tetano
Editor, Senior Moderator
J Clin Med
. 2020 Nov 12;9(11):E3647.
doi: 10.3390/jcm9113647.
Electrocardiographic Findings and Clinical Outcome in Patients with COVID-19 or Other Acute Infectious Respiratory Diseases
Antonio De Vita[SUP] 1 [/SUP], Salvatore Emanuele Ravenna[SUP] 1 [/SUP], Marcello Covino[SUP] 2 [/SUP], Oreste Lanza[SUP] 3 [/SUP], Francesco Franceschi[SUP] 2 [/SUP], Filippo Crea[SUP] 1 [/SUP], Gaetano Antonio Lanza[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Cardiac involvement in coronavirus SARS-CoV-2 infection (COVID-19) has been reported in a sizeable proportion of patients and associated with a negative outcome; furthermore, a pre-existing heart disease is associated with increased mortality in these patients. In this prospective single-center case-control study we investigated whether COVID-19 patients present different rates and clinical implications of an abnormal electrocardiogram (ECG) compared to patients with an acute infectious respiratory disease (AIRD) caused by other pathogens.
Methods: We studied 556 consecutive patients admitted to the emergency department of our hospital with symptoms of AIRD; 324 were diagnosed to have COVID-19 and 232 other causes of AIRD (no-COVID-19 group). Standard 12-lead ECG performed on admission was assessed for various kinds of abnormalities, including ST segment/T wave changes, atrial fibrillation, ventricular arrhythmias, and intraventricular conduction disorders.
Results: ECG abnormalities were found in 120 (37.0%) and 101 (43.5%) COVID-19 and no-COVID-19 groups, respectively (p = 0.13). No differences in ECG abnormalities were found between the 2 groups after adjustment for clinical and laboratory variables. During a follow-up of 45 ? 16 days, 51 deaths (15.7%) occurred in the COVID-19 and 30 (12.9%) in the no-COVID-19 groups (p = 0.39). ST segment depression ≥ 0.5 mm (p = 0.016), QRS duration (p = 0.016) and presence of any ECG abnormality (p = 0.027) were independently associated with mortality at multivariable Cox regression analysis.
Conclusion: Among patients hospitalized because of AIRD, we found no significant differences in abnormal ECG findings between COVID-19 vs. no-COVID-19 patients. The ECG on admission was helpful to identify patients with increased risk of death in both groups of patients.
Keywords: COVID-19; SARS-CoV-2 infection; acute infectious respiratory disease; clinical outcome; electrocardiogram.
. 2020 Nov 12;9(11):E3647.
doi: 10.3390/jcm9113647.
Electrocardiographic Findings and Clinical Outcome in Patients with COVID-19 or Other Acute Infectious Respiratory Diseases
Antonio De Vita[SUP] 1 [/SUP], Salvatore Emanuele Ravenna[SUP] 1 [/SUP], Marcello Covino[SUP] 2 [/SUP], Oreste Lanza[SUP] 3 [/SUP], Francesco Franceschi[SUP] 2 [/SUP], Filippo Crea[SUP] 1 [/SUP], Gaetano Antonio Lanza[SUP] 1 [/SUP]
Affiliations
- PMID: 33198406
- DOI: 10.3390/jcm9113647
Abstract
Background: Cardiac involvement in coronavirus SARS-CoV-2 infection (COVID-19) has been reported in a sizeable proportion of patients and associated with a negative outcome; furthermore, a pre-existing heart disease is associated with increased mortality in these patients. In this prospective single-center case-control study we investigated whether COVID-19 patients present different rates and clinical implications of an abnormal electrocardiogram (ECG) compared to patients with an acute infectious respiratory disease (AIRD) caused by other pathogens.
Methods: We studied 556 consecutive patients admitted to the emergency department of our hospital with symptoms of AIRD; 324 were diagnosed to have COVID-19 and 232 other causes of AIRD (no-COVID-19 group). Standard 12-lead ECG performed on admission was assessed for various kinds of abnormalities, including ST segment/T wave changes, atrial fibrillation, ventricular arrhythmias, and intraventricular conduction disorders.
Results: ECG abnormalities were found in 120 (37.0%) and 101 (43.5%) COVID-19 and no-COVID-19 groups, respectively (p = 0.13). No differences in ECG abnormalities were found between the 2 groups after adjustment for clinical and laboratory variables. During a follow-up of 45 ? 16 days, 51 deaths (15.7%) occurred in the COVID-19 and 30 (12.9%) in the no-COVID-19 groups (p = 0.39). ST segment depression ≥ 0.5 mm (p = 0.016), QRS duration (p = 0.016) and presence of any ECG abnormality (p = 0.027) were independently associated with mortality at multivariable Cox regression analysis.
Conclusion: Among patients hospitalized because of AIRD, we found no significant differences in abnormal ECG findings between COVID-19 vs. no-COVID-19 patients. The ECG on admission was helpful to identify patients with increased risk of death in both groups of patients.
Keywords: COVID-19; SARS-CoV-2 infection; acute infectious respiratory disease; clinical outcome; electrocardiogram.