Elevated resting heart rates are a risk factor for mortality among patients with coronavirus disease 2019 in Wuhan, China

Han Jin; Shengwen Yang; Fan Yang; Long Zhang; Haoyu Weng; Shengcong Liu; Fangfang Fan; Haichao Li; Xizi Zheng; Hongyu Yang; Yan Zhang; Jing Zhou; Jianping Li

doi:10.2478/jtim-2021-0042

Elevated resting heart rates are a risk factor for mortality among patients with coronavirus disease 2019 in Wuhan, China

J Transl Int Med. 2021 Dec 31;9(4):285-293. doi: 10.2478/jtim-2021-0042. eCollection 2021 Dec 1.

Authors

Han Jin¹, Shengwen Yang², Fan Yang¹, Long Zhang¹, Haoyu Weng¹, Shengcong Liu¹, Fangfang Fan¹, Haichao Li³, Xizi Zheng⁴, Hongyu Yang⁴, Yan Zhang¹, Jing Zhou¹, Jianping Li¹

Affiliations

¹ Department of Cardiology, Peking University First Hospital, Beijing 100034, China.
² The Department of Cardiology, Affiliated Beijing Chaoyang Hospital of Capital Medical University, Beijing, 100020, China.
³ Department of Pulmonary Medicine, Peking University First Hospital, Beijing 100034, China.
⁴ Department of Nephrology, Peking University First Hospital, Beijing 100034, China.

Abstract

Background: We evaluated the association between higher resting heart rates (RHRs) and adverse events in COVID-19 patients.

Methods: One hundred and thirty-six patients with laboratory-confirmed COVID-19 were admitted. Outcomes of patients with different RHRs were compared.

Results: Twenty-nine patients had RHRs of <80 bpm (beat per min), 85 had 80-99 bpm and 22 had ≥100 bpm as tachycardia. Those with higher RHRs had lower pulse oxygen saturation (SpO₂) and higher temperatures, and there was a higher proportion of men upon admission (all P < 0.05). Patients with higher RHRs showed higher white blood cell counts and D-dimer, cardiac troponin I (TnI), N-terminal pro-B-type natriuretic peptide and hypersensitive C-reactive protein levels, but lower albumin levels (all P < 0.05) after admission. During follow-up, 26 patients died (mortality rate, 19.1%). The mortality rate was significantly higher among patients with tachycardia than among the moderate and low RHR groups (all P < 0.001). Kaplan-Meier survival curves showed that the risks of death and ventilation use increased for patients with tachycardia (P < 0.001). Elevated RHR as a continuous variable and a mean RHR as tachycardia were independent risk factors for mortality and ventilator use (all P < 0.05) in the multivariable adjusted Cox proportional hazards regression model.

Conclusions: Elevated average RHRs during the first 3 days of hospitalisation were associated with adverse outcomes in COVID-19 patients. Average RHRs as tachycardia can independently predict all-cause mortality.

Keywords: coronavirus disease 2019; prognosis; resting heart rate; risk factor; tachycardia.