Deceleration capacity is associated with acute respiratory distress syndrome in COVID-19

Mizera, Lars; Rath, Dominik; Schoellmann, Anna; Petersen-Uribe, Álvaro; Avdiu, Alban; Zdanytė, Monika; Jaeger, Philippa; Heinzmann, David; Müller, Karin; Gawaz, Meinrad; Eick, Christian; Duckheim, Martin

doi:10.1016/j.hrtlng.2021.07.016

Cited by 9 publications

(36 citation statements)

References 31 publications

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“…After removing duplicates, 1585 results remained and were evaluated for title and abstract check. Therefore, 65 reports were considered in the full-text review stage, and 20 of those were included in the systematic review [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48], while 45 reports were excluded: 2 papers written in Russian [49,50], 5 conference papers [51][52][53][54][55], 3 comments [56][57][58], 4 case reports or case series [59][60][61][62], 2 literature reviews [63,64], 1 study protocol [65], 12 studies that did not perform a formal evaluation of autonomic functions [66][67][68][69][70][71][72][73][74][75]…”

Section: Study Selectionmentioning

confidence: 99%

“…Finally, 22 studies were included in this systematic review [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]94,95]. Details regarding the selection process are available in the PRISMA diagram (Figure 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…Reports assessed as eligible-Refs. [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. Reports added from other sources-Refs.…”

Section: Study Selectionmentioning

confidence: 99%

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Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review

Scala

Rizzo

Bellavia

et al. 2022

JCM

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Although autonomic dysfunction (AD) after the recovery from Coronavirus disease 2019 (COVID-19) has been thoroughly described, few data are available regarding the involvement of the autonomic nervous system (ANS) during the acute phase of SARS-CoV-2 infection. The primary aim of this review was to summarize current knowledge regarding the AD occurring during acute COVID-19. Secondarily, we aimed to clarify the prognostic value of ANS involvement and the role of autonomic parameters in predicting SARS-CoV-2 infection. According to the PRISMA guidelines, we performed a systematic review across Scopus and PubMed databases, resulting in 1585 records. The records check and the analysis of included reports’ references allowed us to include 22 articles. The studies were widely heterogeneous for study population, dysautonomia assessment, and COVID-19 severity. Heart rate variability was the tool most frequently chosen to analyze autonomic parameters, followed by automated pupillometry. Most studies found ANS involvement during acute COVID-19, and AD was often related to a worse outcome. Further studies are needed to clarify the role of autonomic parameters in predicting SARS-CoV-2 infection. The evidence emerging from this review suggests that a complex autonomic nervous system imbalance is a prominent feature of acute COVID-19, often leading to a poor prognosis.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

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Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review

Scala

Rizzo

Bellavia

et al. 2022

JCM

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“…A study by Covino et al showed, however, that in patients aged ≥ 80 years and severe dementia were associated with poor outcome rather than increasing age itself. We and others have previously shown, that impaired myocardial function and elevated concentrations of cardiac biomarkers are associated with worse prognosis in COVID-19 [6 – 8] . SARS-CoV-2 promotes a pro-coagulant environment by inducing platelet activation and inhibiting fibrinolysis [9 – 12] , leading to thromboembolic complications including deep vein thrombosis, pulmonary embolism and myocardial infarction.…”

Section: Introductionmentioning

confidence: 73%

COVID-19 versus seasonal influenza: myocardial injury and prognostic importance

et al. 2022

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Background Acute myocardial injury is associated with poor prognosis in respiratory tract infections. We aimed to highlight the differences in prevalence of myocardial injury and its impact on prognosis in patients with COVID-19 compared to those with seasonal influenza. Methods This was a single-center prospective cohort study with a historical control group. 300 age-/sex-matched SARS-CoV-2 and seasonal influenza positive patients were enrolled. Myocardial injury was assessed by electrocardiogram (ECG), transthoracic echocardiography and biomarkers including high-sensitivity troponin-I. All patients were followed-up for 30 days after enrollment for all-cause mortalitiy, admission to the intensive care unit (ICU) and mechanical ventilation. Results Right ventricular distress was more common in COVID-19 whereas pathological ECG findings and impaired left ventricular function were more prevalent among influenza patients. COVID-19 patients suffered from a higher percentage of hypertension and dyslipidaemia. Contrary to COVID-19, pericardial effusion at admission was associated with poor outcome in the influenza group. Severe course of disease and respiratory failure resulted in significantly higher rates of ICU treatment and mechanical ventilation in COVID-19 patients. Although distribution of myocardial injury was similar, significantly fewer cardiac catheterizations were performed in COVID-19 patients. However, number of cardiac catheterizations was low in both groups. Finally, 30-day mortality was significantly higher in COVID-19 compared to influenza patients. Conclusions In adults requiring hospitalization due to COVID-19 or seasonal influenza, cardiovascular risk factors and signs of myocardial distress differ significantly. Furthermore, cardiovascular comorbidities may impair prognosis in COVID-19 patients to a higher degree than in their influenza counterparts.

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“…1 This virus is responsible for coronavirus disease 2019 (COVID-19), which can have different clinical presentations ranging from mild respiratory symptoms to extremely serious conditions that require intensive care, such as acute respiratory distress syndrome (ARDS). 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

Predictive Factors of Extubation Failure in COVID-19 Mechanically Ventilated Patients

Guzatti

Klein

Oliveira

et al. 2022

J Intensive Care Med

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Purpose: We investigated whether COVID-19 patients on mechanical ventilation (MV) had a different extubation outcome compared to non-COVID-19 patients while identifying predictive factors of extubation failure in the former. Methods: A retrospective, single-center, and observational study was done on 216 COVID-19 patients admitted to an intensive care unit (ICU) between March 2020 and March 2021, aged ≥ 18 years, in use of invasive MV for more than 24 h, which progressed to weaning. The primary outcome that was evaluated was extubation failure during ICU stay. A statistical analysis was performed to evaluate the association of patient characteristics with extubation outcome, and a Poisson regression model determined the predictive value. Results: Seventy-seven patients were extubated; the mean age was 57.2 years, 52.5% were male, and their mean APACHE II score at admission was 17.8. On average, MV duration until extubation was 8.7 ± 3.7 days, with 14.9 ± 10.1 days of ICU stay and 24.6 ± 14.0 days with COVID-19 symptoms. The rate of extubation failure (ie, the patient had to be reintubated during their ICU stay) was 22.1% (n = 17), while extubation was successful in 77.9% (n = 60) of cases. Failure was observed in only 7.8% of cases when evaluated 48 hours after extubation. The mean reintubation time was 4.28 days. After adjusting the analysis for age, sex, during of symptoms, days under MV, dialysis, and PaO2/FiO2 ratio, some parameters independently predicted extubation failure: age ≥ 66 years (APR = 5.12 [1.35-19.46]; p = 0.016), ≥ 31 days of symptoms (APR = 5.45 [0.48-62.19]; p = 0.016), and need for dialysis (APR = 5.10 [2.00-13.00]; p = 0.001), while a PaO2/FiO2 ratio >300 decreased the probability of extubation failure (APR = 0.14 [0.04-0.55]; p = 0.005). The presence of three predictors (ie, age ≥ 66 years, time of symptoms ≥ 31 days, need of dialysis, and PaO2/FiO2 ratio < 200) increased the risk of extubation failure by a factor of 23.0 (95% CI, 3.34-158.5). Conclusion: COVID-19 patients had an extubation failure risk that was almost three times higher than non-COVID-19 patients, with the extubation of the former being delayed compared to the latter. Furthermore, an age ≥ 66 years, time of symptoms ≥ 31 days, need of dialysis, and PaO2/FiO2 ratio > 200 were independent predictors for extubation failure, and the presence of three of these characteristics increased the risk of failure by a factor of 23.0.

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Deceleration capacity is associated with acute respiratory distress syndrome in COVID-19

Cited by 9 publications

References 31 publications

Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review

Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review

COVID-19 versus seasonal influenza: myocardial injury and prognostic importance

Predictive Factors of Extubation Failure in COVID-19 Mechanically Ventilated Patients

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