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Clinical surrogates of dysautonomia predict lethal outcome in COVID-19 on intensive care unit. / Woo, Marcel Seungsu; Mayer, Christina; Fischer, Marlene; Kluge, Stefan; Roedl, Kevin; Gerloff, Christian; Czorlich, Patrick; Thomalla, Götz; Schulze Zur Wiesch, Julian; Schweingruber, Nils.
in: Neurol Res Pract, Jahrgang 5, Nr. 1, 04.05.2023, S. 17.
Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
Woo, MS, Mayer, C, Fischer, M, Kluge, S, Roedl, K, Gerloff, C, Czorlich, P, Thomalla, G, Schulze Zur Wiesch, J 2023, 'Clinical surrogates of dysautonomia predict lethal outcome in COVID-19 on intensive care unit', Neurol Res Pract, Jg. 5, Nr. 1, S. 17. https://doi.org/10.1186/s42466-023-00243-x
APA
Woo, M. S., Mayer, C., Fischer, M., Kluge, S., Roedl, K., Gerloff, C., Czorlich, P., Thomalla, G., Schulze Zur Wiesch, J. (2023). Clinical surrogates of dysautonomia predict lethal outcome in COVID-19 on intensive care unit. Neurol Res Pract, 5(1), 17. https://doi.org/10.1186/s42466-023-00243-x
Vancouver
Woo MS, Mayer C, Fischer M, Kluge S, Roedl K, Gerloff C et al. Clinical surrogates of dysautonomia predict lethal outcome in COVID-19 on intensive care unit. Neurol Res Pract. 2023 Mai 4;5(1):17. https://doi.org/10.1186/s42466-023-00243-x
Bibtex
@article{413c09b3276d47f1abf95fce5980cbbe,
title = "Clinical surrogates of dysautonomia predict lethal outcome in COVID-19 on intensive care unit",
abstract = "BACKGROUND: Unpredictable vegetative deteriorations made the treatment of patients with acute COVID-19 on intensive care unit particularly challenging during the first waves of the pandemic. Clinical correlates of dysautonomia and their impact on the disease course in critically ill COVID-19 patients are unknown.METHODS: We retrospectively analyzed data collected during a single-center observational study (March 2020-November 2021) which was performed at the University Medical Center Hamburg-Eppendorf, a large tertiary medical center in Germany. All patients admitted to ICU due to acute COVID-19 disease during the study period were included (n = 361). Heart rate variability (HRV) and blood pressure variability (BPV) per day were used as clinical surrogates of dysautonomia and compared between survivors and non-survivors at different time points after admission. Intraindividual correlation of vital signs with laboratory parameters were calculated and corrected for age, sex and disease severity.RESULTS: Patients who deceased in ICU had a longer stay (median days ± IQR, survivors 11.0 ± 27.3, non-survivors 14.1 ± 18.7, P = 0.85), in contrast time spent under invasive ventilation was not significantly different (median hours ± IQR, survivors 322 ± 782, non-survivors 286 ± 434, P = 0.29). Reduced HRV and BPV predicted lethal outcome in patients staying on ICU longer than 10 days after adjustment for age, sex, and disease severity. Accordingly, HRV was significantly less correlated with inflammatory markers (e.g. CRP and Procalcitonin) and blood carbon dioxide in non-survivors in comparison to survivors indicating uncoupling between autonomic function and inflammation in non-survivors.CONCLUSIONS: Our study suggests autonomic dysfunction as a contributor to mortality in critically ill COVID-19 patients during the first waves of the pandemic. Serving as a surrogate for disease progression, these findings could contribute to the clinical management of COVID-19 patients admitted to the ICU. Furthermore, the suggested measure of dysautonomia and correlation with other laboratory parameters is non-invasive, simple, and cost-effective and should be evaluated as an additional outcome parameter in septic patients treated in the ICU in the future.",
author = "Woo, {Marcel Seungsu} and Christina Mayer and Marlene Fischer and Stefan Kluge and Kevin Roedl and Christian Gerloff and Patrick Czorlich and G{\"o}tz Thomalla and {Schulze Zur Wiesch}, Julian and Nils Schweingruber",
note = "{\textcopyright} 2023. The Author(s).",
year = "2023",
month = may,
day = "4",
doi = "10.1186/s42466-023-00243-x",
language = "English",
volume = "5",
pages = "17",
journal = "Neurol Res Pract",
issn = "2524-3489",
publisher = "BioMed Central Ltd.",
number = "1",
}
RIS
TY - JOUR
T1 - Clinical surrogates of dysautonomia predict lethal outcome in COVID-19 on intensive care unit
AU - Woo, Marcel Seungsu
AU - Mayer, Christina
AU - Fischer, Marlene
AU - Kluge, Stefan
AU - Roedl, Kevin
AU - Gerloff, Christian
AU - Czorlich, Patrick
AU - Thomalla, Götz
AU - Schulze Zur Wiesch, Julian
AU - Schweingruber, Nils
N1 - © 2023. The Author(s).
PY - 2023/5/4
Y1 - 2023/5/4
N2 - BACKGROUND: Unpredictable vegetative deteriorations made the treatment of patients with acute COVID-19 on intensive care unit particularly challenging during the first waves of the pandemic. Clinical correlates of dysautonomia and their impact on the disease course in critically ill COVID-19 patients are unknown.METHODS: We retrospectively analyzed data collected during a single-center observational study (March 2020-November 2021) which was performed at the University Medical Center Hamburg-Eppendorf, a large tertiary medical center in Germany. All patients admitted to ICU due to acute COVID-19 disease during the study period were included (n = 361). Heart rate variability (HRV) and blood pressure variability (BPV) per day were used as clinical surrogates of dysautonomia and compared between survivors and non-survivors at different time points after admission. Intraindividual correlation of vital signs with laboratory parameters were calculated and corrected for age, sex and disease severity.RESULTS: Patients who deceased in ICU had a longer stay (median days ± IQR, survivors 11.0 ± 27.3, non-survivors 14.1 ± 18.7, P = 0.85), in contrast time spent under invasive ventilation was not significantly different (median hours ± IQR, survivors 322 ± 782, non-survivors 286 ± 434, P = 0.29). Reduced HRV and BPV predicted lethal outcome in patients staying on ICU longer than 10 days after adjustment for age, sex, and disease severity. Accordingly, HRV was significantly less correlated with inflammatory markers (e.g. CRP and Procalcitonin) and blood carbon dioxide in non-survivors in comparison to survivors indicating uncoupling between autonomic function and inflammation in non-survivors.CONCLUSIONS: Our study suggests autonomic dysfunction as a contributor to mortality in critically ill COVID-19 patients during the first waves of the pandemic. Serving as a surrogate for disease progression, these findings could contribute to the clinical management of COVID-19 patients admitted to the ICU. Furthermore, the suggested measure of dysautonomia and correlation with other laboratory parameters is non-invasive, simple, and cost-effective and should be evaluated as an additional outcome parameter in septic patients treated in the ICU in the future.
AB - BACKGROUND: Unpredictable vegetative deteriorations made the treatment of patients with acute COVID-19 on intensive care unit particularly challenging during the first waves of the pandemic. Clinical correlates of dysautonomia and their impact on the disease course in critically ill COVID-19 patients are unknown.METHODS: We retrospectively analyzed data collected during a single-center observational study (March 2020-November 2021) which was performed at the University Medical Center Hamburg-Eppendorf, a large tertiary medical center in Germany. All patients admitted to ICU due to acute COVID-19 disease during the study period were included (n = 361). Heart rate variability (HRV) and blood pressure variability (BPV) per day were used as clinical surrogates of dysautonomia and compared between survivors and non-survivors at different time points after admission. Intraindividual correlation of vital signs with laboratory parameters were calculated and corrected for age, sex and disease severity.RESULTS: Patients who deceased in ICU had a longer stay (median days ± IQR, survivors 11.0 ± 27.3, non-survivors 14.1 ± 18.7, P = 0.85), in contrast time spent under invasive ventilation was not significantly different (median hours ± IQR, survivors 322 ± 782, non-survivors 286 ± 434, P = 0.29). Reduced HRV and BPV predicted lethal outcome in patients staying on ICU longer than 10 days after adjustment for age, sex, and disease severity. Accordingly, HRV was significantly less correlated with inflammatory markers (e.g. CRP and Procalcitonin) and blood carbon dioxide in non-survivors in comparison to survivors indicating uncoupling between autonomic function and inflammation in non-survivors.CONCLUSIONS: Our study suggests autonomic dysfunction as a contributor to mortality in critically ill COVID-19 patients during the first waves of the pandemic. Serving as a surrogate for disease progression, these findings could contribute to the clinical management of COVID-19 patients admitted to the ICU. Furthermore, the suggested measure of dysautonomia and correlation with other laboratory parameters is non-invasive, simple, and cost-effective and should be evaluated as an additional outcome parameter in septic patients treated in the ICU in the future.
U2 - 10.1186/s42466-023-00243-x
DO - 10.1186/s42466-023-00243-x
M3 - SCORING: Journal article
C2 - 37143130
VL - 5
SP - 17
JO - Neurol Res Pract
JF - Neurol Res Pract
SN - 2524-3489
IS - 1
ER -