M Sinkeldam1,2,3, A G Buenen4,5, E Celiker6, M van Diepen6, A M de Vos4,7. 1. Department of Intensive Care, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. m.sinkeldam@cwz.nl. 2. Department of Emergency Medicine, Bernhoven Hospital, Uden, The Netherlands. m.sinkeldam@cwz.nl. 3. Department of Cardiology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. m.sinkeldam@cwz.nl. 4. Department of Emergency Medicine, Bernhoven Hospital, Uden, The Netherlands. 5. Department of Emergency Medicine, Maxima Medical Centre, Veldhoven, The Netherlands. 6. Radboud University, Nijmegen, The Netherlands. 7. Department of Cardiology, Bernhoven Hospital, Uden, The Netherlands.
Abstract
INTRODUCTION: Patients with coronavirus disease 2019 (COVID-19) can present with chest pain. However, the characteristics of this chest pain are unknown. We performed a single-centre observational study to review and summarise chest pain characteristics in COVID-19 patients at first presentation to the emergency department (ED). METHODS: We collected data on characteristics of 'chest pain' reported by COVID-19 patients who attended the ED of Bernhoven Hospital, the Netherlands from 4 through 30 March 2020. RESULTS: We included 497 COVID-19 patients, of whom 83 (17%) reported chest pain upon presentation to the ED. Chest pain characteristics were: present since disease onset (88%), retrosternal location (43%), experienced as compressing/pressure pain (61%), no radiation (61%) and linked to heavy coughing (39%). Patients who reported chest pain were younger than those without chest pain (61 vs 73 years; p < 0.001). Patients with syncope were older (75 vs 72 years; p = 0.017), had a shorter duration of symptoms (5 vs 7 days; p < 0.001) and reported fewer respiratory complaints (68% vs 90%; p < 0.001) than those without syncope. Patients with new-onset atrial arrhythmias presented with a shorter duration of symptoms (5 vs 7 days; p = 0.013), experienced fewer respiratory complaints (72% vs 89%; p = 0.012) and more frequently had a history of cardiovascular disease (79% vs 50%; p = 0.003) than patients who presented without arrythmias. CONCLUSION: Chest pain and other cardiac symptoms were frequently observed in COVID-19 patients. Treating physicians should be aware that chest pain, arrhythmias and syncope can be presenting symptoms of COVID-19.
INTRODUCTION: Patients with coronavirus disease 2019 (COVID-19) can present with chest pain. However, the characteristics of this chest pain are unknown. We performed a single-centre observational study to review and summarise chest pain characteristics in COVID-19 patients at first presentation to the emergency department (ED). METHODS: We collected data on characteristics of 'chest pain' reported by COVID-19 patients who attended the ED of Bernhoven Hospital, the Netherlands from 4 through 30 March 2020. RESULTS: We included 497 COVID-19 patients, of whom 83 (17%) reported chest pain upon presentation to the ED. Chest pain characteristics were: present since disease onset (88%), retrosternal location (43%), experienced as compressing/pressure pain (61%), no radiation (61%) and linked to heavy coughing (39%). Patients who reported chest pain were younger than those without chest pain (61 vs 73 years; p < 0.001). Patients with syncope were older (75 vs 72 years; p = 0.017), had a shorter duration of symptoms (5 vs 7 days; p < 0.001) and reported fewer respiratory complaints (68% vs 90%; p < 0.001) than those without syncope. Patients with new-onset atrial arrhythmias presented with a shorter duration of symptoms (5 vs 7 days; p = 0.013), experienced fewer respiratory complaints (72% vs 89%; p = 0.012) and more frequently had a history of cardiovascular disease (79% vs 50%; p = 0.003) than patients who presented without arrythmias. CONCLUSION: Chest pain and other cardiac symptoms were frequently observed in COVID-19 patients. Treating physicians should be aware that chest pain, arrhythmias and syncope can be presenting symptoms of COVID-19.
Authors: Pierpaolo Pellicori; Gemina Doolub; Chih Mun Wong; Keng Siang Lee; Kenneth Mangion; Mahmood Ahmad; Colin Berry; Iain Squire; Pier D Lambiase; Alexander Lyon; Alex McConnachie; Rod S Taylor; John Gf Cleland Journal: Cochrane Database Syst Rev Date: 2021-03-11
Authors: Thomas Struyf; Jonathan J Deeks; Jacqueline Dinnes; Yemisi Takwoingi; Clare Davenport; Mariska Mg Leeflang; René Spijker; Lotty Hooft; Devy Emperador; Sabine Dittrich; Julie Domen; Sebastiaan R A Horn; Ann Van den Bruel Journal: Cochrane Database Syst Rev Date: 2020-07-07