Prognostic significance of Tp-e interval and Tp-e/QTc ratio in patients with COVID-19
1University of Health Sciences, Okmeydani Training and Research Hospital, Department of Cardiology, Istanbul, Turkey. adematici10@gmail.com.
Insights
Electrocardiography (ECG) repolarization parameters, specifically prolonged T wave peak-to-end (Tp-e) interval and increased Tp-e/QTc ratio, predict mortality in COVID-19 patients. These ECG findings aid in assessing prognosis and guiding treatment for ventricular arrhythmias.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Diagnostics
Background:
- Ventricular arrhythmias are a frequent complication of COVID-19.
- Disease progression and drug treatments can impact ventricular repolarization.
- Surface electrocardiography (ECG) offers a non-invasive method to assess cardiac electrical activity.
Purpose of the Study:
- To investigate the prognostic value of ventricular repolarization parameters derived from surface ECG in COVID-19 patients.
- To determine if specific ECG repolarization metrics can predict mortality risk.
- To correlate ECG findings with clinical outcomes in hospitalized COVID-19 patients.
Main Methods:
- A cohort of 205 hospitalized COVID-19 patients was analyzed.
- 12-lead surface ECGs were recorded upon admission.
- ECG parameters, including T wave peak-to-end (Tp-e) interval and Tp-e/QTc ratio, were evaluated alongside clinical data and patient outcomes by cardiology specialists.
Main Results:
- Older age, elevated D-dimer, and increased high-sensitivity troponin I were associated with mortality.
- Pneumonia on CT scan significantly increased mortality risk (OR: 4.985).
- Prolonged Tp-e interval (OR: 3.421) and elevated Tp-e/QTc ratio (OR: 1.978) were independent predictors of mortality.
Conclusions:
- Prolonged Tp-e interval and increased Tp-e/QTc ratio on admission are significant predictors of mortality in COVID-19 patients.
- Surface ECG is a valuable tool for assessing prognosis and guiding treatment strategies for COVID-19 patients at risk of arrhythmias.
- Early identification of patients at high risk for adverse outcomes can be facilitated by ECG analysis.
Objective:
Ventricular arrhythmias were the most frequent manifestations in patients with COVID-19. Both the natural course of the disease and the treatment drugs used have effects on ventricular repolarization. The objective of this study was to evaluate the effects of repolarization parameters obtained from surface electrocardiography (ECG) on prognosis.
Patients And Methods:
Participants were 205 consecutive patients hospitalized with COVID-19 diagnosis. The 12-lead surface ECG was obtained from each patient on admission. The ECG results were evaluated against the patients' clinical characteristics and outcomes by experienced cardiology specialists.
Results:
The mean age was higher in the non-survivor group compared to the survivor group (57.4 ± 15.7 vs. 65.6 ± 16.6; p = 0.001). The demographical characteristics were similar between the survivor and non-survivor groups. Multivariate analyses demonstrated that age (OR: 1.041; p = 0.009), D-dimer (OR: 1.002; p = 0.031), high-sensitivity troponin I (hs-TnI) (OR: 1.010; p = 0.041), pneumonia on computed tomography (CT) (OR: 4.985; p < 0.001), the peak-to-end interval of the T wave (Tp-e) (OR: 3.421; p < 0.001), and Tp-e/QTc ratio (OR: 1.978; p = 0.013) were statistically significant independent predictors in terms of determining mortality.
Conclusions:
Prolonged Tp-e interval and increased Tp-e/QTc ratio on admission are decent predictors and linked with mortality. ECG is a practical study to evaluate prognosis and potential arrhythmias, as well as initiating suitable treatment.
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