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Korean Circ J
. 2021 Oct;51(10):851-862.
doi: 10.4070/kcj.2021.0116.
Electrocardiographic Manifestations in Patients with COVID-19: Daegu in South Korea
Han-Joon Bae # 1 , Hyun Jun Cho # 2 , Chan-Hee Lee 3 , Myung Hwan Bae 4 , Hyoung-Seob Park 5 , Byung Chun Jung 2 , Dong-Gu Shin 3 , Yongkeun Cho 4 , Jongmin Hwang 5 , Seongwook Han 5 , Kyu-Hwan Park 6 , Se Yong Jang 7 , Young Soo Lee 8
Affiliations
- PMID: 34595853
- DOI: 10.4070/kcj.2021.0116
Abstract
Background and objectives: As the coronavirus disease 2019 (COVID-19) spreads worldwide, cardiac injury in patients infected with COVID-19 becomes a significant concern. Thus, this study investigates the impact of several electrocardiogram (ECG) parameters and disease severity in COVID-19 patients.
Methods: Seven medical centers in Daegu admitted 822 patients with COVID-19 between February and April 2020. This study examined 267 patients among them who underwent an ECG test and evaluated their biochemical parameters like C-reactive protein (CRP), log N-terminal pro-B-type Natriuretic Peptide (NT-proBNP), cardiac enzyme, and ECG parameters (heart rate, PR interval, QRS interval, T inversion, QT interval, and Tpe [the interval between peak to end in a T wave]).
Results: Those patients were divided into 3 groups of mild (100 patients), moderate (89 patients), and severe (78 patients) according to clinical severity score. The level of CRP, log NT-proBNP, and creatinine kinase-myocardial band were significantly increased in severe patients. Meanwhile, severe patients exhibited prolonged QT intervals (QTc) and Tpe (Tpe-c) compared to mild or moderate patients. Moreover, deceased patients (58; 21.7%) showed increased dispersion of QTc and Tpe-c compared with surviving patients (78.2±41.1 vs. 40.8±24.6 ms and 60.2±37.3 vs. 40.8±24.5 ms, both p<0.05, respectively). The QTc dispersion of more than 56.1 ms could predict the mortality in multivariate analysis (odd ratio, 11.55; 95% confidence interval, 3.746-42.306).
Conclusions: COVID-19 infections could involve cardiac injuries, especially cardiac repolarization abnormalities. A prolonged QTc dispersion could be an independent predictable factor of mortality.
Keywords: COVID-19; Coronavirus; ECG.