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Clin Cardiol . Risk factors and electrocardiogram characteristics for mortality in critical inpatients with COVID-19

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  • Clin Cardiol . Risk factors and electrocardiogram characteristics for mortality in critical inpatients with COVID-19


    Clin Cardiol


    . 2020 Oct 22.
    doi: 10.1002/clc.23492. Online ahead of print.
    Risk factors and electrocardiogram characteristics for mortality in critical inpatients with COVID-19


    Lingzhi Li 1 2 , Shudi Zhang 3 , Bing He 2 , Xiaobei Chen 4 , Shihong Wang 2 , Qingyan Zhao 1 5 6



    Affiliations

    Abstract

    Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide.
    Hypothesis: The possible risk factors that lead to death in critical inpatients with coronavirus disease 2019 (COVID-19) are not yet fully understood.
    Methods: In this single-center, retrospective study, we enrolled 113 critical patients with COVID-19 from Renmin Hospital of Wuhan University between February 1, 2020 and March 15, 2020. Patients who survived or died were compared.
    Results: A total of 113 critical patients with COVID-19 were recruited; 50 (44.3%) died, and 63 (55.7%) recovered. The proportion of patients with ventricular arrhythmia was higher in the death group than in the recovery group (P = .021) and was higher among patients with myocardial damage than patients without myocardial damage (P = .013). Multivariate analysis confirmed independent predictors of mortality from COVID-19: age > 70 years (HR 1.84, 95% CI 1.03-3.28), initial neutrophil count over 6.5 109 /L (HR 3.43, 95% CI 1.84-6.40), C-reactive protein greater than 100 mg/L (HR 1.93, 95% CI 1.04-3.59), and lactate dehydrogenase over 300 U/L (HR 2.90, 95% CI 1.26-6.67). Immunoglobulin treatment (HR 0.39, 95% CI 0.21-0.73) can reduce the risk of death. Sinus tachycardia (HR 2.94, 95% CI 1.16-7.46) and ventricular arrhythmia (HR 2.79, 95% CI 1.11-7.04) were independent ECG risk factors for mortality from COVID-19.
    Conclusions: Old age (>70 years), neutrophilia, C-reactive protein greater than 100 mg/L and lactate dehydrogenase over 300 U/L are high-risk factors for mortality in critical patients with COVID-19. Sinus tachycardia and ventricular arrhythmia are independent ECG risk factors for mortality from COVID-19.

    Keywords: COVID-19; arrhythmia; critical type; mortality; risk factors.

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