Electrocardiographic findings and prognostic values in patients hospitalised with COVID-19 in the World Heart Federation Global Study.

BACKGROUND: COVID-19 affects the cardiovascular system and ECG abnormalities may be associated with worse prognosis. We evaluated the prognostic value of ECG abnormalities in individuals with COVID-19. METHODS: Multicentre cohort study with adults hospitalised with COVID-19 from 40 hospitals across 23 countries. Patients were followed-up from admission until 30 days. ECG were obtained at each participating site and coded according to the Minnesota coding criteria. The primary outcome was defined as death from any cause. Secondary outcomes were admission to the intensive care unit (ICU) and major adverse cardiovascular events (MACE). Multiple logistic regression was used to evaluate the association of ECG abnormalities with the outcomes. RESULTS: Among 5313 participants, 2451 had at least one ECG and were included in this analysis. The mean age (SD) was 58.0 (16.1) years, 60.7% were male and 61.1% from lower-income to middle-income countries. The prevalence of major ECG abnormalities was 21.3% (n=521), 447 (18.2%) patients died, 196 (8.0%) had MACE and 1115 (45.5%) were admitted to an ICU. After adjustment, the presence of any major ECG abnormality was associated with a higher risk of death (OR 1.39; 95% CI 1.09 to 1.78) and cardiovascular events (OR 1.81; 95% CI 1.30 to 2.51). Sinus tachycardia (>120 bpm) with an increased risk of death (OR 3.86; 95% CI 1.97 to 7.48), MACE (OR 2.68; 95% CI 1.10 to 5.85) and ICU admission OR 1.99; 95% CI 1.03 to 4.00). Atrial fibrillation, bundle branch block, ischaemic abnormalities and prolonged QT interval did not relate to the outcomes. CONCLUSION: Major ECG abnormalities and a heart rate >120 bpm were prognostic markers in adults hospitalised with COVID-19.

Telemedicine during coronavirus disease-19 pandemic: a paradigm shift in cardiovascular care / La telemedicina durante la pandemia del COVID-19: un cambio de paradigma en la atención cardiovascular

Abstract Introduction: Severe acute respiratory syndrome due to coronavirus disease (COVID-19) has overwhelmingly affected the health-care systems globally. Delivering cardiovascular care has become unusually difficult both for caregivers and physicians in these unprecedented times. Methods: We briefly reviewed how cardiac care can be delivered to patients while limiting the exposure of both patients and healthcare workers through telemedicine services. We made a comparison at our institute of outpatient services through routine and telemedicine visits. Results: We found that telemedicine can be an equally effective alternative cardiac care during the times of pandemic with no significant difference in patients profile admitted through telemedicine services. Conclusions: We concluded that telemedicine can prove to be an effective tool in delivering cardiac care by limiting exposure of both patients and physicians with better triage of cardiac patients in the situation of COVID-19 pandemic and may complement to regular cardiac care in routine times.

Resumen Introducción: El síndrome respiratorio agudo grave dado por el COVID-19 ha afectado de manera abrumadora a los sistemas de salud a nivel mundial. La prestación de servicios de atención cardiovascular se ha tornado inusualmente difícil tanto para los cuidadores como para los médicos en estos tiempos inéditos. Métodos: Realizamos una revisión breve de cómo se puede brindar atención cardíaca a los pacientes a la vez que se limita la exposición tanto de pacientes como del personal de la salud a través de los servicios de telemedicina. Comparamos los servicios ambulatorios habituales con las visitas de telemedicina en nuestro instituto. Resultados: Encontramos que la tele medicina puede ser una alternativa igualmente efectiva de atención cardíaca durante tiempos de pandemia, sin ninguna diferencia significativa en el perfil de los pacientes ingresados a través de los servicios de telemedicina. Conclusiones: Concluimos que la telemedicina puede convertirse en una herramienta efectiva para proporcionar atención en salud cardíaca al limitar la exposición tanto de pacientes como de médicos con un mejor triage de pacientes cardíacos en el contexto de la pandemia por COVID-19, y puede llegar a ser un complemento de la atención cardíaca habitual en tiempos normales.