> top > docs > PMC:7796041 > spans > 2016-33632 > annotations

PMC:7796041 / 2016-33632 JSONTXT

Annnotations TAB JSON ListView MergeView

LitCovid-PubTator

Id Subject Object Predicate Lexical cue tao:has_database_id
101 186-194 Species denotes patients Tax:9606
102 588-596 Species denotes patients Tax:9606
103 791-798 Species denotes patient Tax:9606
104 904-912 Species denotes patients Tax:9606
105 1159-1167 Species denotes patients Tax:9606
106 1283-1291 Species denotes patients Tax:9606
107 1815-1823 Species denotes patients Tax:9606
108 1994-2001 Species denotes patient Tax:9606
109 46-70 Disease denotes coronavirus disease 2019 MESH:C000657245
110 72-80 Disease denotes COVID-19 MESH:C000657245
111 299-313 Disease denotes insufficiently MESH:D000309
112 357-374 Disease denotes myocardial injury MESH:D009202
113 579-587 Disease denotes COVID-19 MESH:C000657245
114 669-688 Disease denotes cardiac arrhythmias MESH:D001145
115 692-700 Disease denotes COVID-19 MESH:C000657245
116 850-868 Disease denotes cardiac arrhythmia MESH:D001145
117 995-1005 Disease denotes arrhythmia MESH:D001145
118 1087-1097 Disease denotes arrhythmia MESH:D001145
119 1132-1140 Disease denotes COVID-19 MESH:C000657245
120 1206-1208 Disease denotes AF MESH:D001281
121 1243-1253 Disease denotes arrhythmic MESH:D001145
122 1330-1349 Disease denotes cardiac arrhythmias MESH:D001145
123 1396-1405 Disease denotes mortality MESH:D003643
124 1409-1417 Disease denotes COVID-19 MESH:C000657245
125 1539-1550 Disease denotes arrhythmias MESH:D001145
126 1554-1562 Disease denotes COVID-19 MESH:C000657245
127 1792-1811 Disease denotes cardiac arrhythmias MESH:D001145
128 1841-1849 Disease denotes COVID-19 MESH:C000657245
129 1918-1937 Disease denotes cardiac arrhythmias MESH:D001145
131 2031-2038 Species denotes Patient Tax:9606
141 2053-2061 Species denotes patients Tax:9606
142 2197-2205 Species denotes patients Tax:9606
143 2525-2533 Species denotes patients Tax:9606
144 2590-2598 Species denotes patients Tax:9606
145 2664-2672 Species denotes patients Tax:9606
146 2067-2075 Disease denotes COVID-19 MESH:C000657245
147 2382-2402 Disease denotes SARS-CoV-2 infection MESH:C000657245
148 2600-2608 Disease denotes COVID-19 MESH:C000657245
149 2721-2741 Disease denotes SARS-CoV-2-infection MESH:C000657245
161 4256-4274 Gene denotes C-reactive protein Gene:1401
162 4276-4279 Gene denotes CRP Gene:1401
163 4285-4298 Gene denotes interleukin-6 Gene:3569
164 4300-4304 Gene denotes IL-6 Gene:3569
165 3424-3431 Species denotes patient Tax:9606
166 3996-4003 Species denotes patient Tax:9606
167 4432-4440 Species denotes patients Tax:9606
168 3682-3693 Disease denotes arrhythmias MESH:D001145
169 3792-3802 Disease denotes arrhythmia MESH:D001145
170 3964-3974 Disease denotes arrhythmia MESH:D001145
171 4402-4409 Disease denotes obesity MESH:D009765
173 4541-4548 Species denotes patient Tax:9606
183 6075-6082 Species denotes patient Tax:9606
184 6288-6296 Species denotes patients Tax:9606
185 5176-5194 Chemical denotes hydroxychloroquine MESH:D006886
186 5222-5240 Chemical denotes hydroxychloroquine MESH:D006886
187 5245-5257 Chemical denotes azithromycin MESH:D017963
188 5102-5112 Disease denotes arrhythmia MESH:D001145
189 5138-5150 Disease denotes hypertension MESH:D006973
190 5152-5174 Disease denotes cardiovascular disease MESH:D002318
191 6343-6353 Disease denotes arrhythmia MESH:D001145
194 6437-6445 Species denotes patients Tax:9606
195 6514-6532 Disease denotes cardiac arrhythmia MESH:D001145
197 6781-6791 Disease denotes arrhythmia MESH:D001145
202 7281-7289 Species denotes patients Tax:9606
203 7095-7105 Disease denotes arrhythmia MESH:D001145
204 7368-7390 Disease denotes cardiovascular disease MESH:D002318
205 7459-7467 Disease denotes COVID-19 MESH:C000657245
215 7617-7625 Species denotes patients Tax:9606
216 7646-7654 Species denotes patients Tax:9606
217 7790-7798 Species denotes patients Tax:9606
218 7548-7567 Disease denotes atrial fibrillation MESH:D001281
219 7569-7571 Disease denotes AF MESH:D001281
220 7640-7642 Disease denotes AF MESH:D001281
221 7684-7686 Disease denotes AF MESH:D001281
222 7701-7703 Disease denotes AF MESH:D001281
223 7813-7815 Disease denotes AF MESH:D001281
242 8299-8307 Species denotes patients Tax:9606
243 9008-9016 Species denotes patients Tax:9606
244 9080-9088 Species denotes patients Tax:9606
245 9201-9209 Species denotes patients Tax:9606
246 9224-9232 Species denotes patients Tax:9606
247 8345-8357 Disease denotes hypertension MESH:D006973
248 8415-8437 Disease denotes Cardiovascular disease MESH:D002318
249 8469-8483 Disease denotes cardiomyopathy MESH:D009202
250 8501-8518 Disease denotes diabetes mellitus MESH:D003920
251 8542-8549 Disease denotes obesity MESH:D009765
252 8608-8625 Disease denotes pulmonary disease MESH:D008171
253 8633-8670 Disease denotes chronic obstructive pulmonary disease MESH:D029424
254 8672-8690 Disease denotes pulmonary fibrosis MESH:D011658
255 8730-8744 Disease denotes cancer disease MESH:D009369
256 8794-8810 Disease denotes immunodeficiency MESH:D007153
257 8890-8911 Disease denotes hematological disease MESH:D006402
258 9255-9262 Disease denotes syncope MESH:D013575
259 9283-9291 Disease denotes COVID-19 MESH:C000657245
270 9414-9422 Species denotes patients Tax:9606
271 9569-9577 Species denotes patients Tax:9606
272 9658-9666 Species denotes patients Tax:9606
273 9955-9963 Species denotes patients Tax:9606
274 10048-10056 Species denotes patients Tax:9606
275 10079-10087 Species denotes patients Tax:9606
276 10207-10215 Species denotes patients Tax:9606
277 10305-10313 Species denotes patients Tax:9606
278 9587-9593 Chemical denotes oxygen MESH:D010100
279 9836-9842 Chemical denotes oxygen MESH:D010100
303 10496-10503 Species denotes patient Tax:9606
304 10590-10597 Species denotes patient Tax:9606
305 10736-10744 Species denotes patients Tax:9606
306 10900-10907 Species denotes patient Tax:9606
307 10982-10989 Species denotes patient Tax:9606
308 11251-11258 Species denotes patient Tax:9606
309 11405-11413 Species denotes patients Tax:9606
310 11433-11441 Species denotes patients Tax:9606
311 11692-11699 Species denotes patient Tax:9606
312 10463-10474 Disease denotes myocarditis MESH:D009205
313 10610-10629 Disease denotes respiratory failure MESH:D012131
314 10682-10693 Disease denotes myocarditis MESH:D009205
315 10765-10786 Disease denotes myocardial infarction MESH:D009203
316 10944-10965 Disease denotes myocardial infarction MESH:D009203
317 11020-11041 Disease denotes myocardial infarction MESH:D009203
318 11179-11199 Disease denotes respiratory symptoms MESH:D012818
319 11335-11343 Disease denotes ischemia MESH:D007511
320 11345-11351 Disease denotes Stroke MESH:D020521
321 11365-11373 Disease denotes ischemic MESH:D007511
322 11492-11511 Disease denotes respiratory failure MESH:D012131
323 11582-11587 Disease denotes death MESH:D003643
324 11635-11662 Disease denotes cardiac circulatory failure MESH:D006333
325 11725-11747 Disease denotes cardiovascular disease MESH:D002318
328 11755-11766 Disease denotes Arrhythmias MESH:D001145
329 11794-11802 Disease denotes COVID-19 MESH:C000657245
346 11820-11828 Species denotes patients Tax:9606
347 12011-12019 Species denotes patients Tax:9606
348 12071-12079 Species denotes patients Tax:9606
349 12121-12128 Species denotes patient Tax:9606
350 12186-12194 Species denotes patients Tax:9606
351 12386-12394 Species denotes patients Tax:9606
352 11847-11858 Disease denotes arrhythmias MESH:D001145
353 11908-11918 Disease denotes arrhythmia MESH:D001145
354 12029-12049 Disease denotes SARS-CoV-2 infection MESH:C000657245
355 12101-12103 Disease denotes AF MESH:D001281
356 12149-12160 Disease denotes bradycardia MESH:D001919
357 12223-12233 Disease denotes arrhythmia MESH:D001145
358 12297-12307 Disease denotes arrhythmia MESH:D001145
359 12361-12371 Disease denotes arrhythmia MESH:D001145
360 12444-12454 Disease denotes arrhythmia MESH:D001145
361 12484-12492 Disease denotes COVID-19 MESH:C000657245
396 12645-12653 Species denotes patients Tax:9606
397 12733-12741 Species denotes patients Tax:9606
398 12927-12934 Species denotes patient Tax:9606
399 13066-13074 Species denotes patients Tax:9606
400 13245-13252 Species denotes patient Tax:9606
401 13357-13365 Species denotes patients Tax:9606
402 13534-13542 Species denotes patients Tax:9606
403 13617-13625 Species denotes patients Tax:9606
404 13634-13642 Species denotes Patients Tax:9606
405 13768-13776 Species denotes patients Tax:9606
406 13846-13854 Species denotes patients Tax:9606
407 13464-13474 Chemical denotes Amiodarone MESH:D000638
408 12509-12519 Disease denotes arrhythmia MESH:D001145
409 12557-12565 Disease denotes COVID-19 MESH:C000657245
410 12567-12569 Disease denotes AF MESH:D001281
411 12598-12608 Disease denotes arrhythmia MESH:D001145
412 12675-12685 Disease denotes arrhythmia MESH:D001145
413 12763-12773 Disease denotes arrhythmia MESH:D001145
414 12822-12824 Disease denotes AF MESH:D001281
415 12862-12872 Disease denotes arrhythmia MESH:D001145
416 12874-12885 Disease denotes Bradycardia MESH:D001919
417 12982-12993 Disease denotes bradycardia MESH:D001919
418 13098-13121 Disease denotes ventricular tachycardia MESH:D017180
419 13123-13125 Disease denotes VT MESH:D017180
420 13172-13174 Disease denotes VT MESH:D017180
421 13204-13228 Disease denotes Ventricular fibrillation MESH:D014693
422 13258-13280 Disease denotes cardiovascular disease MESH:D002318
423 13323-13346 Disease denotes ventricular tachycardia MESH:D017180
424 13460-13462 Disease denotes AF MESH:D001281
425 13648-13659 Disease denotes arrhythmias MESH:D001145
426 13782-13784 Disease denotes AF MESH:D001281
427 13863-13874 Disease denotes arrhythmias MESH:D001145
428 13909-13926 Disease denotes venous thrombosis MESH:D020246
429 13930-13948 Disease denotes pulmonary embolism MESH:D011655
431 13990-14001 Disease denotes Arrhythmias MESH:D001145
452 14137-14145 Species denotes patients Tax:9606
453 14166-14174 Species denotes patients Tax:9606
454 14241-14249 Species denotes Patients Tax:9606
455 14407-14415 Species denotes patients Tax:9606
456 14708-14716 Species denotes patients Tax:9606
457 14764-14772 Species denotes patients Tax:9606
458 14998-15006 Species denotes patients Tax:9606
459 14658-14676 Chemical denotes hydroxychloroquine MESH:D006886
460 14810-14822 Chemical denotes azithromycin MESH:D017963
461 15026-15044 Chemical denotes hydroxychloroquine MESH:D006886
462 14051-14062 Disease denotes arrhythmias MESH:D001145
463 14090-14098 Disease denotes COVID-19 MESH:C000657245
464 14151-14161 Disease denotes arrhythmia MESH:D001145
465 14183-14193 Disease denotes arrhythmia MESH:D001145
466 14221-14229 Disease denotes COVID-19 MESH:C000657245
467 14255-14266 Disease denotes arrhythmias MESH:D001145
468 14317-14329 Disease denotes hypertension MESH:D006973
469 14334-14356 Disease denotes cardiovascular disease MESH:D002318
470 14421-14431 Disease denotes arrhythmia MESH:D001145
471 14629-14637 Disease denotes COVID-19 MESH:C000657245
483 15844-15852 Species denotes patients Tax:9606
484 15162-15184 Disease denotes cardiovascular disease MESH:D002318
485 15189-15201 Disease denotes hypertension MESH:D006973
486 15236-15246 Disease denotes arrhythmia MESH:D001145
487 15403-15425 Disease denotes cardiovascular disease MESH:D002318
488 15481-15491 Disease denotes arrhythmia MESH:D001145
489 15495-15503 Disease denotes COVID-19 MESH:C000657245
490 15527-15539 Disease denotes hypertension MESH:D006973
491 15867-15877 Disease denotes arrhythmia MESH:D001145
492 15910-15920 Disease denotes arrhythmia MESH:D001145
493 16110-16120 Disease denotes arrhythmia MESH:D001145
499 16529-16533 Gene denotes IL-6 Gene:3569
500 16664-16667 Gene denotes CRP Gene:1401
501 16398-16406 Species denotes patients Tax:9606
502 16412-16422 Disease denotes arrhythmia MESH:D001145
503 16567-16577 Disease denotes arrhythmia MESH:D001145
505 16741-16751 Disease denotes Arrhythmia MESH:D001145
521 16822-16830 Species denotes patients Tax:9606
522 17053-17061 Species denotes patients Tax:9606
523 17271-17279 Species denotes Patients Tax:9606
524 17443-17451 Species denotes patients Tax:9606
525 17670-17678 Species denotes patients Tax:9606
526 17404-17410 Chemical denotes oxygen MESH:D010100
527 16836-16846 Disease denotes arrhythmia MESH:D001145
528 16863-16871 Disease denotes COVID-19 MESH:C000657245
529 16993-17003 Disease denotes arrhythmia MESH:D001145
530 17067-17077 Disease denotes arrhythmia MESH:D001145
531 17175-17185 Disease denotes arrhythmia MESH:D001145
532 17294-17304 Disease denotes arrhythmia MESH:D001145
533 17457-17467 Disease denotes arrhythmia MESH:D001145
534 17501-17520 Disease denotes respiratory failure MESH:D012131
535 17696-17706 Disease denotes arrhythmia MESH:D001145
561 17794-17801 Species denotes patient Tax:9606
562 17951-17958 Species denotes patient Tax:9606
563 18043-18051 Species denotes patients Tax:9606
564 18076-18084 Species denotes patients Tax:9606
565 18214-18221 Species denotes patient Tax:9606
566 18375-18383 Species denotes patients Tax:9606
567 18189-18196 Chemical denotes heparin MESH:D006493
568 18222-18229 Chemical denotes heparin MESH:D006493
569 17749-17770 Disease denotes myocardial infarction MESH:D009203
570 17813-17823 Disease denotes arrhythmia MESH:D001145
571 17881-17887 Disease denotes Stroke MESH:D020521
572 17901-17909 Disease denotes ischemic MESH:D007511
573 17970-17980 Disease denotes arrhythmia MESH:D001145
574 18010-18012 Disease denotes AF MESH:D001281
575 18060-18070 Disease denotes arrhythmia MESH:D001145
576 18090-18111 Disease denotes myocardial infarction MESH:D009203
577 18115-18121 Disease denotes stroke MESH:D020521
578 18290-18298 Disease denotes bleeding MESH:D006470
579 18326-18335 Disease denotes mortality MESH:D003643
580 18366-18374 Disease denotes COVID-19 MESH:C000657245
581 18398-18408 Disease denotes arrhythmia MESH:D001145
582 18580-18590 Disease denotes arrhythmia MESH:D001145
583 18739-18761 Disease denotes cardiovascular disease MESH:D002318
584 18804-18826 Disease denotes cardiovascular disease MESH:D002318
585 18875-18884 Disease denotes mortality MESH:D003643
588 18931-18939 Species denotes Patients Tax:9606
589 18945-18964 Disease denotes Atrial Fibrillation MESH:D001281
629 19098-19106 Species denotes patients Tax:9606
630 19298-19306 Species denotes patients Tax:9606
631 19754-19762 Species denotes patients Tax:9606
632 19902-19910 Species denotes patients Tax:9606
633 19931-19939 Species denotes patients Tax:9606
634 20111-20119 Species denotes patients Tax:9606
635 20255-20262 Species denotes patient Tax:9606
636 20530-20537 Species denotes patient Tax:9606
637 20685-20693 Species denotes patients Tax:9606
638 20760-20767 Species denotes patient Tax:9606
639 20790-20798 Species denotes patients Tax:9606
640 20365-20372 Species denotes patient Tax:9606
641 19535-19541 Chemical denotes oxygen MESH:D010100
642 19843-19850 Chemical denotes heparin MESH:D006493
643 19852-19856 Chemical denotes LMWH MESH:D006495
644 19976-19980 Chemical denotes LMWH MESH:D006495
645 20245-20249 Chemical denotes LMWH MESH:D006495
646 18965-18984 Disease denotes Atrial fibrillation MESH:D001281
647 19022-19032 Disease denotes arrhythmia MESH:D001145
648 19060-19068 Disease denotes COVID-19 MESH:C000657245
649 19121-19123 Disease denotes AF MESH:D001281
650 19130-19142 Disease denotes hypertension MESH:D006973
651 19147-19169 Disease denotes cardiovascular disease MESH:D002318
652 19208-19218 Disease denotes arrhythmia MESH:D001145
653 19312-19314 Disease denotes AF MESH:D001281
654 19351-19361 Disease denotes arrhythmia MESH:D001145
655 19385-19387 Disease denotes AF MESH:D001281
656 19768-19770 Disease denotes AF MESH:D001281
657 19798-19806 Disease denotes COVID-19 MESH:C000657245
658 20051-20053 Disease denotes AF MESH:D001281
659 20103-20105 Disease denotes AF MESH:D001281
660 20127-20129 Disease denotes AF MESH:D001281
661 20159-20180 Disease denotes myocardial infarction MESH:D009203
662 20347-20355 Disease denotes ischemia MESH:D007511
663 20466-20474 Disease denotes bleeding MESH:D006470
664 20578-20599 Disease denotes myocardial infarction MESH:D009203
665 20676-20681 Disease denotes death MESH:D003643
666 20699-20701 Disease denotes AF MESH:D001281
667 20815-20834 Disease denotes respiratory failure MESH:D012131
675 20851-20870 Disease denotes Cardiac arrhythmias MESH:D001145
676 20942-20950 Disease denotes COVID-19 MESH:C000657245
677 20960-20982 Disease denotes cardiovascular disease MESH:D002318
678 21036-21047 Disease denotes arrhythmias MESH:D001145
679 21049-21059 Disease denotes Arrhythmia MESH:D001145
680 21119-21136 Disease denotes myocardial injury MESH:D009202
681 21198-21207 Disease denotes mortality MESH:D003643
687 21670-21677 Species denotes patient Tax:9606
688 21436-21447 Disease denotes arrhythmias MESH:D001145
689 21471-21479 Disease denotes COVID-19 MESH:C000657245
690 21601-21612 Disease denotes arrhythmias MESH:D001145
691 21661-21669 Disease denotes COVID-19 MESH:C000657245
707 21829-21837 Species denotes patients Tax:9606
708 22078-22086 Species denotes patients Tax:9606
709 22121-22128 Species denotes patient Tax:9606
710 21995-22004 Species denotes influenza Tax:11309
711 21737-21739 Disease denotes AF MESH:D001281
712 21769-21779 Disease denotes arrhythmia MESH:D001145
713 21870-21880 Disease denotes arrhythmia MESH:D001145
714 21903-21905 Disease denotes AF MESH:D001281
715 21951-21979 Disease denotes respiratory virus infections
716 22069-22077 Disease denotes COVID-19 MESH:C000657245
717 22159-22161 Disease denotes AF MESH:D001281
718 22233-22250 Disease denotes myocardial injury MESH:D009202
719 22392-22400 Disease denotes COVID-19 MESH:C000657245
720 22423-22425 Disease denotes AF MESH:D001281
721 22530-22549 Disease denotes atrial fibrillation MESH:D001281
746 23048-23056 Species denotes patients Tax:9606
747 23172-23180 Species denotes patients Tax:9606
748 23372-23380 Species denotes patients Tax:9606
749 23821-23829 Species denotes patients Tax:9606
750 23942-23950 Species denotes patients Tax:9606
751 23237-23255 Chemical denotes hydroxychloroquine MESH:D006886
752 23260-23272 Chemical denotes azithromycin MESH:D017963
753 23539-23557 Chemical denotes hydroxychloroquine MESH:D006886
754 23618-23630 Chemical denotes azithromycin MESH:D017963
755 23960-23963 Chemical denotes QTc
756 22589-22599 Disease denotes arrhythmia MESH:D001145
757 22637-22645 Disease denotes COVID-19 MESH:C000657245
758 22682-22704 Disease denotes cardiovascular disease MESH:D002318
759 22745-22755 Disease denotes arrhythmia MESH:D001145
760 22852-22862 Disease denotes arrhythmia MESH:D001145
761 22914-22933 Disease denotes infectious diseases MESH:D003141
762 23062-23072 Disease denotes arrhythmia MESH:D001145
763 23503-23535 Disease denotes prolongation of the QTc interval MESH:D008133
764 23561-23569 Disease denotes COVID-19 MESH:C000657245
765 23680-23702 Disease denotes ventricular arrhythmia MESH:D001145
766 23757-23777 Disease denotes torsades des pointes MESH:D016171
767 23835-23858 Disease denotes ventricular arrhythmias MESH:D001145
768 23872-23894 Disease denotes cardiovascular disease MESH:D002318
769 24059-24082 Disease denotes ventricular arrhythmias MESH:D001145
792 24258-24262 Gene denotes IL-6 Gene:3569
793 25097-25101 Gene denotes IL-6 Gene:3569
794 24151-24159 Species denotes Patients Tax:9606
795 24660-24668 Species denotes patients Tax:9606
796 25105-25113 Species denotes patients Tax:9606
797 25495-25502 Species denotes patient Tax:9606
798 24538-24544 Chemical denotes oxygen MESH:D010100
799 24750-24756 Chemical denotes oxygen MESH:D010100
800 24165-24176 Disease denotes arrhythmias MESH:D001145
801 24264-24281 Disease denotes Myocardial injury MESH:D009202
802 24285-24293 Disease denotes COVID-19 MESH:C000657245
803 24416-24426 Disease denotes arrhythmia MESH:D001145
804 24687-24709 Disease denotes cardiovascular disease MESH:D002318
805 24783-24793 Disease denotes arrhythmia MESH:D001145
806 24814-24831 Disease denotes myocardial injury MESH:D009202
807 24835-24843 Disease denotes ischemia MESH:D007511
808 24894-24916 Disease denotes cardiovascular disease MESH:D002318
809 25119-25130 Disease denotes arrhythmias MESH:D001145
810 25149-25157 Disease denotes COVID-19 MESH:C000657245
811 25233-25252 Disease denotes respiratory failure MESH:D012131
812 25257-25274 Disease denotes myocardial injury MESH:D009202
813 25374-25384 Disease denotes arrhythmia MESH:D001145
817 26083-26089 Chemical denotes oxygen MESH:D010100
818 25783-25793 Disease denotes arrhythmia MESH:D001145
819 26297-26314 Disease denotes cardia arrhythmia MESH:D001145
833 26598-26606 Species denotes patients Tax:9606
834 27010-27018 Species denotes patients Tax:9606
835 27203-27211 Species denotes patients Tax:9606
836 26422-26433 Disease denotes arrhythmias MESH:D001145
837 26468-26490 Disease denotes cardiovascular disease MESH:D002318
838 26621-26631 Disease denotes arrhythmia MESH:D001145
839 26786-26796 Disease denotes arrhythmia MESH:D001145
840 26800-26808 Disease denotes COVID-19 MESH:C000657245
841 26892-26900 Disease denotes COVID-19 MESH:C000657245
842 27024-27043 Disease denotes atrial fibrillation MESH:D001281
843 27064-27087 Disease denotes ventricular arrhythmias MESH:D001145
844 27097-27125 Disease denotes supraventricular arrhythmias MESH:D001145
845 27194-27202 Disease denotes COVID-19 MESH:C000657245
856 27814-27824 Species denotes SARS-CoV-2 Tax:2697049
857 27213-27223 Disease denotes Arrhythmia MESH:D001145
858 27251-27259 Disease denotes COVID-19 MESH:C000657245
859 27302-27311 Disease denotes mortality MESH:D003643
860 27395-27417 Disease denotes cardiovascular disease MESH:D002318
861 27470-27488 Disease denotes cardiac arrhythmia MESH:D001145
862 27564-27583 Disease denotes respiratory failure MESH:D012131
863 27691-27696 Disease denotes death MESH:D003643
864 27700-27708 Disease denotes COVID-19 MESH:C000657245
865 27799-27808 Disease denotes infection MESH:D007239
871 28324-28332 Species denotes patients Tax:9606
872 28160-28170 Disease denotes arrhythmia MESH:D001145
873 28206-28216 Disease denotes arrhythmic MESH:D001145
874 28309-28320 Disease denotes arrhythmias MESH:D001145
875 28423-28434 Disease denotes arrhythmias MESH:D001145
878 29026-29034 Species denotes patients Tax:9606
879 29094-29102 Species denotes patients Tax:9606
891 29806-29814 Species denotes Patients Tax:9606
892 30075-30083 Species denotes patients Tax:9606
893 30616-30624 Species denotes patients Tax:9606
894 31056-31064 Species denotes patients Tax:9606
895 30392-30410 Chemical denotes hydroxochloroquine
896 29796-29804 Disease denotes COVID-19 MESH:C000657245
897 30376-30384 Disease denotes COVID-19 MESH:C000657245
898 30544-30554 Disease denotes arrhythmia MESH:D001145
899 30814-30824 Disease denotes arrhythmia MESH:D001145
900 30852-30860 Disease denotes COVID-19 MESH:C000657245
901 31047-31055 Disease denotes COVID-19 MESH:C000657245
911 31123-31131 Species denotes patients Tax:9606
912 31390-31398 Species denotes patients Tax:9606
913 31578-31586 Species denotes patients Tax:9606
914 31137-31155 Disease denotes cardiac arrhythmia MESH:D001145
915 31183-31191 Disease denotes COVID-19 MESH:C000657245
916 31355-31372 Disease denotes myocardial injury MESH:D009202
917 31456-31466 Disease denotes arrhythmic MESH:D001145
918 31477-31485 Disease denotes COVID-19 MESH:C000657245
919 31531-31542 Disease denotes arrhythmias MESH:D001145

LitCovid-PD-HP

Id Subject Object Predicate Lexical cue hp_id
T20 669-688 Phenotype denotes cardiac arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T21 850-868 Phenotype denotes cardiac arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T22 995-1005 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T23 1087-1097 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T24 1206-1208 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T25 1330-1349 Phenotype denotes cardiac arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T26 1539-1550 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T27 1792-1811 Phenotype denotes cardiac arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T28 1918-1937 Phenotype denotes cardiac arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T29 3682-3693 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T30 3792-3802 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T31 3964-3974 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T32 4138-4152 Phenotype denotes high-sensitive http://purl.obolibrary.org/obo/HP_0041092
T33 4402-4409 Phenotype denotes obesity http://purl.obolibrary.org/obo/HP_0001513
T34 4442-4449 Phenotype denotes Obesity http://purl.obolibrary.org/obo/HP_0001513
T35 5102-5112 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T36 5138-5150 Phenotype denotes hypertension http://purl.obolibrary.org/obo/HP_0000822
T37 5152-5174 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T38 6343-6353 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T39 6514-6532 Phenotype denotes cardiac arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T40 6781-6791 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T41 7095-7105 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T42 7368-7390 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T43 7548-7567 Phenotype denotes atrial fibrillation http://purl.obolibrary.org/obo/HP_0005110
T44 7569-7571 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T45 7640-7642 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T46 7684-7686 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T47 7701-7703 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T48 7813-7815 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T49 8345-8357 Phenotype denotes hypertension http://purl.obolibrary.org/obo/HP_0000822
T50 8415-8437 Phenotype denotes Cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T51 8469-8483 Phenotype denotes cardiomyopathy http://purl.obolibrary.org/obo/HP_0001638
T52 8501-8518 Phenotype denotes diabetes mellitus http://purl.obolibrary.org/obo/HP_0000819
T53 8542-8549 Phenotype denotes obesity http://purl.obolibrary.org/obo/HP_0001513
T54 8633-8670 Phenotype denotes chronic obstructive pulmonary disease http://purl.obolibrary.org/obo/HP_0006510
T55 8672-8690 Phenotype denotes pulmonary fibrosis http://purl.obolibrary.org/obo/HP_0002206
T56 8730-8736 Phenotype denotes cancer http://purl.obolibrary.org/obo/HP_0002664
T57 8794-8810 Phenotype denotes immunodeficiency http://purl.obolibrary.org/obo/HP_0002721
T58 8890-8911 Phenotype denotes hematological disease http://purl.obolibrary.org/obo/HP_0001871
T59 9255-9262 Phenotype denotes syncope http://purl.obolibrary.org/obo/HP_0001279
T60 10463-10474 Phenotype denotes myocarditis http://purl.obolibrary.org/obo/HP_0012819
T61 10610-10629 Phenotype denotes respiratory failure http://purl.obolibrary.org/obo/HP_0002878
T62 10682-10693 Phenotype denotes myocarditis http://purl.obolibrary.org/obo/HP_0012819
T63 10765-10786 Phenotype denotes myocardial infarction http://purl.obolibrary.org/obo/HP_0001658
T64 10923-10943 Phenotype denotes ST segment elevation http://purl.obolibrary.org/obo/HP_0012251
T65 10944-10965 Phenotype denotes myocardial infarction http://purl.obolibrary.org/obo/HP_0001658
T66 10999-11019 Phenotype denotes ST segment elevation http://purl.obolibrary.org/obo/HP_0012251
T67 11020-11041 Phenotype denotes myocardial infarction http://purl.obolibrary.org/obo/HP_0001658
T68 11345-11351 Phenotype denotes Stroke http://purl.obolibrary.org/obo/HP_0001297
T69 11355-11380 Phenotype denotes transient ischemic attack http://purl.obolibrary.org/obo/HP_0002326
T70 11382-11385 Phenotype denotes TIA http://purl.obolibrary.org/obo/HP_0002326
T71 11492-11511 Phenotype denotes respiratory failure http://purl.obolibrary.org/obo/HP_0002878
T72 11725-11747 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T73 11755-11766 Phenotype denotes Arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T74 11847-11858 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T75 11908-11918 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T76 12101-12103 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T77 12149-12160 Phenotype denotes bradycardia http://purl.obolibrary.org/obo/HP_0001662
T78 12223-12233 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T79 12297-12307 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T80 12361-12371 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T81 12444-12454 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T82 12509-12519 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T83 12567-12569 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T84 12598-12608 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T85 12675-12685 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T86 12763-12773 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T87 12822-12824 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T88 12862-12872 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T89 12874-12885 Phenotype denotes Bradycardia http://purl.obolibrary.org/obo/HP_0001662
T90 12982-12993 Phenotype denotes bradycardia http://purl.obolibrary.org/obo/HP_0001662
T91 13098-13121 Phenotype denotes ventricular tachycardia http://purl.obolibrary.org/obo/HP_0004756
T92 13123-13125 Phenotype denotes VT http://purl.obolibrary.org/obo/HP_0004756
T93 13172-13174 Phenotype denotes VT http://purl.obolibrary.org/obo/HP_0004756
T94 13204-13228 Phenotype denotes Ventricular fibrillation http://purl.obolibrary.org/obo/HP_0001663
T95 13258-13280 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T96 13323-13346 Phenotype denotes ventricular tachycardia http://purl.obolibrary.org/obo/HP_0004756
T97 13460-13462 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T98 13648-13659 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T99 13782-13784 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T100 13863-13874 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T101 13909-13926 Phenotype denotes venous thrombosis http://purl.obolibrary.org/obo/HP_0004936
T102 13930-13948 Phenotype denotes pulmonary embolism http://purl.obolibrary.org/obo/HP_0002204
T103 13990-14001 Phenotype denotes Arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T104 14051-14062 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T105 14151-14161 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T106 14183-14193 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T107 14255-14266 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T108 14317-14329 Phenotype denotes hypertension http://purl.obolibrary.org/obo/HP_0000822
T109 14334-14356 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T110 14421-14431 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T111 15162-15184 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T112 15189-15201 Phenotype denotes hypertension http://purl.obolibrary.org/obo/HP_0000822
T113 15236-15246 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T114 15403-15425 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T115 15481-15491 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T116 15527-15539 Phenotype denotes hypertension http://purl.obolibrary.org/obo/HP_0000822
T117 15867-15877 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T118 15910-15920 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T119 16110-16120 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T120 16412-16422 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T121 16567-16577 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T122 16741-16751 Phenotype denotes Arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T123 16836-16846 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T124 16993-17003 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T125 17067-17077 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T126 17175-17185 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T127 17294-17304 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T128 17457-17467 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T129 17501-17520 Phenotype denotes respiratory failure http://purl.obolibrary.org/obo/HP_0002878
T130 17696-17706 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T131 17749-17770 Phenotype denotes myocardial infarction http://purl.obolibrary.org/obo/HP_0001658
T132 17813-17823 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T133 17881-17887 Phenotype denotes Stroke http://purl.obolibrary.org/obo/HP_0001297
T134 17891-17916 Phenotype denotes transient ischemic attack http://purl.obolibrary.org/obo/HP_0002326
T135 17918-17921 Phenotype denotes TIA http://purl.obolibrary.org/obo/HP_0002326
T136 17970-17980 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T137 18010-18012 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T138 18060-18070 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T139 18090-18111 Phenotype denotes myocardial infarction http://purl.obolibrary.org/obo/HP_0001658
T140 18115-18121 Phenotype denotes stroke http://purl.obolibrary.org/obo/HP_0001297
T141 18122-18125 Phenotype denotes TIA http://purl.obolibrary.org/obo/HP_0002326
T142 18398-18408 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T143 18580-18590 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T144 18739-18761 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T145 18804-18826 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T146 18945-18964 Phenotype denotes Atrial Fibrillation http://purl.obolibrary.org/obo/HP_0005110
T147 18965-18984 Phenotype denotes Atrial fibrillation http://purl.obolibrary.org/obo/HP_0005110
T148 19022-19032 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T149 19121-19123 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T150 19130-19142 Phenotype denotes hypertension http://purl.obolibrary.org/obo/HP_0000822
T151 19147-19169 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T152 19208-19218 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T153 19312-19314 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T154 19351-19361 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T155 19385-19387 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T156 19768-19770 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T157 20051-20053 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T158 20103-20105 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T159 20127-20129 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T160 20159-20180 Phenotype denotes myocardial infarction http://purl.obolibrary.org/obo/HP_0001658
T161 20578-20599 Phenotype denotes myocardial infarction http://purl.obolibrary.org/obo/HP_0001658
T162 20699-20701 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T163 20815-20834 Phenotype denotes respiratory failure http://purl.obolibrary.org/obo/HP_0002878
T164 20851-20870 Phenotype denotes Cardiac arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T165 20960-20982 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T166 21036-21047 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T167 21049-21059 Phenotype denotes Arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T168 21436-21447 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T169 21601-21612 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T170 21737-21739 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T171 21769-21779 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T172 21870-21880 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T173 21903-21905 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T174 22159-22161 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T175 22423-22425 Phenotype denotes AF http://purl.obolibrary.org/obo/HP_0005110
T176 22530-22549 Phenotype denotes atrial fibrillation http://purl.obolibrary.org/obo/HP_0005110
T177 22589-22599 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T178 22682-22704 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T179 22745-22755 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T180 22852-22862 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T181 23062-23072 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T182 23680-23702 Phenotype denotes ventricular arrhythmia http://purl.obolibrary.org/obo/HP_0004308
T183 23835-23858 Phenotype denotes ventricular arrhythmias http://purl.obolibrary.org/obo/HP_0004308
T184 23872-23894 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T185 24059-24082 Phenotype denotes ventricular arrhythmias http://purl.obolibrary.org/obo/HP_0004308
T186 24165-24176 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T187 24416-24426 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T188 24687-24709 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T189 24783-24793 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T190 24894-24916 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T191 25119-25130 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T192 25233-25252 Phenotype denotes respiratory failure http://purl.obolibrary.org/obo/HP_0002878
T193 25374-25384 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T194 25783-25793 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T195 26304-26314 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T196 26422-26433 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T197 26468-26490 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T198 26621-26631 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T199 26786-26796 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T200 27024-27043 Phenotype denotes atrial fibrillation http://purl.obolibrary.org/obo/HP_0005110
T201 27064-27087 Phenotype denotes ventricular arrhythmias http://purl.obolibrary.org/obo/HP_0004308
T202 27097-27125 Phenotype denotes supraventricular arrhythmias http://purl.obolibrary.org/obo/HP_0005115
T203 27213-27223 Phenotype denotes Arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T204 27395-27417 Phenotype denotes cardiovascular disease http://purl.obolibrary.org/obo/HP_0001626
T205 27470-27488 Phenotype denotes cardiac arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T206 27564-27583 Phenotype denotes respiratory failure http://purl.obolibrary.org/obo/HP_0002878
T207 28160-28170 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T208 28309-28320 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T209 28423-28434 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675
T210 30544-30554 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T211 30814-30824 Phenotype denotes arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T212 31137-31155 Phenotype denotes cardiac arrhythmia http://purl.obolibrary.org/obo/HP_0011675
T213 31531-31542 Phenotype denotes arrhythmias http://purl.obolibrary.org/obo/HP_0011675

LitCovid-sentences

Id Subject Object Predicate Lexical cue
T24 0-2 Sentence denotes 1.
T25 3-15 Sentence denotes Introduction
T26 16-153 Sentence denotes The global pandemic caused by coronavirus disease 2019 (COVID-19) continues to evolve and exerts tremendous strain on healthcare systems.
T27 154-325 Sentence denotes Pathomechanisms differentiating patients at high risk for adverse outcomes from those displaying minor symptoms and a mild course of disease are insufficiently understood.
T28 326-483 Sentence denotes Cardiovascular involvement and myocardial injury are commonly observed and associated prognostic implications have been suggested by early reports [1,2,3,4].
T29 484-603 Sentence denotes Impairment of ventricular function and inflammatory myocardial processes have been detected in COVID-19 patients [5,6].
T30 604-760 Sentence denotes However, evidence regarding prevalence and prognostic effects of cardiac arrhythmias in COVID-19 is sparse and mainly limited to single center observations.
T31 761-933 Sentence denotes Early studies among the first patient cohorts analyzed in China reported an incidence of cardiac arrhythmia of 17%, with rates of up to 44% in patients admitted to ICU [7].
T32 934-1016 Sentence denotes However, there was no information on the respective types of arrhythmia diagnosed.
T33 1017-1205 Sentence denotes Another monocentric study from Pennsylvania reported similar rates of arrhythmia events during hospitalization for COVID-19, in particular in patients treated in an intensive care setting.
T34 1206-1264 Sentence denotes AF was identified as the most common arrhythmic event [8].
T35 1265-1513 Sentence denotes In a cohort of 30 patients from Italy, a possible association of cardiac arrhythmias and increased inflammatory markers as well as mortality in COVID-19 was pointed out, however, with limited reliability of results due to the small sample size [9].
T36 1514-1727 Sentence denotes Insight into the role of arrhythmias in COVID-19 is of particular importance as widely used pharmacological therapies attempting to mitigate the course of disease may be associated with proarrhythmic effects [10].
T37 1728-2012 Sentence denotes This study aims to systematically investigate the prevalence of cardiac arrhythmias in patients hospitalized for COVID-19 at multiple centers, to identify risk factors for the occurrence of cardiac arrhythmias, and to assess their role regarding clinical course and patient prognosis.
T38 2014-2016 Sentence denotes 2.
T39 2017-2024 Sentence denotes Methods
T40 2026-2030 Sentence denotes 2.1.
T41 2031-2048 Sentence denotes Patient Selection
T42 2049-2191 Sentence denotes All patients with COVID-19 who had been hospitalized at the participating centers were included in this registry from 5 March to 17 June 2020.
T43 2192-2331 Sentence denotes Only patients with a complete documentation of the clinical stay (i.e., discharged from the respective center or deceased) were considered.
T44 2332-2510 Sentence denotes Further inclusion criteria were a confirmation of SARS-CoV-2 infection by polymerase chain reaction testing of a nasopharyngeal sample and a duration of hospital stay for ≥ 24 h.
T45 2511-2570 Sentence denotes In total, 166 patients with were included in this registry.
T46 2571-2644 Sentence denotes In the majority of patients, COVID-19 was the reason for hospitalization.
T47 2645-2803 Sentence denotes A subgroup of nine patients had been admitted for different indications and SARS-CoV-2-infection was diagnosed and treated in the course of the hospital stay.
T48 2804-3008 Sentence denotes The study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of the University of Heidelberg (study registration number at the ethics committee: S-281/2020).
T49 3009-3264 Sentence denotes Due to the retrospective, non-interventional nature of the study based solely on data generated and documented during clinical routine processes, informed and written consent was not required in accordance with the statement of the local ethics committee.
T50 3266-3270 Sentence denotes 2.2.
T51 3271-3286 Sentence denotes Data Collection
T52 3287-3479 Sentence denotes All available clinical records including physicians’ and nurses’ written reports, diagnostic test results, telemetry logs and electronic patient files were used for systematic data collection.
T53 3480-3661 Sentence denotes Demographic and clinical baseline parameters, comorbidities, biomarkers, medical therapy as well as information on endpoints regarding the clinical course of disease were extracted.
T54 3662-3813 Sentence denotes Clinically relevant arrhythmias previously diagnosed or incident during hospitalization were recorded and classified according to arrhythmia diagnosis.
T55 3814-3935 Sentence denotes Electrocardiograms (ECGs) conducted at admission to hospital were evaluated regarding QRS and QTc duration, if available.
T56 3936-4086 Sentence denotes If ECG documentation of the arrhythmia was available in the patient file, the diagnosis was confirmed by electrophysiology experts of the study group.
T57 4087-4356 Sentence denotes With respect to biomarker analyses, peak values of high-sensitive troponin T (hsTnT), N-terminal pro-B-type natriuretic peptide (NTproBNP), lactate dehydrogenase (LDH), C-reactive protein (CRP) and interleukin-6 (IL-6) were recorded, if assessed during hospitalization.
T58 4357-4441 Sentence denotes Data on body mass index (BMI) or presence of obesity were available in 138 patients.
T59 4442-4510 Sentence denotes Obesity was defined as BMI > 25 kg/m2 for the purpose of this study.
T60 4512-4516 Sentence denotes 2.3.
T61 4517-4536 Sentence denotes Statistical Methods
T62 4537-4623 Sentence denotes The patient cohort was described using summary measures of the empirical distribution.
T63 4624-4776 Sentence denotes Continuous variables are reported as median (with inter-quartile range, 25th percentile = P25; 75th percentile = P75) or mean ± standard deviation (SD).
T64 4777-4861 Sentence denotes The t-test or Mann-Whitney-Wilcoxon-test were applied for between-group comparisons.
T65 4862-5019 Sentence denotes Dichotomous variables are presented as absolute and relative frequencies and were compared applying the Fisher Boschloo-test from the R package “Exact” [11].
T66 5020-5315 Sentence denotes For the purpose of selecting variables with predictive impact on the incidence of arrhythmia, the variables sex, age, hypertension, cardiovascular disease, hydroxychloroquine, and combined therapy with hydroxychloroquine and azithromycin were initially considered in terms of variable selection.
T67 5316-5442 Sentence denotes First, regularized logistic regression using the elastic net penalty implemented in the package “glmnet” was computed [12,13].
T68 5443-5593 Sentence denotes The hyperparameters α (elastic net mixing parameter) and β (shrinkage parameter) were tuned conducting 5-fold cross-validation (CV) and a grid search.
T69 5594-5777 Sentence denotes Subsequently, multiple logistic regression modeling was conducted only incorporating the selected variables, to estimate the odds ratios (ORs) and their 95% confidence intervals (CI).
T70 5778-5940 Sentence denotes The area under the curve (AUC) value was computed applying the receiver operating characteristics (ROC) curve to evaluate the model using the package “pROC” [14].
T71 5941-6051 Sentence denotes To prevent overestimation of the model’s performance measure, the AUC-value was calculated applying 5-fold CV.
T72 6052-6174 Sentence denotes During 5-fold CV, each patient is part of the training set for four times and is assigned exactly once to the testing set.
T73 6175-6354 Sentence denotes Hence, in each step a model is fitted based on 80% of the data whereas a probability of the remaining 20% of the patients is estimated with respect to the incidence of arrhythmia.
T74 6355-6446 Sentence denotes Information on left ventricular ejection fraction (LVEF) was only available in 44 patients.
T75 6447-6609 Sentence denotes To account for a potential influence of LVEF on the development of cardiac arrhythmia, we performed attempts to impute the missing data (Supplementary Materials).
T76 6610-6723 Sentence denotes Due to a high number of missing values, LVEF was omitted from further analyses to ensure reliability of the data.
T77 6724-6847 Sentence denotes To evaluate the impact of biomarkers on the incidence of arrhythmia, univariate logistic regression modeling was performed.
T78 6848-6978 Sentence denotes The AUC-values und the Youden index for identifying the optimal cut-off value were computed for each biomarker, respectively [15].
T79 6979-7059 Sentence denotes Confidence intervals of the AUC-values were calculated according to DeLong [16].
T80 7060-7185 Sentence denotes To assess the prognostic impact of arrhythmia on clinical outcomes univariate and multiple regression modeling was performed.
T81 7186-7359 Sentence denotes To preserve the validity of multiple regression modeling in the light of the limited number of patients, the models were adjusted for a maximum of two additional covariates.
T82 7360-7501 Sentence denotes Age and cardiovascular disease were chosen due to their clinical significance regarding outcome in COVID-19 shown by previous studies [2,17].
T83 7502-7741 Sentence denotes Due to the high proportion of newly diagnosed atrial fibrillation (AF), we conducted a subgroup analysis comparing patients with incident AF to patients who neither had a history of AF nor displayed AF in the course of the hospitalization.
T84 7742-7858 Sentence denotes Due to the small sample size in the subgroup of patients with incident AF, only descriptive analyses were performed.
T85 7859-8082 Sentence denotes Due to the exploratory character of this analysis, the p-values are interpreted only in a descriptive sense and no adjustment for multiple testing was applied [18]. p-values < 0.05 were denoted as statistically significant.
T86 8083-8170 Sentence denotes The statistical analysis was performed using R version 4.0.2. [19] and SPSS version 25.
T87 8172-8174 Sentence denotes 3.
T88 8175-8182 Sentence denotes Results
T89 8184-8188 Sentence denotes 3.1.
T90 8189-8244 Sentence denotes Baseline Characteristics and Outcomes in Overall Cohort
T91 8245-8335 Sentence denotes Median age was 64.1 ± 16.7 years, and the majority of patients were male (n = 108, 65.1%).
T92 8336-8414 Sentence denotes Arterial hypertension constituted the most common risk factor (n = 83, 50.0%).
T93 8415-8568 Sentence denotes Cardiovascular disease was present in 18.1% (n = 30), cardiomyopathy in 3.0% (n = 5), diabetes mellitus in 17.5% (n = 29), and obesity in 21.7% (n = 36).
T94 8569-8930 Sentence denotes Other relevant comorbidities comprised pulmonary disease (e.g., chronic obstructive pulmonary disease, pulmonary fibrosis) in 14.5% (n = 24), previous or active cancer disease in 8.4% (n = 14), and conditions associated with immunodeficiency (e.g., due to chronic immunosuppression therapy after organ transplantation or hematological disease) in 8.4% (n = 14).
T95 8931-9025 Sentence denotes Information on left ventricular ejection fraction (LVEF) was available in 44 patients (26.5%).
T96 9026-9070 Sentence denotes Mean LVEF in this subgroup was 53.0 ± 12.3%.
T97 9071-9135 Sentence denotes In three patients a cardiac pacemaker had been implanted (1.8%).
T98 9136-9217 Sentence denotes Implanted cardioverter-defibrillators (ICDs) were present in two patients (1.2%).
T99 9218-9320 Sentence denotes Seven patients (4.2%) presented with syncope in association with COVID-19 prior to hospital admission.
T100 9321-9375 Sentence denotes Median duration of hospitalization was 10.5 days (P25:
T101 9376-9388 Sentence denotes 5 days; P75:
T102 9389-9407 Sentence denotes 22 days, n = 154).
T103 9408-9552 Sentence denotes In 12 patients, data on duration of hospitalization could not be assessed due to transfer to a different center not participating in this study.
T104 9553-9748 Sentence denotes The majority of patients required oxygen therapy in the course of hospital stay, and over a third of all patients was admitted to intensive care (ICU) or intermediate care units (IMC) (Figure 1).
T105 9749-9800 Sentence denotes Median duration of ICU/IMC-therapy was 8 days (P25:
T106 9801-9813 Sentence denotes 4 days; P75:
T107 9814-9825 Sentence denotes 22.5 days).
T108 9826-10065 Sentence denotes High-flow oxygen therapy and/or non-invasive ventilation (NIV) by continuous positive airway pressure (CPAP) was necessary in 39 patients (23.5%), and pharmacological circulatory support by vasopressors was provided in 30 patients (18.1%).
T109 10066-10167 Sentence denotes Thirty-seven patients (22.3%) received mechanical ventilation with a median duration of 17 days (P25:
T110 10168-10182 Sentence denotes 7.5 days; P75:
T111 10183-10192 Sentence denotes 26 days).
T112 10193-10285 Sentence denotes Of these, six patients had to be re-intubated after initially successful weaning (Figure 1).
T113 10286-10423 Sentence denotes Only a minority of patients underwent extracorporeal membrane oxygenation (ECMO) or in-hospital cardiopulmonary resuscitation (Figure 1).
T114 10424-10584 Sentence denotes With respect to cardiovascular events, myocarditis was suspected in one patient based on cardiac biomarker-kinetics and mildly reduced LVEF in echocardiography.
T115 10585-10655 Sentence denotes This patient died due to respiratory failure during the hospital stay.
T116 10656-10730 Sentence denotes However, the diagnosis of myocarditis could not be confirmed upon autopsy.
T117 10731-10817 Sentence denotes Four patients were diagnosed with myocardial infarction (2.4%) during hospitalization.
T118 10818-11051 Sentence denotes Percutaneous coronary intervention (PCI) was performed in two cases, of which one patient presented with ST segment elevation myocardial infarction (STEMI) and one patient with non-ST segment elevation myocardial infarction (NSTEMI).
T119 11052-11246 Sentence denotes In the other two cases diagnosed with NSTEMI, medical therapy alone was preferred due to clinical instability with predominant respiratory symptoms and stable echocardiographic and ECG findings.
T120 11247-11344 Sentence denotes One patient with NSTEMI and PCI died in the course of hospitalization due to mesenteric ischemia.
T121 11345-11421 Sentence denotes Stroke or transient ischemic attack (TIA) was seen in three patients (1.8%).
T122 11422-11572 Sentence denotes Twenty-six patients died during hospitalization, predominantly due to respiratory failure (n = 20, 76.9%) or other non-cardiac reasons (n = 5, 19.2%).
T123 11573-11748 Sentence denotes Only one death was attributed to cardiac causes (3.8%), i.e., cardiac circulatory failure in a mechanically ventilated patient with pre-existent severe cardiovascular disease.
T124 11750-11754 Sentence denotes 3.2.
T125 11755-11802 Sentence denotes Arrhythmias During Hospitalization for COVID-19
T126 11803-11882 Sentence denotes In our cohort 34 patients (20.5%) displayed arrhythmias during hospitalization.
T127 11883-12050 Sentence denotes In 17 cases (10.2%), the arrhythmia type occurring during hospital stay had already been previously diagnosed in the respective patients prior to SARS-CoV-2 infection.
T128 12051-12174 Sentence denotes Specifically, in 16 patients previously diagnosed AF occurred, in one patient previously observed bradycardia was recorded.
T129 12175-12372 Sentence denotes Twenty-two patients (13.3%) displayed new-onset arrhythmia that had not been diagnosed before-either without any previous arrhythmia history or in addition to other previously diagnosed arrhythmia.
T130 12373-12493 Sentence denotes Of these, 16 patients (9.6%) had never been diagnosed with any type of arrhythmia prior to hospitalization for COVID-19.
T131 12494-12630 Sentence denotes With regard to arrhythmia diagnosis during hospitalization for COVID-19, AF was the most common type of arrhythmia recorded (Figure 2A).
T132 12631-12873 Sentence denotes Similarly, in patients diagnosed with a new arrhythmia type during hospitalization (Figure 2B) and in patients without any previous arrhythmia diagnosis prior to hospitalization (Figure 2C), AF constituted the most common incident arrhythmia.
T133 12874-12994 Sentence denotes Bradycardia was recorded in four cases, of which one patient already had previously documented asymptomatic bradycardia.
T134 12995-13052 Sentence denotes No pacemaker implantation was necessary in this subgroup.
T135 13053-13158 Sentence denotes In addition, patients with frequent PVCs and ventricular tachycardia (VT) constituted relevant subgroups.
T136 13159-13203 Sentence denotes All recorded VT-episodes were non-sustained.
T137 13204-13347 Sentence denotes Ventricular fibrillation occurred in one patient with cardiovascular disease who had previously received an ICD due to ventricular tachycardia.
T138 13348-13463 Sentence denotes In three patients (1.8%) electrical cardioversion was performed for termination of hemodynamically compromising AF.
T139 13464-13633 Sentence denotes Amiodarone for pharmacological cardioversion was administered in four patients (2.4%), and chronic antiarrhythmic medical therapy was initiated in three patients (1.8%).
T140 13634-13802 Sentence denotes Patients with arrhythmias more often received therapeutic anticoagulation therapy (Table 1) in accordance with the high proportion of patients with AF in this subgroup.
T141 13803-13949 Sentence denotes Reasons for therapeutic anticoagulation in patients without arrhythmias were previous or new diagnosis of venous thrombosis or pulmonary embolism.
T142 13951-13955 Sentence denotes 3.3.
T143 13956-14001 Sentence denotes Clinical Predictors for New-Onset Arrhythmias
T144 14002-14240 Sentence denotes We analyzed predisposing factors associated with arrhythmias during hospitalization for COVID-19 comparing baseline characteristics of patients with arrhythmia and patients without arrhythmia during hospitalization for COVID-19 (Table 1).
T145 14241-14367 Sentence denotes Patients with arrhythmias were older and more often had been diagnosed with hypertension and cardiovascular disease (Table 1).
T146 14368-14517 Sentence denotes QTc duration at baseline was longer in patients with arrhythmia, however, median values were within the physiological range in both groups (Table 1).
T147 14518-14638 Sentence denotes Furthermore, we analyzed the prevalence of potentially proarrhythmic medication administered in the context of COVID-19.
T148 14639-14741 Sentence denotes In both subgroups, hydroxychloroquine was used in 44.1% and 44.6% of patients, respectively (Table 1).
T149 14742-14823 Sentence denotes A smaller fraction of patients in both groups additionally received azithromycin.
T150 14824-14938 Sentence denotes There was no statistically significant difference in the use of QT-prolonging drugs between both groups (Table 1).
T151 14939-15060 Sentence denotes Median QTc-duration at baseline was within normal range in patients who later received hydroxychloroquine (409.0 ms; P25:
T152 15061-15075 Sentence denotes 390.5 ms, P75:
T153 15076-15086 Sentence denotes 421.5 ms).
T154 15087-15257 Sentence denotes Regularized logistic regression led to the selection of the variables age, cardiovascular disease and hypertension with respect to the prediction of arrhythmia incidence.
T155 15258-15601 Sentence denotes The subsequently fitted multiple logistic regression model revealed significant association of age (OR 1.036; 95% CI 1.004–1.074; p = 0.036) and cardiovascular disease (OR 3.307; 95% CI 1.329–8.232; p = 0.01) with incident arrhythmia in COVID-19, whereas the effect of hypertension was not significant (OR 2.08; 95% CI 0.794–5.796; p = 0.144).
T156 15602-15692 Sentence denotes As measure of the model’s performance an area under the curve (AUC) value of 0.74 (95% CI:
T157 15693-15781 Sentence denotes 0.65; 0.84) was estimated by applying 5-fold cross-validation (Supplementary Figure S1).
T158 15782-15944 Sentence denotes Left ventricular ejection fraction was documented in 47.1% of patients with incident arrhythmia and only 21.2% of cases without arrhythmia during hospitalization.
T159 15945-16142 Sentence denotes Attempts at imputing LVEF and including the imputed dataset in the final logistic regression model hinted at a potential role of LVEF as an additional predictor for arrhythmia incidence (Table S1).
T160 16143-16298 Sentence denotes However, due to the high number of missing values, LVEF was omitted from the final logistic regression model to ensure reliability of statistical analyses.
T161 16299-16484 Sentence denotes With regard to peak levels of cardiac and inflammatory biomarkers assessed during hospitalization, patients with arrhythmia displayed higher levels of hsTnT and NTproBNP (Figure 3A, B).
T162 16485-16707 Sentence denotes Additionally, a more pronounced increase in IL-6 and LDH could be detected in the arrhythmia subgroup, whereas there was no statistically significant difference in peak levels of CRP between groups (Table 2, Figure 3C, D).
T163 16709-16713 Sentence denotes 3.4.
T164 16714-16771 Sentence denotes Prognostic Implications of Arrhythmia on Clinical Outcome
T165 16772-16882 Sentence denotes Overall duration of hospitalization was longer in patients with arrhythmia associated with COVID-19 (Table 3).
T166 16883-17038 Sentence denotes Univariate analysis showed an increase of hospitalization duration of 11.4 days with the presence of incident arrhythmia (95% CI 6.05–16.7 days; p <0.001).
T167 17039-17270 Sentence denotes Additionally, patients with arrhythmia were more often admitted to ICU or IMC wards (OR 2.37; 95% CI 1.10–5.09; p = 0.03), and incident arrhythmia was associated with a longer duration of hospitalization on ICU/IMC wards (Table 3).
T168 17271-17429 Sentence denotes Patients with incident arrhythmia more often received vasopressors for circulatory support and non-invasive ventilation or high-flow oxygen-therapy (Table 3).
T169 17430-17594 Sentence denotes Importantly, patients with arrhythmia more often presented with severe respiratory failure requiring mechanical ventilation (OR 6.69; 95% CI 2.92–15.35; p < 0.001).
T170 17595-17717 Sentence denotes Duration of mechanical ventilation was not significantly different between patients with and without arrhythmia (Table 3).
T171 17718-17880 Sentence denotes With regard to cardiac events, myocardial infarction was more common in the patient group with arrhythmia, however, with a low overall number of events (Table 3).
T172 17881-18071 Sentence denotes Stroke or transient ischemic attack (TIA) occurred in one case in the patient group with arrhythmia who had a prior diagnosis of AF and frequent PVCs, and in two patients without arrhythmia.
T173 18072-18313 Sentence denotes All patients with myocardial infarction or stroke/TIA had received anticoagulation therapy with low-molecular-weight-heparin, however, in one patient heparin-therapy was paused after coronary angiography due to severe bleeding complications.
T174 18314-18470 Sentence denotes In-hospital mortality was significantly elevated in COVID-19 patients with incident arrhythmia during hospitalization (OR 3.02; 95% CI 1.22–7.46; p = 0.02).
T175 18471-18772 Sentence denotes Multiple regression analyses adjusting for differences in baseline parameters revealed that the incidence of arrhythmia constitutes a more powerful prognostic factor regarding hospitalization duration and the need for mechanical ventilation than age and prevalence of cardiovascular disease (Table 4).
T176 18773-18903 Sentence denotes Finally, previous diagnosis of cardiovascular disease in our cohort was significantly associated with mortality in these analyses.
T177 18905-18909 Sentence denotes 3.5.
T178 18910-18964 Sentence denotes Subgroup Analysis of Patients with Atrial Fibrillation
T179 18965-19069 Sentence denotes Atrial fibrillation constituted the most common incident arrhythmia during hospitalization for COVID-19.
T180 19070-19229 Sentence denotes In the subgroup analysis of patients with incident AF, age, hypertension and cardiovascular disease were associated with incidence of the arrhythmia (Table 5).
T181 19230-19315 Sentence denotes Both cardiac and inflammatory markers showed a stronger increase in patients with AF.
T182 19316-19488 Sentence denotes Similar to the effects of incident arrhythmia in the overall cohort, AF itself was associated with longer overall hospitalization times and longer duration of ICU/IMC care.
T183 19489-19673 Sentence denotes Additionally, an increased need for high-flow oxygen therapy or non-invasive ventilation, mechanical ventilation and pharmacological circulatory support could be seen in this subgroup.
T184 19674-19807 Sentence denotes Information regarding initiation of anticoagulation therapy was available in 10 patients with AF during hospitalization for COVID-19.
T185 19808-19926 Sentence denotes In six cases, low-molecular-weight heparin (LMWH) in therapeutic doses was applied, two other patients received NOACs.
T186 19927-20106 Sentence denotes Two patients only received prophylactic doses of LMWH, in one case due to a low CHA2DS2-Vasc-Score of 1 and a self-limiting AF-episode, in one case due to delayed diagnosis of AF.
T187 20107-20181 Sentence denotes Two patients in the AF-subgroup were diagnosed with myocardial infarction.
T188 20182-20250 Sentence denotes In both cases, anticoagulation therapy had been initiated with LMWH.
T189 20251-20356 Sentence denotes One patient underwent PCI and died in the later course of the hospitalization due to mesenteric ischemia.
T190 20357-20519 Sentence denotes In this patient anticoagulation therapy had been paused for 22 days after coronary angiography due to severe bleeding complications requiring transfusion therapy.
T191 20520-20662 Sentence denotes The other patient received medical treatment as a type-II myocardial infarction was suspected due to stable echocardiography und ECG-findings.
T192 20663-20835 Sentence denotes All cases of death in patients with AF were attributed to non-cardiac causes: in addition to the patient described above three patients deceased due to respiratory failure.
T193 20837-20839 Sentence denotes 4.
T194 20840-20850 Sentence denotes Discussion
T195 20851-20951 Sentence denotes Cardiac arrhythmias were the most common cardiac event associated with hospitalization for COVID-19.
T196 20952-21048 Sentence denotes Age and cardiovascular disease were identified as risk factors for the incidence of arrhythmias.
T197 21049-21315 Sentence denotes Arrhythmia was associated with elevated cardiac biomarkers suggesting myocardial injury, need for ICU/IMC care and mechanical ventilation as well as mortality, and constituted an independent predictor of prolonged hospitalization and need for mechanical ventilation.
T198 21316-21530 Sentence denotes This is the first multicenter study including both tertiary care centers and regional hospitals focusing on the role of arrhythmias in hospitalization for COVID-19, considering both clinical and biomarker profiles.
T199 21531-21702 Sentence denotes With respect to age, baseline parameters and the overall incidence of arrhythmias, our cohort corresponds to previously described COVID-19 patient populations [7,8,17,20].
T200 21703-21881 Sentence denotes In accordance with prior results, AF was the most common incident arrhythmia both in the entire cohort and in the subgroup of patients without any previous history of arrhythmia.
T201 21882-22092 Sentence denotes An elevated risk for AF has been described in association with other respiratory virus infections, in particular influenza [21], however, with a lower incidence compared to our cohort of COVID-19-patients [22].
T202 22093-22307 Sentence denotes The present analyses of the patient subgroup with newly diagnosed AF revealed not only a relevant increase in cardiac biomarkers hinting at myocardial injury but also significantly elevated inflammatory biomarkers.
T203 22308-22555 Sentence denotes This may point to an association between the degree of inflammatory state caused by COVID-19 and susceptibility to AF, which is in line with previous findings regarding inflammatory mechanisms promoting the development of atrial fibrillation [23].
T204 22556-22756 Sentence denotes With respect to risk factors for arrhythmia incidence during hospitalization for COVID-19, we could identify age and previous cardiovascular disease as predictors for the occurrence of any arrhythmia.
T205 22757-22939 Sentence denotes These baseline characteristics have previously been shown to predispose for the development of arrhythmia in the general population without association with infectious diseases [24].
T206 22940-23044 Sentence denotes Thus, they may reflect a subgroup of greater general susceptibility to additional proarrhythmic effects.
T207 23045-23181 Sentence denotes In patients with arrhythmia in our cohort, QTc duration was longer at admission, albeit within normal range in the majority of patients.
T208 23182-23381 Sentence denotes Dynamic changes of the QTc interval under therapy with hydroxychloroquine and azithromycin cannot be evaluated as repeated ECGs during hospital stay were not systematically available in all patients.
T209 23382-23459 Sentence denotes Thus, proarrhythmic effects of these drugs cannot be excluded in this cohort.
T210 23460-23647 Sentence denotes Previous reports point towards significant prolongation of the QTc interval by hydroxychloroquine in COVID-19 which is even more enhanced in combination with azithromycin therapy [25,26].
T211 23648-23733 Sentence denotes However, the rate of associated ventricular arrhythmia has been low in these studies.
T212 23734-23986 Sentence denotes Similarly, no typical “torsades des pointes” were seen in our cohort: in three of five patients with ventricular arrhythmias pre-existent cardiovascular disease was present, and only one of the remaining two patients received QTc-prolonging medication.
T213 23987-24150 Sentence denotes Thus, rather than induced by direct effects of administered medication, ventricular arrhythmias may have been due to other predisposing risk factors in our cohort.
T214 24151-24263 Sentence denotes Patients with arrhythmias during hospitalization showed elevated cardiac biomarkers and elevated levels of IL-6.
T215 24264-24400 Sentence denotes Myocardial injury in COVID-19 has been reported by multiple studies, however, the underlying mechanisms have yet to be elucidated [2,4].
T216 24401-24638 Sentence denotes In our cohort, arrhythmia itself may have promoted a more pronounced increase in hsTNT and NTproBNP by an additional shift in myocardial oxygen demand under a restricted respiratory function and by increasing atrial and ventricular load.
T217 24639-24794 Sentence denotes In particular, among patients with pre-existent cardiovascular disease a myocardial supply-demand-imbalance of oxygen may become evident during arrhythmia.
T218 24795-25011 Sentence denotes On the other hand, myocardial injury or ischemia-especially in the light of a higher prevalence of cardiovascular disease in this subgroup-may have exerted proarrhythmic effects in addition to the inflammatory state.
T219 25012-25145 Sentence denotes Such additional inflammatory influences are implicated by the pronounced increase in IL-6 in patients with arrhythmias in our cohort.
T220 25146-25280 Sentence denotes In COVID-19 a state of hyperinflammation is commonly observed and correlates with both respiratory failure and myocardial injury [27].
T221 25281-25511 Sentence denotes Based on our observations, it may additionally constitute a risk factor for the incidence of arrhythmia but distinct molecular mechanisms have yet to be investigated in experimental studies and larger, prospective patient cohorts.
T222 25512-25617 Sentence denotes Estimating optimal cut-off values is associated with uncertainty and is affected by the study population.
T223 25618-25721 Sentence denotes Therefore, the calculated cut-offs for the biomarkers in this study should be interpreted with caution.
T224 25722-25911 Sentence denotes With respect to clinical outcome, an association of incident arrhythmia with the need for ICU/IMC-care was identified, which is in line with the previous observations from Pennsylvania [8].
T225 25912-26042 Sentence denotes However, age and cardiac co-morbidities have been identified as potential confounders in our analyses regarding ICU/IMC admission.
T226 26043-26153 Sentence denotes Furthermore, rates of NIV- or high-flow oxygen-therapy and need for vasopressors were increased in this group.
T227 26154-26329 Sentence denotes These observations, together with the results from biomarker analyses, reflect an association of the severity of disease with the incidence of cardia arrhythmia in our cohort.
T228 26330-26516 Sentence denotes More specifically, we show that mechanical ventilation is associated with the occurrence of arrhythmias, even when correcting for age and cardiovascular disease as potential confounders.
T229 26517-26713 Sentence denotes Additionally, overall duration of hospitalization was significantly increased in patients with incident arrhythmia in multiple regression analyses, which has not been reported by previous studies.
T230 26714-26809 Sentence denotes This result points towards a potentially independent prognostic role of arrhythmia in COVID-19.
T231 26810-26953 Sentence denotes In light of limited ventilator- and hospital-capacity during peak episodes of the COVID-19-pandemic, these aspects are of particular relevance.
T232 26954-27212 Sentence denotes In this context, our exploratory univariate analysis of patients with atrial fibrillation shows that not only ventricular arrhythmias but also supraventricular arrhythmias may have implications on the clinical course during hospitalization COVID-19 patients.
T233 27213-27339 Sentence denotes Arrhythmia during hospitalization for COVID-19 was associated with increased in-hospital mortality in the univariate analysis.
T234 27340-27584 Sentence denotes However, in multiple regression analyses, pre-existent cardiovascular disease had a stronger prognostic implication than incident cardiac arrhythmia regarding this aspect, even though the majority of fatal cases were due to respiratory failure.
T235 27585-27714 Sentence denotes This is in line with observations from large multicenter cohorts identifying risk factors for in-hospital death in COVID-19 [28].
T236 27715-27899 Sentence denotes With respect to a wide range of symptoms and prognostic severity associated with an infection with SARS-CoV-2, further studies aiming at individualized risk stratification are crucial.
T237 27901-27912 Sentence denotes Limitations
T238 27913-27986 Sentence denotes Due to its retrospective design, this study carries inherent limitations.
T239 27987-28197 Sentence denotes Despite thorough analysis of clinical records and use of different source documents (e.g., discharge notes, nurses’ reports, daily doctors’ documentation) underreporting of arrhythmia events cannot be excluded.
T240 28198-28295 Sentence denotes Not all arrhythmic events during the clinical course may have been documented in written reports.
T241 28296-28393 Sentence denotes Asymptomatic arrhythmias in patients without continuous ECG-monitoring may also have been missed.
T242 28394-28531 Sentence denotes However, clinically relevant arrhythmias leading to medical interventions are documented as part of the participating centers’ standards.
T243 28532-28652 Sentence denotes Baseline and outcome data recorded in this study were prespecified and screened for in the available clinical documents.
T244 28653-28730 Sentence denotes Missing parameters were specifically inquired from the participating centers.
T245 28731-28898 Sentence denotes Due to different admission protocols and diagnostic standards, there are remaining missing values with regard to certain baseline parameters or biomarker measurements.
T246 28899-29035 Sentence denotes However, we clearly indicate this limitation in the respective tables whenever information was available only in a subgroup of patients.
T247 29036-29295 Sentence denotes QTc-duration was available at baseline in the majority of patients, however, due to different standards of ECG-based follow-up, QTc-duration in the course of hospitalization, e.g., during therapy with QT-prolonging drugs, could not be systematically analyzed.
T248 29296-29439 Sentence denotes Inclusion of both tertiary and secondary-level hospitals may lead to treatment bias due to different standards of care or available facilities.
T249 29440-29601 Sentence denotes Importantly, in our study, all contributing centers provide intermediate and intensive care units and operate according to national and international guidelines.
T250 29602-29741 Sentence denotes Cardiorespiratory monitoring, non-invasive and mechanical ventilation are carried out according to guidelines in all participating centers.
T251 29742-29805 Sentence denotes All centers treated both moderate and severe cases of COVID-19.
T252 29806-29956 Sentence denotes Patients requiring extracorporeal life support were primarily treated at tertiary centers but constituted a minority of subjects in this study cohort.
T253 29957-30036 Sentence denotes Therefore, we do not expect significant bias due to differences in center size.
T254 30037-30169 Sentence denotes However, due to the limited number of patients in the respective subgroups a comprehensive analysis of this aspect was not feasible.
T255 30170-30309 Sentence denotes In order to provide further insight, we present an overview into the types and individual contribution of participating centers (Table S1).
T256 30310-30452 Sentence denotes Additionally, individual specific therapy attemps with respect to COVID-19, e.g., hydroxochloroquine administration, were specified (Table 1).
T257 30453-30641 Sentence denotes Left ventricular ejection fraction (LVEF) may have constituted an additional predictor for arrhythmia, however, the value was not provided in a relevant number of patients in this cohorts.
T258 30642-30861 Sentence denotes In order to account for this limitation, we attempted imputation of these values (Supplementary Materials) hinting at a potential role of reduced LVEF as a risk factor for arrhythmia during hospitalization for COVID-19.
T259 30862-30982 Sentence denotes However, these results are exploratory and have to be interpreted with caution due to the high number of missing values.
T260 30983-31065 Sentence denotes Further efforts should be made to study this specific aspect in COVID-19 patients.
T261 31067-31069 Sentence denotes 5.
T262 31070-31081 Sentence denotes Conclusions
T263 31082-31279 Sentence denotes The present multicenter study identifies patients with cardiac arrhythmia during hospitalization for COVID-19 as a high-risk subgroup characterized by severe course of disease and adverse outcomes.
T264 31280-31426 Sentence denotes Underlying pathomechanisms may be related to a hyperinflammatory state and myocardial injury, particularly in patients with cardiac comorbidities.
T265 31427-31616 Sentence denotes Due to the high incidence of arrhythmic events in COVID-19 and their potential prognostic implications, arrhythmias should be screened for in affected patients with respective risk factors.