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      COVID-19 reveals Brugada pattern in an adolescent patient

      brief-report

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          Abstract

          A diagnosis of Brugada pattern in paediatric or adolescent patients is rare. COVID-19 is characterised by fevers and a pro-inflammatory state, which may serve as inciting factors for Brugada pattern. Recently described in two adult patients, we report the first case of Brugada pattern in an adolescent with COVID-19.

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          Most cited references9

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          Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic

          The coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 that has significant implications for the cardiovascular care of patients. First, those with COVID-19 and pre-existing cardiovascular disease have an increased risk of severe disease and death. Second, infection has been associated with multiple direct and indirect cardiovascular complications including acute myocardial injury, myocarditis, arrhythmias, and venous thromboembolism. Third, therapies under investigation for COVID-19 may have cardiovascular side effects. Fourth, the response to COVID-19 can compromise the rapid triage of non-COVID-19 patients with cardiovascular conditions. Finally, the provision of cardiovascular care may place health care workers in a position of vulnerability as they become hosts or vectors of virus transmission. We hereby review the peer-reviewed and pre-print reports pertaining to cardiovascular considerations related to COVID-19 and highlight gaps in knowledge that require further study pertinent to patients, health care workers, and health systems.
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            Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2

            In communities with high rates of coronavirus disease 2019, reports have emerged of children with an unusual syndrome of fever and inflammation.
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              Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19

              Abstract Background Hydroxychloroquine has been widely administered to patients with Covid-19 without robust evidence supporting its use. Methods We examined the association between hydroxychloroquine use and intubation or death at a large medical center in New York City. Data were obtained regarding consecutive patients hospitalized with Covid-19, excluding those who were intubated, died, or discharged within 24 hours after presentation to the emergency department (study baseline). The primary end point was a composite of intubation or death in a time-to-event analysis. We compared outcomes in patients who received hydroxychloroquine with those in patients who did not, using a multivariable Cox model with inverse probability weighting according to the propensity score. Results Of 1446 consecutive patients, 70 patients were intubated, died, or discharged within 24 hours after presentation and were excluded from the analysis. Of the remaining 1376 patients, during a median follow-up of 22.5 days, 811 (58.9%) received hydroxychloroquine (600 mg twice on day 1, then 400 mg daily for a median of 5 days); 45.8% of the patients were treated within 24 hours after presentation to the emergency department, and 85.9% within 48 hours. Hydroxychloroquine-treated patients were more severely ill at baseline than those who did not receive hydroxychloroquine (median ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen, 223 vs. 360). Overall, 346 patients (25.1%) had a primary end-point event (180 patients were intubated, of whom 66 subsequently died, and 166 died without intubation). In the main analysis, there was no significant association between hydroxychloroquine use and intubation or death (hazard ratio, 1.04, 95% confidence interval, 0.82 to 1.32). Results were similar in multiple sensitivity analyses. Conclusions In this observational study involving patients with Covid-19 who had been admitted to the hospital, hydroxychloroquine administration was not associated with either a greatly lowered or an increased risk of the composite end point of intubation or death. Randomized, controlled trials of hydroxychloroquine in patients with Covid-19 are needed. (Funded by the National Institutes of Health.)
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                Author and article information

                Journal
                Cardiol Young
                Cardiol Young
                CTY
                Cardiology in the Young
                Cambridge University Press (Cambridge, UK )
                1047-9511
                1467-1107
                03 August 2020
                : 1-3
                Affiliations
                Division of Paediatric Cardiology, Morgan Stanley Children’s Hospital of New York-Presbyterian, Columbia University Medical Center , New York, New York, USA
                Author notes
                Author for correspondence: Nak Hyun Choi, MD, 3959 Broadway, CHN 2-253, New York, NY10032, USA. Tel: +1 212 305 6543; Fax: +1 212 342 5704. E-mail: Nhc9002@ 123456nyp.org
                Author information
                https://orcid.org/0000-0002-5934-4647
                https://orcid.org/0000-0001-8672-6782
                Article
                S1047951120002619
                10.1017/S1047951120002619
                7450227
                32741394
                67d75aff-9576-4a03-9214-b8a9d7dc82b2
                © Cambridge University Press 2020

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 July 2020
                : 28 July 2020
                Page count
                Figures: 2, References: 10, Pages: 3
                Categories
                Brief Report

                brugada,coronavirus,electrocardiogram
                brugada, coronavirus, electrocardiogram

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