Out-Of-Hospital Cardiac Arrest during the Coronavirus Disease 2019 (COVID-19) Pandemic in Brazil: The Hidden Mortality

Mesquita, Claudio Tinoco

doi:10.36660/abc.20210041

Acessibilidade / Reportar erro

Brasil

Arquivos Brasileiros de Cardiologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Short Editorial • Arq. Bras. Cardiol. 116 (2) • Feb 2021 • https://doi.org/10.36660/abc.20210041 copy

Out-Of-Hospital Cardiac Arrest during the Coronavirus Disease 2019 (COVID-19) Pandemic in Brazil: The Hidden Mortality

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The world changed in just a few months after the emergence of the novel coronavirus disease 2019 (COVID-19), caused by a beta coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Brazil currently has the world’s second-highest COVID-19 death toll, second only to the USA. The COVID-19 pandemic is spreading fast in the world with more than 181 countries affected. This editorial refers to the article published in Arquivos Brasileiros de Cardiologia: “Increase in home deaths due to cardiorespiratory arrest in times of COVID-19 pandemic.”¹ Their main results show a gradual increase in the rate of out-of-hospital cardiac arrest during the Coronavirus disease 2019 (COVID-19) pandemic in the city of Belo Horizonte, Minas Gerais, Brazil. Their data demonstrate a proportional increase of 33% of home deaths in March 2020 compared to previous periods. Their study is the first Brazilian paper to demonstrate the same trend observed in other countries.

COVID-19/complications; Betacoronavirus; Mortality; Pandemics; Heart Arrest; Risk Factors, Elderly; Cardiovascular Diseases, Pneumopathies

Cardiovascular Complication	Frequency	Implications
Myocardial injury and myocarditis	7–20% of patients with COVID-19	Myocardial injury is associated with a 5-fold increase in the need for invasive mechanical ventilation and an 11-fold increase in mortality
Acute coronary syndrome (ACS)	Less than 5% of patients with COVID-19	Reduction in hospitalizations for ACS and a 40% reduction in ST-segment elevation myocardial infarction during the pandemic. This decrease in ACS cases is associated with a similar increase in out-of-hospital cardiac arrest.
Heart failure	Incidence of 24% in all patients with COVID-19 and 49% in patients who died	Heart failure can contribute to respiratory failure in patients with ARDS. Adequate management of HF is mandatory to reduce mortality.
Arrhythmias and sudden cardiac arrest	Malignant arrhythmias, such as ventricular tachycardia and fibrillation, can occur in patients with elevated levels of troponin T	Atrial and ventricular tachycardia and fibrillation can be triggered by myocardial injury, systemic causes or drug interactions. Special attention is needed with drug-induced QT prolongation
Coagulation abnormalities and thrombosis	Elevated levels of d-dimer (>0.5 mg/l) can be found in 60% of those with severe illnesses	Optimal anticoagulation regimen to prevent thromboembolic events is not known but anticoagulation is often empirically prescribed. Recommendations on antithrombotic treatment and PCI for acute coronary syndromes should be maintained during COVID-19 treatment

Sociedade Brasileira de Cardiologia - SBC Avenida Marechal Câmara, 160, sala: 330, Centro, CEP: 20020-907, (21) 3478-2700 - Rio de Janeiro - RJ - Brazil, Fax: +55 21 3478-2770 - São Paulo - SP - Brazil
E-mail: revista@cardiol.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Mailing Address: Claudio Tinoco Mesquita • Universidade Federal Fluminense Faculdade de Medicina - Departamento de Radiologia - Av. Marques do Paraná, 303. Postal Code 24230-322, Centro, Niterói, RJ – Brazil E-mail: claudiotinocomesquita@gmail.com