Deceleration capacity is associated with acute respiratory distress syndrome in COVID-19.
Lars Mizera, Dominik Rath, Anna Schoellmann and 9 others
PMID 34428736WHAT IT FOUND
Low deceleration capacity on an ECG Holter recording was associated with ARDS in 60 hospitalized COVID-19 patients: 3.2 ms vs 6.6 ms, and below 4.5 ms in 75.7% with ARDS versus 34.8% without.
Key findings
01ARDS developed in 37 of 60 patients.
02Deceleration capacity was lower in patients with ARDS than in those without ARDS (3.2 ± 2.2 ms vs 6.6 ± 6.1 ms), and a value below 4.5 ms was more common in ARDS (75.7% vs 34.8%).
03After adjustment, lower deceleration capacity remained associated with ARDS, and its ROC area was 0.76.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was small and single-center, and the authors said the results are hypothesis generating and need further prospective control studies. Only hospitalized patients were included, so the ARDS rate may not apply to less severe outpatient cases. Deceleration capacity can only be calculated in people with sinus rhythm, so patients with atrial fibrillation or pacemakers were excluded. The study is observational, so it shows association, not that deceleration capacity causes ARDS or that acting on it improves outcomes. A prior related interim analysis was reported, with a different endpoint and fewer enrolled persons.
Declared interests
The paper is listed as non-U.S. government research support. The authors disclosed a prior related interim analysis accepted in another journal, with a different endpoint and fewer enrolled persons.
The easy way to misread this
Do not treat low deceleration capacity as a proven bedside tool for predicting or preventing ARDS. This was a small observational study of hospitalized patients, and the authors said the data are hypothesis generating and need further prospective control studies.