tetano
Editor, Senior Moderator
Am J Med Sci
. 2021 Feb 10;S0002-9629(20)30549-8.
doi: 10.1016/j.amjms.2020.12.012. Online ahead of print.
Wide QRS Complex and Lateral ST-T Segment Abnormality Are Associated With Worse Clinical Outcomes in COVID-19 Patients
Mehmet Rasih Sonsoz[SUP] 1 [/SUP], Aytac Oncul[SUP] 2 [/SUP], Erdem Cevik[SUP] 2 [/SUP], Huseyin Orta[SUP] 2 [/SUP], Mustafa Yilmaz[SUP] 2 [/SUP], Elif Ayduk Govdeli[SUP] 2 [/SUP], Asli Nalbant[SUP] 2 [/SUP], Zeynep Gizem Demirtakan[SUP] 2 [/SUP], Mirac Tonyali[SUP] 2 [/SUP], Damla Durmus[SUP] 2 [/SUP], Ilkay Anakli[SUP] 3 [/SUP], Ozlem Polat[SUP] 3 [/SUP], Yunus Catma[SUP] 4 [/SUP], Naci Senkal[SUP] 4 [/SUP], Alpay Medetalibeyoglu[SUP] 4 [/SUP], Murat Kose[SUP] 4 [/SUP], Samim Emet[SUP] 2 [/SUP], Tufan Tukek[SUP] 4 [/SUP]
Affiliations
Abstract
Background: The information on electrocardiographic features of patients with coronavirus disease 2019 (COVID-19) is limited. Our aim was to determine if baseline electrocardiographic features of hospitalized COVID-19 patients are associated with markers of myocardial injury and clinical outcomes.
Methods: In this retrospective, single center cohort study, we included 223 hospitalized patients with laboratory-confirmed COVID-19. Clinical, electrocardiographic and laboratory data were collected and analyzed. Primary composite endpoint of mortality, need for invasive mechanical ventilation, or admission to the intensive care unit was assessed.
Results: Forty patients (17.9%) reached the primary composite endpoint. Patients with the primary composite endpoint were more likely to have wide QRS complex (>120 ms) and lateral ST-T segment abnormality. The multivariable Cox regression showed increasing odds of the primary composite endpoint associated with acute respiratory distress syndrome (odds ratio 7.76, 95% CI 2.67-22.59; p < 0.001), acute cardiac injury (odds ratio 3.14, 95% CI 1.26-7.99; p = 0.016), high flow oxygen therapy (odds ratio 2.43, 95% CI 1.05-5.62; p = 0.037) and QRS duration longer than >120 ms (odds ratio 3.62, 95% CI 1.39-9.380; p = 0.008) Patients with a wide QRS complex (>120 ms) had significantly higher median level of troponin T and pro-BNP than those without it. Patients with abnormality of lateral ST-T segment had significantly higher median level of troponin T and pro-BNP than patients without.
Conclusions: The presence of QRS duration longer than 120 ms and lateral ST-T segment abnormality were associated with worse clinical outcomes and higher levels of myocardial injury biomarkers.
Keywords: COVID-19; Electrocardiogram; Mortality; Myocardial injury; Wide QRS complex.
. 2021 Feb 10;S0002-9629(20)30549-8.
doi: 10.1016/j.amjms.2020.12.012. Online ahead of print.
Wide QRS Complex and Lateral ST-T Segment Abnormality Are Associated With Worse Clinical Outcomes in COVID-19 Patients
Mehmet Rasih Sonsoz[SUP] 1 [/SUP], Aytac Oncul[SUP] 2 [/SUP], Erdem Cevik[SUP] 2 [/SUP], Huseyin Orta[SUP] 2 [/SUP], Mustafa Yilmaz[SUP] 2 [/SUP], Elif Ayduk Govdeli[SUP] 2 [/SUP], Asli Nalbant[SUP] 2 [/SUP], Zeynep Gizem Demirtakan[SUP] 2 [/SUP], Mirac Tonyali[SUP] 2 [/SUP], Damla Durmus[SUP] 2 [/SUP], Ilkay Anakli[SUP] 3 [/SUP], Ozlem Polat[SUP] 3 [/SUP], Yunus Catma[SUP] 4 [/SUP], Naci Senkal[SUP] 4 [/SUP], Alpay Medetalibeyoglu[SUP] 4 [/SUP], Murat Kose[SUP] 4 [/SUP], Samim Emet[SUP] 2 [/SUP], Tufan Tukek[SUP] 4 [/SUP]
Affiliations
- PMID: 33581838
- DOI: 10.1016/j.amjms.2020.12.012
Abstract
Background: The information on electrocardiographic features of patients with coronavirus disease 2019 (COVID-19) is limited. Our aim was to determine if baseline electrocardiographic features of hospitalized COVID-19 patients are associated with markers of myocardial injury and clinical outcomes.
Methods: In this retrospective, single center cohort study, we included 223 hospitalized patients with laboratory-confirmed COVID-19. Clinical, electrocardiographic and laboratory data were collected and analyzed. Primary composite endpoint of mortality, need for invasive mechanical ventilation, or admission to the intensive care unit was assessed.
Results: Forty patients (17.9%) reached the primary composite endpoint. Patients with the primary composite endpoint were more likely to have wide QRS complex (>120 ms) and lateral ST-T segment abnormality. The multivariable Cox regression showed increasing odds of the primary composite endpoint associated with acute respiratory distress syndrome (odds ratio 7.76, 95% CI 2.67-22.59; p < 0.001), acute cardiac injury (odds ratio 3.14, 95% CI 1.26-7.99; p = 0.016), high flow oxygen therapy (odds ratio 2.43, 95% CI 1.05-5.62; p = 0.037) and QRS duration longer than >120 ms (odds ratio 3.62, 95% CI 1.39-9.380; p = 0.008) Patients with a wide QRS complex (>120 ms) had significantly higher median level of troponin T and pro-BNP than those without it. Patients with abnormality of lateral ST-T segment had significantly higher median level of troponin T and pro-BNP than patients without.
Conclusions: The presence of QRS duration longer than 120 ms and lateral ST-T segment abnormality were associated with worse clinical outcomes and higher levels of myocardial injury biomarkers.
Keywords: COVID-19; Electrocardiogram; Mortality; Myocardial injury; Wide QRS complex.