Dataset Information

Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey.

ABSTRACT:

Background

Cardiac implantable electronic device (CIED) implantation rates as well as the clinical and procedural characteristics and outcomes in patients with known active coronavirus disease 2019 (COVID-19) are unknown.

Objective

The purpose of this study was to gather information regarding CIED procedures during active COVID-19, performed with personal protective equipment, based on an international survey.

Methods

Fifty-three centers from 13 countries across 4 continents provided information on 166 patients with known active COVID-19 who underwent a CIED procedure.

Results

The CIED procedure rate in 133,655 hospitalized COVID-19 patients ranged from 0 to 16.2 per 1000 patients (P <.001). Most devices were implanted due to high-degree/complete atrioventricular block (112 [67.5%]) or sick sinus syndrome (31 [18.7%]). Of the 166 patients in the study survey, the 30-day complication rate was 13.9% and the 180-day mortality rate was 9.6%. One patient had a fatal outcome as a direct result of the procedure. Differences in patient and procedural characteristics and outcomes were found between Europe and North America. An older population (76.6 vs 66 years; P <.001) with a nonsignificant higher complication rate (16.5% vs 7.7%; P = .2) was observed in Europe vs North America, whereas higher rates of critically ill patients (33.3% vs 3.3%; P <.001) and mortality (26.9% vs 5%; P = .002) were observed in North America vs Europe.

Conclusion

CIED procedure rates during known active COVID-19 disease varied greatly, from 0 to 16.2 per 1000 hospitalized COVID-19 patients worldwide. Patients with active COVID-19 infection who underwent CIED implantation had high complication and mortality rates. Operators should take these risks into consideration before proceeding with CIED implantation in active COVID-19 patients.

SUBMITTER: Tovia-Brodie O

PROVIDER: S-EPMC8547796 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey.

Tovia-Brodie Oholi O Rav Acha Moshe M Belhassen Bernard B Gasperetti Alessio A Schiavone Marco M Forleo Giovanni Battista GB Guevara-Valdivia Milton E ME Ruiz David Valdeolivar DV Lellouche Nicolas N Hamon David D Castagno Davide D Bellettini Matteo M De Ferrari Gaetano M GM Laredo Mikael M Carvès Jean-Baptiste JB Ignatiuk Barbara B Pasquetto Giampaolo G De Filippo Paolo P Malanchini Giovanni G Pavri Behzad B BB Raphael Craig C Rivetti Luigi L Mantovan Roberto R Chinitz Jason J Harding Melissa M Boriani Giuseppe G Casali Edoardo E Wan Elaine Y EY Biviano Angelo A Macias Carlos C Havranek Stepan S Lazzerini Pietro Enea PE Canu Antonio M AM Zardini Marco M Conte Giulio G Cano Óscar Ó Casella Michela M Rudic Boris B Omelchenko Alexander A Mathuria Nilesh N Upadhyay Gaurav A GA Danon Asaf A Schwartz Arie Lorin AL Maury Philippe P Nakahara Shiro S Goldenberg Gustavo G Schaerli Nicolas N Bereza Sergiy S Auricchio Angelo A Glikson Michael M Michowitz Yoav Y

Heart rhythm 20211026 2

<h4>Background</h4>Cardiac implantable electronic device (CIED) implantation rates as well as the clinical and procedural characteristics and outcomes in patients with known active coronavirus disease 2019 (COVID-19) are unknown.<h4>Objective</h4>The purpose of this study was to gather information regarding CIED procedures during active COVID-19, performed with personal protective equipment, based on an international survey.<h4>Methods</h4>Fifty-three centers from 13 countries across 4 continent ...[more]

PMID: 34710561

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Project description:Children have been mostly excluded from COVID-19 clinical trials, and, as a result, most medicines approved for COVID-19 have no pediatric indication. In addition, access to COVID-19 therapeutics remains limited. Collecting physicians' experiences with off-label use of therapeutics is important to inform global prioritization processes and better target pediatric research and development. A standardized questionnaire was designed to explore the use of therapeutics used to treat COVID-19 and multisystem inflammatory syndrome in children (MIS-C) in pediatric patients globally. Seventy-three physicians from 29 countries participated. For COVID-19, steroids were used by 75.6% of respondents; remdesivir and monoclonal antibodies were prescribed by 48.6% and 27.1% of respondents, respectively. For MIS-C, steroids were prescribed by 79.1% of respondents and intravenous immunoglobulins by 69.6%. The use of these products depended on their pediatric approval and the limited availability of antivirals and most monoclonal antibodies in Africa, South America, Southeast Asia, and Eastern Europe. Off-label prescription resulted widespread due to the paucity of clinical trials in young children at the time of the survey; though, based on our survey results, it was generally safe and led to clinical benefits. Conclusion: This survey provides a snapshot of current practice for treating pediatric COVID-19 worldwide, informing global prioritization efforts to better target pediatric research and development for COVID-19 therapeutics. Off-label use of such medicines is widespread for the paucity of clinical trials under 12 years and 40 kg, though appears to be safe and generally results in clinical benefits, even in young children. However, access to care, including medicine availability, differs widely globally. Clinical development of COVID-19 antivirals and monoclonal antibodies requires acceleration to ensure pediatric indication and allow worldwide availability of therapeutics that will enable more equitable access to COVID-19 treatment. What is Known: • Children have been mostly excluded from COVID-19 clinical trials, and, as a result, most medicines approved for COVID-19 have no pediatric indication. • Access to care differs widely globally, so because of the diversity of national healthcare systems; the unequal availability of medicines for COVID-19 treatment represents an obstacle to the pediatric population's universal right to health care. What is New: • Off-label COVID-19 drug prescription is widespread due to the lack of clinical trials in children younger than 12 years and weighing less than 40 kg, but relatively safe and generally leading to clinical benefit. • The application of the GAP-f framework to COVID-19 medicines is crucial, ensuring widespread access to all safe and effective drugs, enabling the rapid development of age-appropriate formulations, and developing specific access plans (including stability, storage, packaging, and labeling) for distribution in low- and middle-income countries (LMICs). Antivirals and monoclonal antibodies may benefit from the acceleration to reach widespread and equal diffusion.

Dataset Information

Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey.

Background

Objective

Methods

Results

Conclusion

Publications

Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey.

Similar Datasets

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