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Br J Cardiol . ECG changes in hospitalised patients with COVID-19 infection

tetano

Editor, Senior Moderator
Br J Cardiol


. 2021 Jun 2;28(2):24.
doi: 10.5837/bjc.2021.024. eCollection 2021.
ECG changes in hospitalised patients with COVID-19 infection


Mengshi Yuan[SUP] 1 [/SUP], Zafraan Zathar[SUP] 2 [/SUP], Frantisek Nihaj[SUP] 3 [/SUP], Stavros Apostolakis[SUP] 4 [/SUP], Fairoz Abdul[SUP] 5 [/SUP], Derek Connolly[SUP] 6 [/SUP], Chetan Varma[SUP] 7 [/SUP], Vinoda Sharma[SUP] 8 [/SUP]



Affiliations

Abstract

The coronavirus disease 2019 (COVID-19) commonly involves the respiratory system but increasingly cardiovascular involvement is recognised. We assessed electrocardiogram (ECG) abnormalities in patients with COVID-19. We performed retrospective analysis of the hospital's COVID-19 database from April to May 2020. Any ECG abnormality was defined as: 1) new sinus bradycardia; 2) new/worsening bundle-branch block; 3) new/worsening heart block; 4) new ventricular or atrial bigeminy/trigeminy; 5) new-onset atrial fibrillation (AF)/atrial flutter or ventricular tachycardia (VT); and 6) new-onset ischaemic changes. Patients with and without any ECG change were compared. There were 455 patients included of whom 59 patients (12.8%) met criteria for any ECG abnormality. Patients were older (any ECG abnormality 77.8 ± 12 years vs. no ECG abnormality 67.4 ± 18.2 years, p<0.001) and more likely to die in-hospital (any ECG abnormality 44.1% vs. no ECG abnormality 27.8%, p=0.011). Coxproportional hazard analysis demonstrated any ECG abnormality (hazard ratio
1.97, 95% confidence interval [CI] 1.12 to 3.47, p=0.019), age (HR 1.03, 95%CI 1.01 to 1.05, p=0.0009), raised high sensitivity troponin I (HR 2.22, 95%CI 1.27 to 3.90, p=0.006) and low estimated glomerular filtration rate (eGFR) (HR 1.73, 95%CI 1.04 to 2.88, p=0.036) were independent predictors of in-hospital mortality. In conclusion, any new ECG abnormality is a significant predictor of in-hospital mortality.

Keywords: COVID-19; electrocardiogram (ECG) change; outcomes.
 
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