Lyle, MDRichard Ramonell, MDMaxwell Hockstein, MDGeorge Chang, MDDavid Markham, MDCharles Searles, MDMichael McDaniel, MDJefferson Baer, MDCindy Powell, MDLisa Daniels, MDthe Emory COVID-19 Quality and Clinical Research CollaborativeMax W. AdelmanScott ArnoSara C. AuldTheresa BarnesWilliam BenderJames M. BlumGaurav BudhraniStephanie BusbyLaurence BusseMark Caridi-ScheibleDavid CarpenterNikulkumar ChaudhariCraig M. CoopersmithLisa DanielsJohnathan A. EdwardsJane FazioBabar FizaEliana GonzalezRia GripaldoCharles GrodzinRobert GroffAlfonso C. Hernandez-RomieuMax HocksteinDan HuntCraig S. JabaleyJesse T. JacobColleen KraftGreg S. MartinSamer MelhamNirja MehtaChelsea ModlinDavid J. MurphyJung ParkDeepa PatelCindy PowellAmit PrabhakarJeeyon RimRamzy RimawiChad RobichauxNicholas ScanlonMilad SharifpourBashar StaitiehMichael SterlingJonathan SuarezColin SwensonNancy ThakkarAlexander TruongHima VeeramachaneniAlvaro VelasquezMichael WaldmannMax WeinmannThanushi WynnJoel ZivotWolters KluwerarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care Explorations, Vol 2, Iss 12, p e0288 (2020) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 |
| spellingShingle |
Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Randi Connor-Schuler, MD A. Ian Wong, MD Anand Shah, MD Babar Fiza, MD Melissa Lyle, MD Richard Ramonell, MD Maxwell Hockstein, MD George Chang, MD David Markham, MD Charles Searles, MD Michael McDaniel, MD Jefferson Baer, MD Cindy Powell, MD Lisa Daniels, MD the Emory COVID-19 Quality and Clinical Research Collaborative Max W. Adelman Scott Arno Sara C. Auld Theresa Barnes William Bender James M. Blum Gaurav Budhrani Stephanie Busby Laurence Busse Mark Caridi-Scheible David Carpenter Nikulkumar Chaudhari Craig M. Coopersmith Lisa Daniels Johnathan A. Edwards Jane Fazio Babar Fiza Eliana Gonzalez Ria Gripaldo Charles Grodzin Robert Groff Alfonso C. Hernandez-Romieu Max Hockstein Dan Hunt Craig S. Jabaley Jesse T. Jacob Colleen Kraft Greg S. Martin Samer Melham Nirja Mehta Chelsea Modlin David J. Murphy Jung Park Deepa Patel Cindy Powell Amit Prabhakar Jeeyon Rim Ramzy Rimawi Chad Robichaux Nicholas Scanlon Milad Sharifpour Bashar Staitieh Michael Sterling Jonathan Suarez Colin Swenson Nancy Thakkar Alexander Truong Hima Veeramachaneni Alvaro Velasquez Michael Waldmann Max Weinmann Thanushi Wynn Joel Zivot Experience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 2019 |
| description |
Objectives:. Coronavirus disease 2019 is associated with high mortality rates and multiple organ damage. There is increasing evidence that these patients are at risk for various cardiovascular insults; however, there are currently no guidelines for the diagnosis and management of such cardiovascular complications in patients with coronavirus disease 2019. We share data and recommendations from a multidisciplinary team to highlight our institution’s clinical experiences and guidelines for managing cardiovascular complications of coronavirus disease 2019.
Design, Setting, and Patients:. This was a retrospective cohort study of patients admitted to one of six ICUs dedicated to the care of patients with coronavirus disease 2019 located in three hospitals within one academic medical center in Atlanta, Georgia.
Measurements/Interventions:. Chart review was conducted for sociodemographic, laboratory, and clinical data. Rates of specific cardiovascular complications were assessed, and data were analyzed using a chi-square or Wilcoxon rank-sum test for categorical and continuous variables. Additionally, certain cases are presented to demonstrate the sub committee’s recommendations.
Main Results:. Two-hundred eighty-eight patients were admitted to the ICU with coronavirus disease 2019. Of these, 86 died (29.9%), 242 (84.03%) had troponin elevation, 70 (24.31%) had dysrhythmias, four (1.39%) had ST-elevation myocardial infarction, eight (2.78%) developed cor pulmonale, and 190 (65.97%) with shock. There was increased mortality risk in patients with greater degrees of troponin elevation (p < 0.001) and with the development of arrhythmias (p < 0.001), cor pulmonale (p < 0.001), and shock (p < 0.001).
Conclusions:. While there are guidelines for the diagnosis and management of pulmonary complications of coronavirus disease 2019, there needs to be more information regarding the management of cardiovascular complications as well. These recommendations garnered from the coronavirus disease 2019 cardiology subcommittee from our institution will add to the existing knowledge of these potential cardiovascular insults as well as highlight suggestions for the diagnosis and management of the range of cardiovascular complications of coronavirus disease 2019. Additionally, with the spread of coronavirus disease 2019, our case-based recommendations provide a bedside resource for providers newly caring for patients with coronavirus disease 2019. |
| format |
article |
| author |
Randi Connor-Schuler, MD A. Ian Wong, MD Anand Shah, MD Babar Fiza, MD Melissa Lyle, MD Richard Ramonell, MD Maxwell Hockstein, MD George Chang, MD David Markham, MD Charles Searles, MD Michael McDaniel, MD Jefferson Baer, MD Cindy Powell, MD Lisa Daniels, MD the Emory COVID-19 Quality and Clinical Research Collaborative Max W. Adelman Scott Arno Sara C. Auld Theresa Barnes William Bender James M. Blum Gaurav Budhrani Stephanie Busby Laurence Busse Mark Caridi-Scheible David Carpenter Nikulkumar Chaudhari Craig M. Coopersmith Lisa Daniels Johnathan A. Edwards Jane Fazio Babar Fiza Eliana Gonzalez Ria Gripaldo Charles Grodzin Robert Groff Alfonso C. Hernandez-Romieu Max Hockstein Dan Hunt Craig S. Jabaley Jesse T. Jacob Colleen Kraft Greg S. Martin Samer Melham Nirja Mehta Chelsea Modlin David J. Murphy Jung Park Deepa Patel Cindy Powell Amit Prabhakar Jeeyon Rim Ramzy Rimawi Chad Robichaux Nicholas Scanlon Milad Sharifpour Bashar Staitieh Michael Sterling Jonathan Suarez Colin Swenson Nancy Thakkar Alexander Truong Hima Veeramachaneni Alvaro Velasquez Michael Waldmann Max Weinmann Thanushi Wynn Joel Zivot |
| author_facet |
Randi Connor-Schuler, MD A. Ian Wong, MD Anand Shah, MD Babar Fiza, MD Melissa Lyle, MD Richard Ramonell, MD Maxwell Hockstein, MD George Chang, MD David Markham, MD Charles Searles, MD Michael McDaniel, MD Jefferson Baer, MD Cindy Powell, MD Lisa Daniels, MD the Emory COVID-19 Quality and Clinical Research Collaborative Max W. Adelman Scott Arno Sara C. Auld Theresa Barnes William Bender James M. Blum Gaurav Budhrani Stephanie Busby Laurence Busse Mark Caridi-Scheible David Carpenter Nikulkumar Chaudhari Craig M. Coopersmith Lisa Daniels Johnathan A. Edwards Jane Fazio Babar Fiza Eliana Gonzalez Ria Gripaldo Charles Grodzin Robert Groff Alfonso C. Hernandez-Romieu Max Hockstein Dan Hunt Craig S. Jabaley Jesse T. Jacob Colleen Kraft Greg S. Martin Samer Melham Nirja Mehta Chelsea Modlin David J. Murphy Jung Park Deepa Patel Cindy Powell Amit Prabhakar Jeeyon Rim Ramzy Rimawi Chad Robichaux Nicholas Scanlon Milad Sharifpour Bashar Staitieh Michael Sterling Jonathan Suarez Colin Swenson Nancy Thakkar Alexander Truong Hima Veeramachaneni Alvaro Velasquez Michael Waldmann Max Weinmann Thanushi Wynn Joel Zivot |
| author_sort |
Randi Connor-Schuler, MD |
| title |
Experience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 2019 |
| title_short |
Experience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 2019 |
| title_full |
Experience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 2019 |
| title_fullStr |
Experience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 2019 |
| title_full_unstemmed |
Experience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 2019 |
| title_sort |
experience with cardiology-oriented outcomes in critically ill patients with coronavirus disease 2019 |
| publisher |
Wolters Kluwer |
| publishDate |
2020 |
| url |
https://doaj.org/article/a6206361b9f04169a224a5e6be8a86da |
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