Evidence map›Paper›PMID 35724437›Full record

ArticleJournal of infection and public health2022

Secondary bacterial infections are a leading factor triggering New Onset Atrial Fibrillation in intubated ICU Covid-19 ARDS patients.

George E Zakynthinos, Vasiliki Tsolaki, Nikitas Karavidas, Vassileios Vazgiourakis, George Dimeas, Konstantinos Mantzarlis, George Vavougios, Demosthenes Makris

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of infection and public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
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  3. Review
  4. Article
  5. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

George E ZakynthinosCritical Care Department, University Hospital of Larissa, University of Thessaly Faculty of Medicine, Greece.
Vasiliki TsolakiCritical Care Department, University Hospital of Larissa, University of Thessaly Faculty of Medicine, Greece. Electronic address: vasotsolaki@yahoo.com.
Nikitas KaravidasCritical Care Department, University Hospital of Larissa, University of Thessaly Faculty of Medicine, Greece.
Vassileios VazgiourakisCritical Care Department, University Hospital of Larissa, University of Thessaly Faculty of Medicine, Greece.
George DimeasUniversity of Thessaly Faculty of Medicine, Greece.
Konstantinos MantzarlisCritical Care Department, University Hospital of Larissa, University of Thessaly Faculty of Medicine, Greece.
George VavougiosDepartment of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Greece.
Demosthenes MakrisCritical Care Department, University Hospital of Larissa, University of Thessaly Faculty of Medicine, Greece.
University Hospital of Larissa · GRUniversity of Thessaly · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac arrhythmias, mainly atrial fibrillation (AF), is frequently reported in COVID-19 patients, more often in Intensive Care Unit (ICU) patients, yet causality has not been virtually explored. Moreover, non-Covid ICU patients frequently present AF, sepsis being the major trigger. We aimed to examine whether sepsis or other factors-apart from Covid-19 myocardial involvement-contribute to elicit New Onset AF (NOAF) in intubated ICU patients.

methodsConsecutive intubated, Covid-19ARDS patients, were prospectively studied for factors triggering NOAF. Demographics, data on Covid-19 infection duration, laboratory findings (troponin as well), severity of illness and ARDS were compared between NOAF and control group (no AF) on admission. In NOAF patients, echocardiographic findings, laboratory and secondary infection data on the AF day were compared to the preceding days and/or ICU admission data.

resultsAmong 105 patients screened, 79 were eligible; nineteen presented NOAF (24%). Baseline characteristics did not differ between the NOAF and control groups. Troponin levels were mildly elevated upon ICU admission in both groups. Left ventricular global longitudinal strain was impaired (<16.5%) in 63% vs 78% in the two groups, respectively. The right ventricle was mildly dilated, and pericardial effusion was present in 52 vs 43%, respectively. NOAF occurred on the 18 ± 4.8 days from Covid-19 symptoms' onset, and the 8.5 ± 2.1 ICUday. A septic secondary infection episode occurred in 89.5% of the patients in the NOAF group ( vs 41.6% in the control group (p < 0.001). In fact, NOAF occurred concurrently with a secondary septic episode in 84.2% of the patients. Sepsis presence was the only factor associated to NOAF occurrence (OR 16.63, p = 0.002). Noradrenaline, lactate and inflammation biomarkers gradually increased in the days before AF (all p < 0.05). Echocardiographic findings did not change on NOAF occurrence.

conclusionSecondary infections seem to be major contributors for NOAF occurrence in Covid-19 patients, probably playing the role of the "second hit" in an affected myocardium from Covid-19.

Indexed as

Atrial FibrillationBacterial InfectionsCoinfectionCOVID-19Cross InfectionRespiratory Distress SyndromeSepsisHumansIntensive Care UnitsRisk FactorsTroponinTroponinCovid-19 ARDSICUNew Onset Atrial FibrillationSepsisSeptic shock

Identifiers

PMID35724437
PMCPMC9385194
OpenAlexW4282974619

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.