Relative bradycardia in patients with COVID-19

Capoferri, Gioele; Osthoff, Michael; Egli, Adrian; Stoeckle, Marcel; Bassetti, Stefano

doi:10.1016/j.cmi.2020.08.013

Cited by 41 publications

(57 citation statements)

References 5 publications

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“…[4][5][6][7][8][9][10] Two papers speak specifically to associations between COVID-19 and relative bradycardia in adults, seen in states of high metabolic demand such as increased body temperature during which tachycardia would be expected. [11][12][13] One study found that one-third of adult patients with severe COVID-19 infection but overall stable vital signs developed sinus bradycardia at some point during the course of their illness. 4 Additionally, there are reports of adult patients infected with COVID-19 who develop bradycardia related to medications such as lopinavir-ritonavir, 14 hydroxychloroquine and other QT-interval-prolonging medications 15 and of course sedating medications.…”

Section: Discussionmentioning

confidence: 99%

Sinus bradycardia in a toddler with multisystem inflammatory syndrome in children (MIS-C) related to COVID-19

et al. 2021

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This report documents a case of sinus bradycardia in a hospitalised 27-month-old girl with a history of moderate persistent asthma, recent suspected viral respiratory infection and suspicion for multisystem inflammatory syndrome in children (MIS-C). This patient developed profound sinus bradycardia during her hospitalisation despite an overall well clinical appearance and good outcome. Reports of bradycardia related to COVID-19 infection are few but growing in number. In this article, we discuss what has been observed in the literature about bradycardia in relation to COVID-19 and MIS-C. We also propose sinus bradycardia as a potential sign of MIS-C with recent respiratory symptoms, which would warrant close follow-up of such patients.

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Section: Discussionmentioning

confidence: 99%

Sinus bradycardia in a toddler with multisystem inflammatory syndrome in children (MIS-C) related to COVID-19

et al. 2021

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“…Cardiovascular involvement during the course of SARS-CoV-2 infection has been increasingly reported [3]. However, very few data regarding RB are present, showing that age was associated with RB and that RB did not influence clinical outcomes [1,2]. Herein, we describe the prevalence and clinical features of RB at hospital admission in patients with COVID-19 and we found that it was present in 41.6% of subjects with COVID-19 and fever.…”

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confidence: 89%

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confidence: 99%

“…concomitant fever (BT ! 38.3 C) [1]. Median (interquartile range) and frequency with percentage were used for continuous and categorical variables.…”

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confidence: 99%

“…RB has been associated with several non-infectious and infectious conditions such as typhoid fever, Legionnaire's disease and leptospirosis [4]. Although generally referring to a condition characterized by an inverse relationship between temperature and HR, definition of RB widely differed among studies, leading to a high variation of its prevalence [1,2]. However, irrespective from the used definitions, RB was a common finding in COVID-19.…”

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Prevalence and clinical significance of relative bradycardia at hospital admission in patients with coronavirus disease 2019 (COVID-19)

Oliva

Franchi

Gatto

et al. 2021

Clinical Microbiology and Infection

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Heart rhythm disorders are increasingly reported during coronavirus virus disease 2019 and the presence of relative bradycardia (RB), known as an inappropriate low heart rate (HR) in response to an increased body temperature (BT), has been reported only occasionally [1]. However, its definition varied widely among studies and little is known regarding its role in predicting clinical outcomes [1,2]. We evaluated the prevalence and clinical significance of RB at hospital admission in patients with COVID-19. From March to September 2020, we performed a retrospective singlecentre study including all adult patients hospitalized at Policlinico Umberto I-Sapienza University (Rome) with confirmed COVID-19 (SARS-CoV-2 RNA detected by real-time PCR on nasopharyngeal swab). Exclusion criteria were treatment with HR-lowering agents and non-sinus rhythm at ECG. RB was defined as HR < 90 bpm and

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A novel study on SARS‐COV‐2 virus associated bradycardia as a predictor of mortality‐retrospective multicenter analysis

Kumar¹,

Arcuri²,

Chaudhuri³

et al. 2021

Clinical Cardiology

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Background 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. Methodology 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. Results 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 R2) of variance in the mortality, correctly classified 88.6% of cases, and was statistically significant X2 (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]). Conclusion 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.

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Relative bradycardia in patients with COVID-19

Cited by 41 publications

References 5 publications

Sinus bradycardia in a toddler with multisystem inflammatory syndrome in children (MIS-C) related to COVID-19

Sinus bradycardia in a toddler with multisystem inflammatory syndrome in children (MIS-C) related to COVID-19

Prevalence and clinical significance of relative bradycardia at hospital admission in patients with coronavirus disease 2019 (COVID-19)

A novel study on SARS‐COV‐2 virus associated bradycardia as a predictor of mortality‐retrospective multicenter analysis

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