Association between electrocardiographic features and mortality in COVID-19 patients
Daniel Antwi-Amoabeng1, Bryce D Beutler1, Sahajpreet Singh1
1Department of Internal Medicine, University of Nevada, Reno, School of Medicine, Reno, NV, USA.
Summary
Electrocardiogram (ECG) abnormalities like atrial fibrillation and flutter predict mortality in COVID-19 patients. Systemic inflammation may cause these potentially lethal cardiac arrhythmias, necessitating further research.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease-19 (COVID-19) is associated with cardiovascular events.
- Systemic inflammation in COVID-19 may trigger arrhythmias and conduction abnormalities.
- The specific ECG disturbances and their impact on mortality in COVID-19 require further characterization.
Purpose of the Study:
- To characterize electrocardiographic (ECG) disturbances in COVID-19 patients.
- To investigate the association between ECG findings and mortality in COVID-19.
- To explore potential risk factors and pathogenesis of COVID-19-associated cardiac arrhythmias.
Main Methods:
- ECGs were analyzed from 186 COVID-19-positive patients.
- Common arrhythmias and ECG intervals were documented.
- Statistical analyses, including Fisher's exact test and multivariable logistic regression, were used to assess mortality predictors.
Main Results:
- Atrial fibrillation (A-Fib), atrial flutter, and ST-segment depression predicted mortality.
- Patients who died had a higher mean ventricular rate compared to survivors.
- Therapeutic anticoagulation showed a trend towards reduced mortality, but without statistical significance.
Conclusions:
- COVID-19-associated arrhythmias may stem from systemic inflammation and/or hypoxia.
- Potentially lethal conduction abnormalities can be induced in COVID-19 patients.
- Further longitudinal studies are needed to understand risk factors, pathogenesis, and management of these arrhythmias.
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