tetano
Editor, Senior Moderator
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[SUP] #[/SUP][SUP] 1 [/SUP], Hyun Jun Cho[SUP] #[/SUP][SUP] 2 [/SUP], Chan-Hee Lee[SUP] 3 [/SUP], Myung Hwan Bae[SUP] 4 [/SUP], Hyoung-Seob Park[SUP] 5 [/SUP], Byung Chun Jung[SUP] 2 [/SUP], Dong-Gu Shin[SUP] 3 [/SUP], Yongkeun Cho[SUP] 4 [/SUP], Jongmin Hwang[SUP] 5 [/SUP], Seongwook Han[SUP] 5 [/SUP], Kyu-Hwan Park[SUP] 6 [/SUP], Se Yong Jang[SUP] 7 [/SUP], Young Soo Lee[SUP] 8 [/SUP]
Affiliations
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.
. 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[SUP] #[/SUP][SUP] 1 [/SUP], Hyun Jun Cho[SUP] #[/SUP][SUP] 2 [/SUP], Chan-Hee Lee[SUP] 3 [/SUP], Myung Hwan Bae[SUP] 4 [/SUP], Hyoung-Seob Park[SUP] 5 [/SUP], Byung Chun Jung[SUP] 2 [/SUP], Dong-Gu Shin[SUP] 3 [/SUP], Yongkeun Cho[SUP] 4 [/SUP], Jongmin Hwang[SUP] 5 [/SUP], Seongwook Han[SUP] 5 [/SUP], Kyu-Hwan Park[SUP] 6 [/SUP], Se Yong Jang[SUP] 7 [/SUP], Young Soo Lee[SUP] 8 [/SUP]
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.