About: The Prognostic Value of Electrocardiogram at Presentation to Emergency Department in Patients With COVID-19

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	The Prognostic Value of Electrocardiogram at Presentation to Emergency Department in Patients With COVID-19
Creator	Kirtane, Ajay Madhavan, Mahesh Wan, Elaine Clerkin, Kevin Defilippis, Ersilia Dizon, Jose Ehlert, Frederick Fried, Justin Gavin, Nicholas Gupta, Aakriti Hripcsak, George Kumaraiah, Deepa Lawlor, Matthew Leon, Martin Morrow, John Natarajan, Karthik Poterucha, Timothy Rabbani, Leroy Saluja, Deepak Schwartz, Allan Sayer, Gabriel Uriel, Nir Yarmohammadi, Hirad Burkhoff, Dan Defilippis, Griffin Dizon, Saluja Elias, Pierre Ey, Wan Griffin, Jan Jain, Sneha Jp, Morrow Moses, Jeffrey Perotte, Adler Raikhelkar, Jayant Redfors, Bjorn Rosenblum, Hannah Roth, Zachary Ss, Jain Tj, Poterucha Zb, Roth
Source	Elsevier; PMC
abstract	ABSTRACT Background Rapid risk stratification is essential during the COVID-19 pandemic. We aimed to study whether combining vital signs and electrocardiogram (ECG) analysis can improve early prognostication. Methods 1,258 adults with COVID-19 seen at three hospitals in New York in March and April 2020 were analyzed. ECGs at presentation to the emergency department were systematically read by electrophysiologists. The primary outcome was a composite of mechanical ventilation or death 48 hours from diagnosis. The prognostic value of ECG abnormalities was assessed in a model adjusted for demographics, comorbidities, and vital signs. Results At 48 hours, 73 patients (6%) had died and 174 (14%) were alive but receiving mechanical ventilation with 277 (22%) patients dying by 30 days. Early development of respiratory failure was common, with 53% of all intubations occurring within 48 hours of presentation. In a multivariable logistic regression, atrial fibrillation/flutter (OR 2.5, 95% CI [1.1-6.2]), right ventricular strain (OR 2.7, 95% CI [1.3-6.1]), and ST segment abnormalities (OR 2.4, 95% CI [1.5-3.8]) were associated with death or mechanical ventilation at 48 hours. In 108 patients without these ECG abnormalities and with normal respiratory vitals (rate <20 and saturation >95%), only 5 (5%) died or required mechanical ventilation by 48 hours versus 68 of 216 patients (31%) having both ECG and respiratory vital sign abnormalities. Conclusions The combination of abnormal respiratory vital signs and ECG findings of atrial fibrillation/flutter, right ventricular strain, or ST segment abnormalities accurately prognosticates early deterioration in patients with COVID-19 and may assist with patient triage.
has issue date	2020-08-15(xsd:dateTime)
bibo:doi	10.1016/j.mayocp.2020.07.028
has license	els-covid
sha1sum (hex)	150586f05e3992aabab0a4b20fee24031ecc53d3
schema:url	https://doi.org/10.1016/j.mayocp.2020.07.028
resource representing a document's title	The Prognostic Value of Electrocardiogram at Presentation to Emergency Department in Patients With COVID-19
has PubMed Central identifier	PMC7428764
schema:publication	Mayo Clin Proc
resource representing a document's body	covid:150586f05e3992aabab0a4b20fee24031ecc53d3#body_text
is schema:about of	named entity 'electrocardiogram' named entity 'ECG' named entity 'Presenting' named entity 'Electrocardiogram' covid:arg/150586f05e3992aabab0a4b20fee24031ecc53d3 named entity 'Title' named entity 'ECG' named entity 'Short Title' named entity 'Prognostic' named entity 'COVID-19' named entity 'Electrocardiogram' named entity 'emergency department' named entity 'symptom' named entity 'Wuhan' named entity 'vital sign' named entity 'mmHg' named entity 'ESR' named entity 'diabetes' named entity 'decompensate' named entity 'ECG' named entity 'ECGs' named entity 'oxygen saturation' named entity 'comorbidities' named entity 'ventricular hypertrophy' named entity 'vital signs' named entity 'chest radiograph' named entity 'Myocardial injury' named entity 'SOFA score' named entity '3.4 million' named entity 'oxygen therapy' named entity 'ECG' named entity 'COVID' named entity 'COVID' named entity 'neutrophilia' named entity 'risk factors' named entity 'oxygen saturation' named entity 'ECG' named entity 'cardiovascular disease' named entity 'diabetes' named entity '15 A' named entity 'medical attention' named entity 'respiratory symptoms' named entity 'ECG' named entity 'triage'

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