Amyloidosis/diagnostic imaging* ; Cardiomyopathies/diagnostic imaging* ; Diagnostic Imaging ; Humans ; Prealbumin/genetics*

OBJECTIVE: Obesity has been shown to be associated with adverse outcomes in viral infections such as influenza, but previous studies on coronavirus disease 2019 (COVID-19) had mixed results. The aim of this systematic review is to investigate the relationship between COVID-19 and obesity. METHODS: We performed a systematic review and meta-analysis. A literature search of MEDLINE, EMBASE, Scopus, Web of Science, CENTRAL, OpenGrey and preprint servers medRxiv and bioRxiv was performed, with no restriction on language or date of publication. Primary outcomes of this study were intensive care unit (ICU) admission or critical disease, severe disease and mortality. Secondary outcome was a positive COVID-19 test. Meta-analysis was performed using OpenMeta-Analyst software, and heterogeneity was tested using Cochran's Q test and I2 statistic. The study protocol was registered on PROSPERO (CRD42020184953). RESULTS: A total of 1,493 articles were identified and 61 studies on 270,241 patients were included. The pooled prevalence of obesity was 27.6% (95% confidence interval [CI] 22.0-33.2) in hospitalised patients. Obesity was not significantly associated with increased ICU admission or critical illness (odds ratio [OR] 1.25, 95% CI 0.99-1.58, CONCLUSION Obesity increased the risk of severe disease, mortality and infection with COVID-19. Higher body mass index was associated with ICU admission and critical disease. Patients who are obese may be more susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and infected patients should be monitored closely for adverse outcomes.
Body Mass Index ; COVID-19/therapy* ; Critical Care ; Critical Illness ; Global Health ; Hospitalization ; Humans ; Obesity/complications* ; Prognosis ; Risk Factors ; Severity of Illness Index

Bradyarrhythmias are commonly encountered in clinical practice. While there are several electrocardiographic criteria and algorithms for tachyarrhythmias, there is no algorithm for bradyarrhythmias to the best of our knowledge. In this article, we propose a diagnostic algorithm that uses simple concepts: (1) the presence or absence of P waves, (2) the relationship between the number of P waves and QRS complexes, and (3) the regularity of time intervals (PP, PR and RR intervals). We believe this straightforward, stepwise method provides a structured and thorough approach to the wide differential diagnosis of bradyarrhythmias, and in doing so, reduces misdiagnosis and mismanagement.
Humans ; Bradycardia/therapy* ; Algorithms ; Diagnosis, Differential ; Electrocardiography

Cardiomyopathies/therapy* ; Humans ; Sarcoidosis/therapy*

Stress (Takotsubo) cardiomyopathy (SC) is a cardiomyopathy characterised by transient myocardial dysfunction, commonly triggered by a surge in catecholamine. Electrocardiographic features may mimic other conditions, such as myocardial infarction. We presented two cases of SC and reviewed the electrocardiographic features of this disease entity.

Digoxin is a commonly prescribed drug in the management of heart failure and atrial fibrillation. Despite its widespread use, most clinicians have little experience with recognising clinical signs and symptoms that might suggest a potentially lethal drug toxicity. We herein describe two cases with specific reference to the electrocardiographic changes induced by digoxin and discuss the predisposing factors for toxicity, recognition of possible toxicity and treatment approaches.

Arrhythmias, Cardiac ; Atrial Flutter/diagnosis* ; Electrocardiography ; Humans

Adenosine Monophosphate ; analogs & derivatives ; therapeutic use ; Adult ; Aged ; Alanine ; analogs & derivatives ; therapeutic use ; Anti-Arrhythmia Agents ; therapeutic use ; Arrhythmias, Cardiac ; diagnosis ; epidemiology ; Coronavirus Infections ; diagnosis ; drug therapy ; epidemiology ; Echocardiography ; Electrocardiography ; methods ; statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; Male ; Pandemics ; statistics & numerical data ; Pneumonia, Viral ; diagnosis ; drug therapy ; epidemiology ; Sampling Studies ; Severe Acute Respiratory Syndrome ; diagnosis ; epidemiology ; Singapore ; Treatment Outcome