Clin Cardiol . The prognostic significance of electrocardiography findings in patients with coronavirus disease 2019: A retrospective study

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Clin Cardiol


. 2021 May 11.
doi: 10.1002/clc.23628. Online ahead of print.
The prognostic significance of electrocardiography findings in patients with coronavirus disease 2019: A retrospective study


Deyan Yang ¹ , Jing Li ² , Peng Gao ¹ , Taibo Chen ¹ , Zhongwei Cheng ¹ , Kangan Cheng ¹ , Hua Deng ¹ , Quan Fang ¹ , Chunfeng Yi ² , Hongru Fan ² , Yonghong Wu ² , Liwei Li ² , Yong Fang ² , Guowei Tian ² , Wan Pan ² , Fan Zhang ²



Affiliations

• PMID: 33973673
• DOI: 10.1002/clc.23628

Abstract

Background: Coronavirus disease 2019 (COVID-19) has reached a pandemic level. Cardiac injury is not uncommon among COVID-19 patients. We sought to describe the electrocardiographic characteristics and to identify the prognostic significance of electrocardiography (ECG) findings of patients with COVID-19.
Hypothesis: ECG abnormality was associated with higher risk of death.
Methods: Consecutive patients with laboratory-confirmed COVID-19 and definite in-hospital outcome were retrospectively included. Demographic characteristics and clinical data were extracted from medical record. Initial ECGs at admission or during hospitalization were reviewed. A point-based scoring system of abnormal ECG findings was formed, in which 1 point each was assigned for the presence of axis deviation, arrhythmias, atrioventricular block, conduction tissue disease, QTc interval prolongation, pathological Q wave, ST-segment change, and T-wave change. The association between abnormal ECG scores and in-hospital mortality was assessed in multivariable Cox regression models.
Results: A total of 306 patients (mean 62.84 ? 14.69 years old, 48.0% male) were included. T-wave change (31.7%), QTc interval prolongation (30.1%), and arrhythmias (16.3%) were three most common found ECG abnormalities. 30 (9.80%) patients died during hospitalization. Abnormal ECG scores were significantly higher among non-survivors (median 2 points vs 1 point, p < 0.001). The risk of in-hospital death increased by a factor of 1.478 (HR 1.478, 95% CI 1.131-1.933, p = 0.004) after adjusted by age, comorbidities, cardiac injury and treatments.
Conclusions: ECG abnormality was common in patients admitted for COVID-19 and was associated with adverse in-hospital outcome. In-hospital mortality risk increased with increasing abnormal ECG scores.

Keywords: cardiac injury; coronavirus; electrocardiography; outcome.