Department of Internal Medicine, Hemet Global Medical Center, Hemet, California, USA.
Divison of Cardiology, Loma Linda University School of Medicine, Loma Linda, California, USA.
Clin Cardiol. 2021 Jun;44(6):857-862. doi: 10.1002/clc.23622. Epub 2021 May 8.
SARS-CoV2 has affected more than 73.8 million individuals. While SARS-CoV2 is considered a predominantly respiratory virus, we report a trend of bradycardia among hospitalized patients, particularly in association with mortality.
The multi-center retrospective analysis consisted of 1053 COVID-19 positive patients from March to August 2020. A trend of bradycardia was noted in the study population. Absolute bradycardia and profound bradycardia was defined as a sustained heart rate < 60 BPM and < 50 BPM, respectively, on two separate occasions, a minimum of 4 h apart during hospitalization. Each bradycardic event was confirmed by two physicians and exclusion criteria included: less than 18 years old, end of life bradycardia, left AMA, or taking AV Nodal blockers. Data was fetched using a SQL program through the EMR and data was analyzed using SPSS 27.0. A logistic regression was done to study the effect of bradycardia, age, gender, and BMI on mortality in the study group.
24.9% patients had absolute bradycardia while 13.0% had profound bradycardia. Patients with absolute bradycardia had an odds ratio of 6.59 (95% CI [2.83-15.36]) for mortality compared with individuals with a normal HR response. The logistic regression model explained 19.6% (Nagelkerke R ) of variance in the mortality, correctly classified 88.6% of cases, and was statistically significant X (5)=47.10, p < .001. For each year of age > 18, the odds of dying increased 1.048 times (95% CI [1.25-5.27]).
The incidence of absolute bradycardia was found in 24.9% of the study cohort and these individuals were found to have a significant increase in mortality.
SARS-CoV2 已影响超过 7380 万人。虽然 SARS-CoV2 被认为主要是一种呼吸道病毒，但我们报告了住院患者心动过缓的趋势，特别是与死亡率相关的趋势。
这项多中心回顾性分析纳入了 2020 年 3 月至 8 月期间的 1053 名 COVID-19 阳性患者。研究人群中注意到心动过缓的趋势。绝对心动过缓及严重心动过缓定义为两次间隔至少 4 小时，在住院期间两次分别至少持续 4 小时，心率 < 60 BPM 和 < 50 BPM。每次心动过缓事件均由两名医生确认，并排除标准包括：年龄小于 18 岁、生命终末期心动过缓、左前降支病变或服用房室结阻滞剂。使用 EMR 中的 SQL 程序获取数据，并使用 SPSS 27.0 进行数据分析。使用逻辑回归研究研究组中心动过缓、年龄、性别和 BMI 对死亡率的影响。
24.9%的患者存在绝对心动过缓，13.0%的患者存在严重心动过缓。与正常 HR 反应者相比，存在绝对心动过缓的患者的死亡比值比为 6.59（95%CI[2.83-15.36]）。逻辑回归模型解释了死亡率的 19.6%（Nagelkerke R）的变异性，正确分类了 88.6%的病例，且统计学上显著（X（5）=47.10，p<.001）。年龄每增加 1 岁，死亡的几率增加 1.048 倍（95%CI[1.25-5.27]）。
研究队列中发现 24.9%的患者存在绝对心动过缓，这些患者的死亡率显著增加。
