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J-waves in acute COVID-19: A novel disease characteristic and predictor of mortality?

Naufal Shamilevich Zagidullin1,2, Lukas J Motloch3, Timur Ilgamovich Musin1

  • 1Department of Internal Medicine I, Bashkir State Medical University, Ufa, Russian Federation.

Plos One
|October 14, 2021
PubMed

Insights

J-waves, often seen on electrocardiograms (ECGs), were found in 12.2% of hospitalized COVID-19 patients. These J-waves independently predicted higher 28-day mortality, highlighting their clinical significance.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Electrocardiography

Background:

  • J-waves are common ECG findings (5-6%) linked to ventricular tachycardias.
  • COVID-19 patients frequently exhibit arrhythmias and non-specific ECG changes.
  • The incidence of J-waves in acute COVID-19 has not been previously analyzed.

Purpose of the Study:

  • To determine the incidence of J-waves in patients hospitalized with acute COVID-19 pneumonia.
  • To correlate J-wave presence with clinical characteristics and 28-day mortality.
  • To assess the prognostic value of J-waves in acute COVID-19.

Main Methods:

  • Retrospective analysis of 386 hospitalized COVID-19 pneumonia patients.
  • Screening of admission ECGs for the presence of J-waves.
  • Correlation of J-wave findings with clinical data and 28-day mortality outcomes.

Main Results:

  • J-waves were detected in 12.2% of patients.
  • Factors associated with J-waves included older age, female sex, history of stroke/heart failure, high CRP, and high BMI.
  • J-wave presence was linked to significantly higher 28-day mortality (14.9% vs. 3.8%, p=0.001).
  • J-waves were an independent predictor of 28-day mortality (OR 2.76).
  • J-waves resolved or diminished in 36.4% of survivors at 6-8 month follow-up.

Conclusions:

  • J-waves are frequently observed in admission ECGs of COVID-19 patients.
  • J-waves appear to be an independent predictor of 28-day mortality in this population.
  • The transient nature of J-waves in survivors suggests potential dynamic cardiac involvement.
Abstract

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