PDF(Pubmed)
Abstract：
UNASSIGNED: Relative-tachycardia (RT), a phenomenon of unproportionately high heart-rate elevation in response to fever, has been previously attributed to unfavourable outcomes in severe-inflammatory-response-syndrome (SIRS). Relative heart-rate to body-temperature ratio (RHR) and its prognostic associations in patients with severe and critical coronavirus disease 2019 (COVID-19) have not been investigated.
UNASSIGNED: We retrospectively analyzed heart-rate and body-temperature data at admission in patients who were hospitalized due to COVID-19 at a tertiary center from March 2020 to June 2021. After excluding patients with known heart rate affecting medications (beta-blockers and other antiarrhythmics) and atrial fibrillation, a total of 3490 patients were analyzed. Patients were divided into quartiles based on RHR on admission, with patients belonging to the 1st quartile designated as having relative-bradycardia (RB) and patients belonging to 4th quartile designated as having RT. Comparisons with baseline clinical characteristics and the course of treatment were done.
UNASSIGNED: There were 57.5% male patients. Median age was 69 years. Most patients had severe or critical COVID-19 at admission. Median heart-rate at the time of hospital admission was 90/min, median body-temperature was 38 °C, and median RHR was 2.36 with interquartile-range 2.07-2.65. RB in comparison to middle-range RHR was significantly associated with older age, higher comorbidity burden, less severe COVID-19 and less pronounced inflammatory profile, and in comparison to RT additionally with higher frequency of hyperlipoproteinemia but lower frequency of obesity. RT in comparison to middle-range RHR was significantly associated with younger age, more severe COVID-19, lower comorbidity burden, lower frequency of arterial hypertension, higher frequency of diabetes mellitus, and more pronounced inflammatory profile. In multivariate analyses adjusted for clinically meaningful parameters, RB patients experienced more favorable survival compared to RT, whereas RT patients experienced higher mortality in comparison to RB and middle-range RHR patients, independently of older age, male sex, higher comorbidity burden and higher COVID-19 severity.
UNASSIGNED: Heart rate and axillary temperature are an indispensable part of a clinical exam, easy to measure, at effectively no cost. RT at admission, as a sign of excessive activation of the sympathetic nervous system, is independently associated with fatal outcomes in COVID-19 patients.
UNASSIGNED: We retrospectively analyzed heart-rate and body-temperature data at admission in patients who were hospitalized due to COVID-19 at a tertiary center from March 2020 to June 2021. After excluding patients with known heart rate affecting medications (beta-blockers and other antiarrhythmics) and atrial fibrillation, a total of 3490 patients were analyzed. Patients were divided into quartiles based on RHR on admission, with patients belonging to the 1st quartile designated as having relative-bradycardia (RB) and patients belonging to 4th quartile designated as having RT. Comparisons with baseline clinical characteristics and the course of treatment were done.
UNASSIGNED: There were 57.5% male patients. Median age was 69 years. Most patients had severe or critical COVID-19 at admission. Median heart-rate at the time of hospital admission was 90/min, median body-temperature was 38 °C, and median RHR was 2.36 with interquartile-range 2.07-2.65. RB in comparison to middle-range RHR was significantly associated with older age, higher comorbidity burden, less severe COVID-19 and less pronounced inflammatory profile, and in comparison to RT additionally with higher frequency of hyperlipoproteinemia but lower frequency of obesity. RT in comparison to middle-range RHR was significantly associated with younger age, more severe COVID-19, lower comorbidity burden, lower frequency of arterial hypertension, higher frequency of diabetes mellitus, and more pronounced inflammatory profile. In multivariate analyses adjusted for clinically meaningful parameters, RB patients experienced more favorable survival compared to RT, whereas RT patients experienced higher mortality in comparison to RB and middle-range RHR patients, independently of older age, male sex, higher comorbidity burden and higher COVID-19 severity.
UNASSIGNED: Heart rate and axillary temperature are an indispensable part of a clinical exam, easy to measure, at effectively no cost. RT at admission, as a sign of excessive activation of the sympathetic nervous system, is independently associated with fatal outcomes in COVID-19 patients.
摘要：
■相对心动过速（RT），因发烧而导致心率异常升高的现象，先前已被归因于严重炎症反应综合征（SIRS）的不利结局。尚未研究2019年重症和危重冠状病毒病（COVID-19）患者的相对心率与体温之比（RHR）及其预后相关性。
我们回顾性分析了2020年3月至2021年6月在三级中心因COVID-19住院的患者入院时的心率和体温数据。排除已知心率影响药物（β受体阻滞剂和其他抗心律失常药）和心房颤动的患者后，共对3490例患者进行了分析.入院时根据RHR将患者分为四分位数，属于第1四分位数的患者被指定为具有相对心动过缓（RB），属于第4四分位数的患者被指定为具有RT。与基线临床特征和治疗过程进行比较。
■有57.5%的男性患者。中位年龄为69岁。大多数患者入院时患有严重或危重的COVID-19。入院时的心率中位数为90/min，中位体温为38°C，中位数RHR为2.36，四分位数间距为2.07-2.65。与中档RHR相比，RB与年龄显着相关，较高的共病负担，不太严重的COVID-19和不太明显的炎症特征，与RT相比，高脂蛋白血症的发生率更高，但肥胖的发生率更低。与中档RHR相比，RT与年轻年龄显着相关，更严重的COVID-19，降低共病负担，动脉高血压的频率较低，糖尿病的发病率较高，和更明显的炎症特征。在针对有临床意义的参数进行调整的多变量分析中，与RT相比，RB患者的生存率更高，而与RB和中程RHR患者相比，RT患者的死亡率更高，独立于年龄，男性,更高的共病负担和更高的COVID-19严重程度。
■心率和腋窝温度是临床检查不可或缺的一部分，易于测量，实际上是没有成本的。RT在入院时，作为交感神经系统过度激活的标志，与COVID-19患者的致命结局独立相关。
我们回顾性分析了2020年3月至2021年6月在三级中心因COVID-19住院的患者入院时的心率和体温数据。排除已知心率影响药物（β受体阻滞剂和其他抗心律失常药）和心房颤动的患者后，共对3490例患者进行了分析.入院时根据RHR将患者分为四分位数，属于第1四分位数的患者被指定为具有相对心动过缓（RB），属于第4四分位数的患者被指定为具有RT。与基线临床特征和治疗过程进行比较。
■有57.5%的男性患者。中位年龄为69岁。大多数患者入院时患有严重或危重的COVID-19。入院时的心率中位数为90/min，中位体温为38°C，中位数RHR为2.36，四分位数间距为2.07-2.65。与中档RHR相比，RB与年龄显着相关，较高的共病负担，不太严重的COVID-19和不太明显的炎症特征，与RT相比，高脂蛋白血症的发生率更高，但肥胖的发生率更低。与中档RHR相比，RT与年轻年龄显着相关，更严重的COVID-19，降低共病负担，动脉高血压的频率较低，糖尿病的发病率较高，和更明显的炎症特征。在针对有临床意义的参数进行调整的多变量分析中，与RT相比，RB患者的生存率更高，而与RB和中程RHR患者相比，RT患者的死亡率更高，独立于年龄，男性,更高的共病负担和更高的COVID-19严重程度。
■心率和腋窝温度是临床检查不可或缺的一部分，易于测量，实际上是没有成本的。RT在入院时，作为交感神经系统过度激活的标志，与COVID-19患者的致命结局独立相关。
