Prolonged QT predicts prognosis in COVID-19

Area of Science:

• Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• Coronavirus disease-2019 (COVID-19) is a severe illness causing multi-organ dysfunction.
• Abnormal electrocardiograms, including QT prolongation, are associated with poor outcomes in COVID-19 patients.
• QT prolongation in COVID-19 has been previously linked to pharmacological effects.

Purpose of the Study:

• To investigate the effects of COVID-19 illness on the corrected QT interval (QTc).
• To determine if QTc prolongation is associated with mortality in COVID-19 patients.

Main Methods:

• A retrospective study of 293 consecutive COVID-19 patients admitted to the hospital.
• Comparison of demographic data, laboratory findings, and electrocardiograms between survivors and non-survivors.
• Multivariate Cox-regression analysis to identify predictors of mortality.

Main Results:

• Deceased patients were older and had higher levels of C-reactive protein and troponin.
• A significantly longer QTc interval was observed in non-survivors compared to survivors (461.1 ms vs 449.3 ms).
• QTc prolongation (>455 ms for males, >465 ms for females) was a significant predictor of mortality (HR 1.49).

Conclusions:

• QTc prolongation occurs during COVID-19 illness.
• QTc prolongation is associated with increased mortality risk in COVID-19 patients.
• Monitoring QTc interval may aid in risk stratification for severe COVID-19 outcomes.