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31 days of COVID-19-cardiac events during restriction of public life-a comparative study.

ABSTRACT: AIMS:The coronavirus SARS-CoV-2 outbreak led to the most recent pandemic of the twenty-first century. To contain spread of the virus, many nations introduced a public lockdown. How the pandemic itself and measures of social restriction affect hospital admissions due to acute cardiac events has rarely been evaluated yet. METHODS AND RESULTS:German public authorities announced measures of social restriction between March 21st and April 20th, 2020. During this period, all patients suffering from an acute cardiac event admitted to our hospital (N?=?94) were assessed and incidence rate ratios (IRR) of admissions for acute cardiac events estimated, and compared with those during the same period in the previous three years (2017-2019, N?=?361). Admissions due to cardiac events were reduced by 22% as compared to the previous years (n?=?94 vs. an average of n?=?120 per year for 2017-2019). Whereas IRR for STEMI 1.20 (95% CI 0.67-2.14) and out-of-hospital cardiac arrest IRR 0.82 (95% CI 0.33-2.02) remained similar, overall admissions with an IRR of 0.78 (95% CI 0.62-0.98) and IRR for NSTEMI with 0.46 (95% CI 0.27-0.78) were significantly lower. In STEMI patients, plasma concentrations of high-sensitivity troponin T at admission were significantly higher (644 ng/l, IQR 372-2388) compared to 2017-2019 (195 ng/l, IQR 84-1134; p?=?0.02). CONCLUSION:The SARS-CoV-2 pandemic and concomitant social restrictions are associated with reduced cardiac events admissions to our tertiary care center. From a public health perspective, strategies have to be developed to assure patients are seeking and getting medical care and treatment in time during SARS-CoV-2 pandemic.

SUBMITTER: Rattka M

PROVIDER: S-EPMC7268583 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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31 days of COVID-19-cardiac events during restriction of public life-a comparative study.

Rattka Manuel M Baumhardt Michael M Dreyhaupt Jens J Rothenbacher Dietrich D Thiessen Kevin K Markovic Sinisa S Rottbauer Wolfgang W Imhof Armin A

Clinical research in cardiology : official journal of the German Cardiac Society 20200603 12

<h4>Aims</h4>The coronavirus SARS-CoV-2 outbreak led to the most recent pandemic of the twenty-first century. To contain spread of the virus, many nations introduced a public lockdown. How the pandemic itself and measures of social restriction affect hospital admissions due to acute cardiac events has rarely been evaluated yet.<h4>Methods and results</h4>German public authorities announced measures of social restriction between March 21st and April 20th, 2020. During this period, all patients su ...[more]

PMID: 32494921

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Project description:BackgroundCOVID-19 is associated with cardiac complications.ObjectivesThe purpose of this study was to estimate the prevalence, risk factors, and outcomes associated with acute cardiac events during COVID-19-associated hospitalizations among adults.MethodsDuring January 2021 to November 2021, medical chart abstraction was conducted on a probability sample of adults hospitalized with laboratory-confirmed SARS-CoV-2 infection identified from 99 U.S. counties in 14 U.S. states in the COVID-19-Associated Hospitalization Surveillance Network. We calculated the prevalence of acute cardiac events (identified by International Classification of Diseases-10th Revision-Clinical Modification codes) by history of underlying cardiac disease and examined associated risk factors and disease outcomes.ResultsAmong 8,460 adults, 11.4% (95% CI: 10.1%-12.9%) experienced an acute cardiac event during a COVID-19-associated hospitalization. Prevalence was higher among adults who had underlying cardiac disease (23.4%; 95% CI: 20.7%-26.3%) compared with those who did not (6.2%; 95% CI: 5.1%-7.6%). Acute ischemic heart disease (5.5%; 95% CI: 4.5%-6.5%) and acute heart failure (5.4%; 95% CI: 4.4%-6.6%) were the most prevalent events; 0.3% (95% CI: 0.1%-0.5%) experienced acute myocarditis or pericarditis. Risk factors varied by underlying cardiac disease status. Patients with ≥1 acute cardiac event had greater risk of intensive care unit admission (adjusted risk ratio: 1.9; 95% CI: 1.8-2.1) and in-hospital death (adjusted risk ratio: 1.7; 95% CI: 1.3-2.1) compared with those who did not.ConclusionsAcute cardiac events were common during COVID-19-associated hospitalizations, particularly among patients with underlying cardiac disease, and are associated with severe disease outcomes. Persons at greater risk for experiencing acute cardiac events during COVID-19-associated hospitalizations might benefit from more intensive clinical evaluation and monitoring during hospitalization.

Project description:BackgroundThe COVID-19 pandemic has become a global public health event, attracting worldwide attention. As a tool to monitor public awareness, internet search engines have been widely used in public health emergencies.ObjectiveThis study aims to use online search data (Baidu Index) to monitor the public's attention and verify internet search engines' function in public attention monitoring of public health emergencies.MethodsWe collected the Baidu Index and the case monitoring data from January 20, 2020, to April 20, 2020. We combined the Baidu Index of keywords related to COVID-19 to describe the public attention's temporal trend and spatial distribution, and conducted the time lag cross-correlation analysis.ResultsThe Baidu Index temporal trend indicated that the changes of the Baidu Index had a clear correspondence with the development time node of the pandemic. The Baidu Index spatial distribution showed that in the regions of central and eastern China, with denser populations, larger internet user bases, and higher economic development levels, the public was more concerned about COVID-19. In addition, the Baidu Index was significantly correlated with six case indicators of new confirmed cases, new death cases, new cured discharge cases, cumulative confirmed cases, cumulative death cases, and cumulative cured discharge cases. Moreover, the Baidu Index was 0-4 days earlier than new confirmed and new death cases, and about 20 days earlier than new cured and discharged cases while 3-5 days later than the change of cumulative cases.ConclusionsThe national public's demand for epidemic information is urgent regardless of whether it is located in the hardest hit area. The public was more sensitive to the daily new case data that represents the progress of the epidemic, but the public's attention to the epidemic situation in other areas may lag behind. We could set the Baidu Index as the sentinel and the database in the online infoveillance system for infectious disease and public health emergencies. According to the monitoring data, the government needs to prevent and control the possible outbreak in advance and communicate the risks to the public so as to ensure the physical and psychological health of the public in the epidemic.

Project description:ImportanceSupplemental oxygen is ubiquitously used in patients with COVID-19 and severe hypoxemia, but a lower dose may be beneficial.ObjectiveTo assess the effects of targeting a Pao2 of 60 mm Hg vs 90 mm Hg in patients with COVID-19 and severe hypoxemia in the intensive care unit (ICU).Design, setting, and participantsMulticenter randomized clinical trial including 726 adults with COVID-19 receiving at least 10 L/min of oxygen or mechanical ventilation in 11 ICUs in Europe from August 2020 to March 2023. The trial was prematurely stopped prior to outcome assessment due to slow enrollment. End of 90-day follow-up was June 1, 2023.InterventionsPatients were randomized 1:1 to a Pao2 of 60 mm Hg (lower oxygenation group; n = 365) or 90 mm Hg (higher oxygenation group; n = 361) for up to 90 days in the ICU.Main outcomes and measuresThe primary outcome was the number of days alive without life support (mechanical ventilation, circulatory support, or kidney replacement therapy) at 90 days. Secondary outcomes included mortality, proportion of patients with serious adverse events, and number of days alive and out of hospital, all at 90 days.ResultsOf 726 randomized patients, primary outcome data were available for 697 (351 in the lower oxygenation group and 346 in the higher oxygenation group). Median age was 66 years, and 495 patients (68%) were male. At 90 days, the median number of days alive without life support was 80.0 days (IQR, 9.0-89.0 days) in the lower oxygenation group and 72.0 days (IQR, 2.0-88.0 days) in the higher oxygenation group (P = .009 by van Elteren test; supplemental bootstrapped adjusted mean difference, 5.8 days [95% CI, 0.2-11.5 days]; P = .04). Mortality at 90 days was 30.2% in the lower oxygenation group and 34.7% in the higher oxygenation group (risk ratio, 0.86 [98.6% CI, 0.66-1.13]; P = .18). There were no statistically significant differences in proportion of patients with serious adverse events or in number of days alive and out of hospital.Conclusion and relevanceIn adult ICU patients with COVID-19 and severe hypoxemia, targeting a Pao2 of 60 mm Hg resulted in more days alive without life support in 90 days than targeting a Pao2 of 90 mm Hg.Trial registrationClinicalTrials.gov Identifier: NCT04425031.

Dataset Information

31 days of COVID-19-cardiac events during restriction of public life-a comparative study.

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31 days of COVID-19-cardiac events during restriction of public life-a comparative study.

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