Electrocardiogram analysis of patients with different types of COVID-19
Yina Wang1, Lie Chen1, Jingyi Wang1
1Division of Cardiology and Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
Electrocardiogram (ECG) changes like ST-T changes, sinus tachycardia, and atrial fibrillation are significant in diagnosing COVID-19 severity and cardiac issues. These arrhythmias can predict in-hospital death and ventilator use in patients with coronavirus disease 2019.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, causing coronavirus disease 2019 (COVID-19), is associated with myocardial damage and arrhythmias.
- Electrocardiogram (ECG) monitoring is crucial for assessing COVID-19 patients' cardiac status.
Purpose of the Study:
- To compare ECG changes between critically severe and severe COVID-19 patients.
- To identify risk factors for ST-T changes and atrial fibrillation in COVID-19.
- To investigate the predictive value of ECG parameters for in-hospital mortality and ventilator use.
Main Methods:
- Retrospective analysis of ECG data from COVID-19 patients.
- Univariate and multivariate logistic regression to analyze correlations between serum markers, medical history, and ECG findings.
- Assessment of ECG parameters' association with in-hospital death and ventilator use.
Main Results:
- Critically severe COVID-19 patients exhibited higher rates of male sex, stroke, elevated cardiac troponin I (cTnI), N-terminal of the prohormone brain natriuretic peptide (NT-proBNP), d-dimer, hs-CRP, hyperkalemia, and hypocalcemia.
- Significant differences in ST-T changes, sinus tachycardia, atrial fibrillation, and atrial tachycardia were observed between groups.
- Elevated cTnI and NT-proBNP were independent risk factors for ST-T changes; elevated NT-proBNP and age for atrial fibrillation.
- Sinus tachycardia and atrial fibrillation independently predicted in-hospital death and ventilator use.
Conclusions:
- ECG abnormalities including ST-T changes, sinus tachycardia, and atrial fibrillation are vital for diagnosing COVID-19 severity, myocardial injury, and cardiac insufficiency.
- Sinus tachycardia and atrial fibrillation serve as independent predictors of adverse outcomes, including in-hospital death and need for mechanical ventilation.
Background:
Severe acute respiratory syndrome coronavirus 2 causes acute myocardial damage and arrhythmia in coronavirus disease 2019 (COVID-19) patients. Studying the changes of electrocardiogram is of great significance for the diagnosis of patients with COVID-19.
Methods:
A retrospective analysis method was adopted to compare the electrocardiogram changes between COVID-19 critically severe and severe patients. Univariate and multivariate logistic regression were used to analyze the correlation of the levels of serum indexes and past medical history with ST-T changes and atrial fibrillation. And the correlation of ECG parameters with in-hospital death and ventilator use were investigated by using the same methods.
Results:
The incidence of male, stroke, elevated cardiac troponin I (cTnI), N-terminal of the prohormone brain natriuretic peptide (NT-proBNP), d-dimer, high-sensitivity C-reactive protein (hs-CRP), hyperkalemia, and hypocalcemia in the critically ill patients was higher than that in severe patients. There were differences in ST-T changes, sinus tachycardia, atrial fibrillation, and atrial tachycardia between the two groups. Multivariate logistic regression analysis showed that elevated cTnI and NT-proBNP were the independent risk factors of ST-T changes. Elevated NT-proBNP and age were the independent risk factors of atrial fibrillation. Sinus tachycardia and atrial fibrillation were the independent risk factors of in-hospital death and ventilator use.
Conclusion:
ST-T changes, sinus tachycardia, and atrial fibrillation are with great significance in the diagnosis of the severity, myocardia injury, and cardiac insufficiency of COVID-19 patients. Sinus tachycardia and atrial fibrillation could be used as independent variables predicting in-hospital death and ventilator use.
Related Concept Videos
01:29Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:28Electrocardiogram Fundamentals
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
01:16ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
01:30Dysrhythmias V: Evaluating Dysrhythmias
01:25Correlation between ECG and Cardiac Cycle
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...