Heart Rate in Patients with SARS-CoV-2 Infection: Prevalence of High Values at Discharge and Relationship with Disease Severity

The most common arrhythmia associated with COronaVIrus-related Disease (COVID) infection is sinus tachycardia. It is not known if high Heart Rate (HR) in COVID is simply a marker of higher systemic response to sepsis or if its persistence could be related to a long-term autonomic dysfunction. The aim of our work is to assess the prevalence of elevated HR at discharge in patients hospitalized for COVID-19 and to evaluate the variables associated with it. We enrolled 697 cases of SARS-CoV2 infection admitted in our hospital after February 21 and discharged within 23 July 2020. We collected data on clinical history, vital signs, laboratory tests and pharmacological treatment. Severe disease was defined as the need for Intensive Care Unit (ICU) admission and/or mechanical ventilation. Median age was 59 years (first-third quartile 49, 74), and male was the prevalent gender (60.1%). 84.6% of the subjects showed a SARS-CoV-2 related pneumonia, and 13.2% resulted in a severe disease. Mean HR at admission was 90 ± 18 bpm with a mean decrease of 10 bpm to discharge. Only 5.5% of subjects presented HR > 100 bpm at discharge. Significant predictors of discharge HR at multiple linear model were admission HR (mean increase = β = 0.17 per bpm, 95% CI 0.11; 0.22, p < 0.001), haemoglobin (β = −0.64 per g/dL, 95% CI −1.19; −0.09, p = 0.023) and severe disease (β = 8.42, 95% CI 5.39; 11.45, p < 0.001). High HR at discharge in COVID-19 patients is not such a frequent consequence, but when it occurs it seems strongly related to a severe course of the disease.

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Non-intrusive vital sign monitoring using an intelligent pillow based on a piezoelectric ceramic sensor

Journal of Engineered Fibers and Fabrics ◽

10.1177/1558925020977268 ◽

2020 ◽

Vol 15 ◽

pp. 155892502097726

Author(s):

Wei Wang ◽

Zhiqiang Pang ◽

Ling Peng ◽

Fei Hu

Keyword(s):

Heart Rate ◽

Real Time ◽

Piezoelectric Ceramic ◽

Low Cost ◽

Body Movement ◽

Vital Signs ◽

High Heart Rate ◽

Detection Accuracy ◽

Processing Unit ◽

Real Time Monitoring

Performing real-time monitoring for human vital signs during sleep at home is of vital importance to achieve timely detection and rescue. However, the existing smart equipment for monitoring human vital signs suffers the drawbacks of high complexity, high cost, and intrusiveness, or low accuracy. Thus, it is of great need to develop a simplified, nonintrusive, comfortable and low cost real-time monitoring system during sleep. In this study, a novel intelligent pillow was developed based on a low-cost piezoelectric ceramic sensor. It was manufactured by locating a smart system (consisting of a sensing unit i.e. a piezoelectric ceramic sensor, a data processing unit and a GPRS communication module) in the cavity of the pillow made of shape memory foam. The sampling frequency of the intelligent pillow was set at 1000 Hz to capture the signals more accurately, and vital signs including heart rate, respiratory rate and body movement were derived through series of well established algorithms, which were sent to the user’s app. Validation experimental results demonstrate that high heart-rate detection accuracy (i.e. 99.18%) was achieved in using the intelligent pillow. Besides, human tests were conducted by detecting vital signs of six elder participants at their home, and results showed that the detected vital signs may well predicate their health conditions. In addition, no contact discomfort was reported by the participants. With further studies in terms of validity of the intelligent pillow and large-scale human trials, the proposed intelligent pillow was expected to play an important role in daily sleep monitoring.

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A Prospective Case Control Study To Evaluate The CRADLE Vital Signs Alert Device For Detection Of Patients With Clinically Important Malaria In Refugee Settings

10.21203/rs.3.rs-47471/v1 ◽

2020 ◽

Author(s):

Katy Kuhrt ◽

Paul T Seed ◽

Andrew H Shennan

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Severe Malaria ◽

Low Cost ◽

Severe Disease ◽

Vital Signs ◽

Trial Registration ◽

Control Group ◽

Shock Index ◽

Likelihood Ratios

Abstract Background: Malaria is a significant threat to refugee populations. Bidibidi Refugee Settlement, Northern Uganda hosts 223 000 of Uganda’s 1.4 million refugees, vulnerable to malaria due to crowded conditions and limited access to preventative measures and health care. Early detection and referral of suspected malaria cases is key to reducing associated morbidity and mortality. We therefore aimed to evaluate shock index (heart rate/ systolic blood pressure), calculated by the CRADLE Vital Signs Alert (VSA) device, an easy-to-use blood pressure and heart rate monitor, for detection of malaria as grounds for whether the device could be used for low cost identification and referral of patients by non-medically trained Village Health Team workers (VHTs).Methods: CRADLE VSA devices and related training were delivered to all health facilities and VHTs in Bidibidi Refugee Settlement from April to August 2018. CRADLE VSA readings was performed as part of routine patient assessment. CRADLE VSA data (blood pressure, heart rate) and assigned diagnoses were collected from health facility data record books and shock index calculated for each case. Cases were grouped into predefined disease categories, including malaria and severe malaria. A control group consisted of refugees undergoing asymptomatic screening using the CRADLE VSA. Average shock index was calculated for cases and controls and prespecified disease categories, and predictive statistics to evaluate shock index for prediction of malaria and severe malaria.Results: Five hundred and eighty-seven CRADLE VSA devices were delivered. Malaria accounted for 26% (915/3577) of cases and had the highest shock index compared to other disease categories. Positive likelihood ratios for shock index using a threshold of greater than or equal to 0.9 were 5 and 11 for malaria and severe malaria respectively.Conclusion: Malaria accounted for over a quarter of cases. Positive likelihood ratios indicated that patients with shock index greater than or equal to 0.9 were 5 and 11 times more likely to be suffering from malaria and severe malaria respectively, indicating that the CRADLE VSA could be used by non-medically trained VHTs to identify patients likely to have malaria, and those most at risk of severe disease needing urgent referral. Trial Registration: This is an observational study and therefore does not have or require a trial registration. Appropriate permissions were granted by UN Refugee Council, Ministry of Health and Office of the Prime Minister.

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Contact-free sensor signals as a new digital biomarker for cardiovascular disease: chances and challenges

European Heart Journal - Digital Health ◽

10.1093/ehjdh/ztaa006 ◽

2020 ◽

Vol 1 (1) ◽

pp. 30-39

Author(s):

Hugo Saner ◽

Samuel Elia Johannes Knobel ◽

Narayan Schuetz ◽

Tobias Nef

Keyword(s):

Cardiovascular Disease ◽

Heart Rate ◽

Wearable Sensors ◽

Pressure Sensors ◽

Vital Signs ◽

Signal Acquisition ◽

Motion Sensors ◽

Early Results ◽

Contact Free

Abstract Multiple sensor systems are used to monitor physiological parameters, activities of daily living and behaviour. Digital biomarkers can be extracted and used as indicators for health and disease. Signal acquisition is either by object sensors, wearable sensors, or contact-free sensors including cameras, pressure sensors, non-contact capacitively coupled electrocardiogram (cECG), radar, and passive infrared motion sensors. This review summarizes contemporary knowledge of the use of contact-free sensors for patients with cardiovascular disease and healthy subjects following the PRISMA declaration. Chances and challenges are discussed. Thirty-six publications were rated to be of medium (31) or high (5) relevance. Results are best for monitoring of heart rate and heart rate variability using cardiac vibration, facial camera, or cECG; for respiration using cardiac vibration, cECG, or camera; and for sleep using ballistocardiography. Early results from radar sensors to monitor vital signs are promising. Contact-free sensors are little invasive, well accepted and suitable for long-term monitoring in particular in patient’s homes. A major problem are motion artefacts. Results from long-term use in larger patient cohorts are still lacking, but the technology is about to emerge the market and we can expect to see more clinical results in the near future.

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Characteristics of pregnancy as determinants of cardiac oscillator of a baby in the early neonatal period of life

Pediatrician (St Petersburg) ◽

10.17816/ped5477-84 ◽

2014 ◽

Vol 5 (4) ◽

pp. 77-84

Author(s):

Ahmad Wakah ◽

Irina Vladimirovna Solodkova ◽

Tat’yana Leonidovna Kornishina ◽

Elizaveta Viktorovna Malkina ◽

Ol’ga Viktorovna Shadrina ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Neonatal Period ◽

Severe Disease ◽

Study Drug ◽

Heart Rhythm ◽

Normal Pregnancy ◽

Spectral Density Function ◽

High Heart Rate ◽

Early Neonatal Period

In order to assess the influence of course of pregnancy upon rate and rhythm of heartbeat of a baby in the early neonatal period of life, parameters of babies’ cardiac oscillators were described in terms of power spectral density function calculated for rows of 100-250 consecutive ECG RR-intervals registered during orthodox sleep. Correlation of heart rhythm characteristics, ECG patterns of a baby during first 5 days after delivery and parameters of pregnancy described both in terms of nosology and symptoms (122 parameters in total) were analyzed. 160 newborns were enrolled in the study. Drug abuse, impossi-bility to fill in the query form or informal consent, severe disease of baby, gestational age less than 28 weeks and/or body weight at birth less than 1500 grams were specified as major exclusion criteria. It was shown that preeclampsia during the first half of pregnancy and women’s illness, associated with body temperature higher than 38 degrees Celsius after 8 week of pregnancy are among major determinants of babies’ cardiac oscillator in the early neonatal period of life, but they don’t affect the ECG wave amplitude and the duration of PQ and QT intervals. Pregnancy complicated during the first half promotes bradycardia and high heart rate variability and pregnancy complicated during the second half promotes tachycardia and low heart rate variability in babies during at least 5 days after delivery. Hypothetical spatial models of pacemaker areas were proposed for cases of normal pregnancy, pregnancy complicated in the first half and pregnancy complicated in the second half.

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‘A Prospective Case Control Study to Evaluate The CRADLE Vital Signs Alert Device For Detection of Patients With Clinically Important Malaria in Refugee Settings’.

10.21203/rs.3.rs-205157/v1 ◽

2021 ◽

Author(s):

Katy Kuhrt ◽

Paul T Seed ◽

Andrew H Shennan

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Severe Malaria ◽

Low Cost ◽

Severe Disease ◽

Vital Signs ◽

Trial Registration ◽

Control Group ◽

Shock Index ◽

Likelihood Ratios

Abstract BackgroundMalaria is a significant threat to refugee populations. Bidibidi Refugee Settlement, Northern Uganda hosts 223 000 of Uganda’s 1.4 million refugees, vulnerable to malaria due to crowded conditions and limited access to preventative measures and health care. Early detection and referral of suspected malaria cases is key to reducing associated morbidity and mortality. We therefore aimed to evaluate shock index (heart rate/ systolic blood pressure), calculated by the CRADLE Vital Signs Alert (VSA) device, an easy-to-use blood pressure and heart rate monitor, for detection of malaria as grounds for whether the device could be used for low cost identification and referral of patients by non-medically trained Village Health Team workers (VHTs).Methods CRADLE VSA devices and related training were delivered to all health facilities and VHTs in Bidibidi Refugee Settlement from April to August 2018. CRADLE VSA readings was performed as part of routine patient assessment. CRADLE VSA data (blood pressure, heart rate) and assigned diagnoses were collected from health facility data record books and shock index calculated for each case. Cases were grouped into predefined disease categories, including malaria and severe malaria. A control group consisted of refugees undergoing asymptomatic screening using the CRADLE VSA. Average shock index was calculated for cases and controls and prespecified disease categories, and predictive statistics to evaluate shock index for prediction of malaria and severe malaria.ResultsFive hundred and eighty-seven CRADLE VSA devices were delivered. Malaria accounted for 26% (915/3577) of cases and had the highest shock index compared to other disease categories. Positive likelihood ratios for shock index using a threshold of greater than or equal to 0.9 were 5 and 11 for malaria and severe malaria respectively.ConclusionMalaria accounted for over a quarter of cases. Positive likelihood ratios indicated that patients with shock index greater than or equal to 0.9 were 5 and 11 times more likely to be suffering from malaria and severe malaria respectively, indicating that the CRADLE VSA could be used by non-medically trained VHTs to identify patients likely to have malaria, and those most at risk of severe disease needing urgent referral. Trial RegistrationThis is an observational study and therefore does not have or require a trial registration. Appropriate permissions were granted by UN Refugee Council, Ministry of Health and Office of the Prime Minister.

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