[ECG changes in COVID-19]
1National Medical Research Center for Cardiology, Moscow, Russia.
Insights
COVID-19 infection can cause right heart strain, indicated by electrocardiogram (ECG) changes like right bundle branch block and signs of hypertrophy. Further research is needed to fully understand these cardiac impacts.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Coronavirus disease 2019 (COVID-19) is a global pandemic.
- Cardiac complications are increasingly recognized in COVID-19 patients.
- Electrocardiography (ECG) is a crucial tool for assessing cardiac function.
Purpose of the Study:
- To evaluate electrocardiographic (ECG) changes in patients diagnosed with COVID-19.
- To identify specific ECG signs indicative of right ventricular (RV) stress in COVID-19.
Main Methods:
- Analysis of 150 12-lead ECGs from 75 COVID-19 patients.
- Diagnosis confirmed by clinical presentation, chest CT, and positive COVID-19 test.
- Evaluation of ECG signs for RV systolic and diastolic overload.
Main Results:
- Common findings included RV P wave abnormalities (41.3%), incomplete right bundle branch block (42.6%), and STQIIITIII pattern (33.3%).
- Signs of RV hypertrophy (14.7%) and RV myocardial stress (16%) were observed.
- Diffuse hypoxia signs, such as tall T waves, were present in 28% of patients.
Conclusions:
- COVID-19 infection is associated with significant electrocardiographic changes reflecting right heart strain.
- ECG findings like right bundle branch block and RV hypertrophy are prevalent.
- Longitudinal studies are necessary to fully characterize the hemodynamic and electrocardiographic dynamics in COVID-19 recovery.
Abstract:
Aim To evaluate changes in 12-lead ECG in patients with coronavirus infection.Materials and methods This article describes signs of electrocardiographic right ventricular "stress" in patients with COVID-19. 150 ECGs of 75 COVID-19 patients were analyzed in the Institute of Cardiology of the National Medical Research Centre for Therapy and Preventive Medicine. The diagnosis was based on the clinical picture of community-acquired pneumonia, data of chest multispiral computed tomography, and a positive test for COVID-19. ECG was recorded both in 3-6 and in 12 leads. Signs of right ventricular (RV) stress, so-called systolic overload (high R and inverted TV1-3 and TII, III, aVF), and diastolic overload (RV wall hypertrophy and cavity dilatation; complete or incomplete right bundle branch block) were evaluated.Results The most common signs for impaired functioning of the right heart include emergence of the RV P wave phase (41.3 %), incomplete right bundle branch block (42.6 %), ECG of the SIQ IIITIII type (33.3 %) typical for thromboembolic complications, and signs of RV hypertrophy, primarily increased SV5-6 (14.7 %). These changes are either associated with signs of RV myocardial stress (16 %) or appear on the background of signs for diffuse hypoxia evident as tall, positive, sharp-ended T waves in most leads (28 %).Conclusion A conclusive, comprehensive assessment of the reversal of hemodynamic disorders and electrocardiographic dynamics in patients with COVID-19 will be possible later, when more data become available.
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