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Wide QRS Complex and Lateral ST-T Segment Abnormality Are Associated With Worse Clinical Outcomes in COVID-19

Mehmet Rasih Sonsoz1, Aytac Oncul1, Erdem Cevik1

  • 1Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.

The American Journal of the Medical Sciences
|February 14, 2021
PubMed

Insights

Electrocardiogram (ECG) findings like a wide QRS complex and lateral ST-T abnormalities in COVID-19 patients predict worse outcomes and higher myocardial injury markers. These ECG features are crucial for assessing hospitalized coronavirus disease 2019 patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Limited information exists on electrocardiographic (ECG) features in patients with coronavirus disease 2019 (COVID-19).
  • Understanding ECG patterns may help predict clinical trajectories and outcomes in hospitalized COVID-19 patients.

Purpose of the Study:

  • To investigate the association between baseline electrocardiographic features in hospitalized COVID-19 patients and markers of myocardial injury.
  • To determine if specific ECG findings correlate with adverse clinical outcomes in this patient population.

Main Methods:

  • Retrospective, single-center cohort study including 223 hospitalized patients with laboratory-confirmed COVID-19.
  • Collection and analysis of clinical, electrocardiographic, and laboratory data.
  • Assessment of a primary composite endpoint including mortality, need for invasive mechanical ventilation, or intensive care unit admission.

Main Results:

  • Forty patients (17.9%) met the primary composite endpoint.
  • Wider QRS complex (>120 ms) and lateral ST-T segment abnormalities were more common in patients with adverse outcomes.
  • Multivariable analysis identified wide QRS duration (>120 ms), acute respiratory distress syndrome, acute cardiac injury, and high-flow oxygen therapy as predictors of the primary endpoint.

Conclusions:

  • A QRS duration exceeding 120 ms and lateral ST-T segment abnormalities are associated with poorer clinical outcomes in COVID-19 patients.
  • These ECG findings correlate with elevated levels of myocardial injury biomarkers, including troponin T and pro-BNP.
Abstract

Keywords:
COVID-19ElectrocardiogramMortalityMyocardial injuryWide QRS complex

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