J Cardiothorac Vasc Anesth . Electrocardiographic Features and Outcome: Correlations in 124 Hospitalized Patients With COVID-19 and Cardiovascular Events

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J Cardiothorac Vasc Anesth


. 2022 Jan 13;S1053-0770(22)00042-8.
doi: 10.1053/j.jvca.2022.01.011. Online ahead of print.
Electrocardiographic Features and Outcome: Correlations in 124 Hospitalized Patients With COVID-19 and Cardiovascular Events


Pavani Nathala ¹ , Vidyulata Salunkhe ¹ , Harideep Samanapally ¹ , Qian Xu ² , Stephen Furmanek ¹ , Omar H Fahmy ¹ , Fnu Deepti ¹ , Alex Glynn ¹ , Trevor McGuffin ³ , Dylan C Goldsmith ⁴ , Jessica Petrey ⁵ , Tshura Ali ¹ , Derek Titus ⁶ , Ruth Carrico ¹ , Julio Ramirez ¹ , Demetra Antimisiaris ⁷ , Sean P Clifford ⁶ , Siddharth Pahwa ⁸ , Lynn Roser ⁴ , Maiying Kong ² , Jiapeng Huang ⁹ , Center of Excellence for Research in Infectious Diseases (CERID) Coronavirus Study Group on behalf of the COVID-19 Cardiovascular Research Group (COVID-CVRG)



Affiliations

• PMID: 35165040
• DOI: 10.1053/j.jvca.2022.01.011

Abstract

Objectives: Electrocardiographic (ECG) changes have been associated with coronavirus disease 2019 (COVID-19) severity. However, the progression of ECG findings in patients with COVID-19 has not been studied. The purpose of this study was to describe ECG features at different stages of COVID-19 cardiovascular (CV) events and to examine the effects of specific ECG parameters and cardiac-related biomarkers on clinical outcomes in COVID-19.
Design: Retrospective, cohort study.
Setting: Major tertiary-care medical centers and community hospitals in Louisville, KY.
Participants: A total of 124 patients with COVID-19 and CV events during hospitalization.
Interventions: None.
Measurements and main results: Twelve-lead ECG parameters, biomarkers of cardiac injuries, and clinical outcomes were analyzed with Spearman correlation coefficients and Kruskal-Wallis 1-way analysis of variance. Atrial fibrillation/atrial flutter was more frequent on the ECG obtained at the time of the CV event when compared with admission ECG (9.5% v 26.9%; p = 0.007). Sinus tachycardia was higher in the last available hospital ECG than the CV event ECG (37.5% v 20.4%; p = 0.031). Admission ECG-corrected QT interval was significantly associated with admission troponin levels (R = 0.52; p < 0.001). The last available hospital ECG showed nonsurvivors had longer QRS duration than survivors (114.6 v 91.2 ms; p = 0.026), and higher heart rate was associated with longer intensive care unit length of stay (Spearman ρ = 0.339; p = 0.032).
Conclusions: In hospitalized patients with COVID-19 and CV events, ECGs at various stages of COVID-19 hospitalization showed significantly different features with dissimilar clinical outcome correlations.

Keywords: COVID-19; ECG; SARS-CoV-2; cardiovascular events; electrocardiogram; mortality.