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J Electrocardiol . Fragmented QRS on surface electrocardiography as a predictor of cardiac mortality in patients with SARS-CoV-2 infection

tetano

Editor, Senior Moderator
J Electrocardiol


. 2021 Mar 17;66:108-112.
doi: 10.1016/j.jelectrocard.2021.03.001. Online ahead of print.
Fragmented QRS on surface electrocardiography as a predictor of cardiac mortality in patients with SARS-CoV-2 infection


Arzu Yildirim[SUP] 1 [/SUP], I Oguz Karaca[SUP] 2 [/SUP], Filiz Kizilirmak Yilmaz[SUP] 2 [/SUP], H Murat Gunes[SUP] 2 [/SUP], Beytullah Cakal[SUP] 2 [/SUP]



Affiliations
Free PMC article

Abstract

Aims: Although severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is mainly a respiratory system disease, recent studies reported that cardiac injury is associated with poor outcomes in this population. There are few studies which assessed standard electrocardiogram (ECG) as a prognostic tool during the course of SARS-CoV-2 infection. The aim of this study is to identify the relationship between of ECG parameters and prognosis of patients infected with SARS-CoV-2.
Method and results: A total of 114 consecutive patients with a confirmed diagnosis of SARS-CoV-2 infection between March 2020 and May 2020 were included in the study. Standard 12?lead surface ECG was reviewed for presence of fragmented QRS (fQRS), abnormal Q wave, T wave inversion, and duration of QRS. fQRS was observed in 36.8% (n = 42) of the patients who had SARS-CoV-2. Patient groups with and without fQRS did not differ in terms of age, gender, the presence of comorbid diseases and medical treatment. Hospitalization duration, intensive care unit(ICU) requirement, all-cause mortality, and cardiac mortality were found to be higher in patients with fQRS (all p values <0.05). There was a positive correlation between QRS duration and duration of hospital stay (p < 0.001, r = 0.421). QRS duration was also found to be associated with intensive care need, all-cause mortality, and cardiac mortality.
Conclusion: Our data shows that QRS duration and the presence of fQRS on standard ECG can help to identify patients with worse clinical outcome admitted for SARS-CoV-2 infection.

Keywords: COVID-19; Cardiac mortality; Electrocardiography; Fragmented QRS; SARS-CoV-2 infection.
 
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