Continuous monitoring of advanced hemodynamic parameters shows early cardiovascular changes in a cohort of 492 COVID-19 hospitalized patients.
2Biobeat, Biobeat Technologies LTD, Petah Tikva, Israel, Israel
3Wolfson Medical Center, Holon,, the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, Israel
4Department of Epidemiology and Preventive Medicine, School of Public Health,, Sackler Faculty of Medicine and Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv, Israel, Israel
5Heart Institute, Hadassah Ein Kerem Medical Center, Faculty of Medicine, Hebrew University of Jerusalem; Department of Medicine, Hadassah Medical Center, Israel
6Rambam Health Care Campus,, Israel and the Bruce Rappaport faculty of medicine, Technion, Haifa, Israel
7The Baruch Padeh Medical Center Poriya, The Faculty of Medicine in Galilee, Bar Ilan University, Israel, Israel
8The Soroka University Medical Center,, Ben-Gurion University of the Negev., Israel
9The Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem; Department of Medicine, Hadassah Medical Center, Israel
Introduction
COVID-19 exerts deleterious cardiopulmonary effects, leading to a worse prognosis in the most affected. The aim of this retrospective multicenter observational cohort study was to analyze the trajectories of key advanced hemodynamic parameters amongst hospitalized COVID-19 patients according to different risk populations using a chest-patch wearable providing continuous remote patient monitoring.
Material and method
The study was conducted in five COVID-19 isolation units. Patients admitted to the units were connected to a photoplethysmography-based noninvasive remote advanced hemodynamic monitor after completing a basic risk factor survey. Physiological parameters were measured every 15 minutes during the hospitalization, including cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), heart rate, blood pressure (BP), respiratory rate, blood oxygen saturation (SpO2), and body temperature.
Results and discussion
492 COVID-19 patients (179 females, average age 58.7 years) were included in the final analysis, with more than 3 million measurements collected during an average of 75.3 hours. Overall, within the first five days of hospitalizations, we found a significant increase in SVR, and a significant decrease in SpO2, DBP, CO, and CI (p < 0.01 for all). The changes were more prominent in high-risk populations- males, older age, and obesity and had a temporal correspondence to changes in respiratory parameters.
Conclusions
This is the first comprehensive continuous advanced hemodynamic profiling of COVID-19 patients. Worse hemodynamic status was prominent in high-risk populations.
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