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P wave peak time and P wave dispersion in severe COVID-19 infection
P Turker Duyuler1, S Duyuler, B Demirtaş
1Department of Cardiology, Ankara Bilkent City Hospital, Ankara, Turkey. turkerpinar1982@hotmail.com.
Insights
Electrocardiogram (ECG) P wave indices, including P wave dispersion (Pdis), P wave peak time in V1 lead (PWPTV1), and D2 lead (PWPTD2), are associated with COVID-19 severity. These ECG markers can predict intensive care unit (ICU) admission in patients with COVID-19.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Diagnostics
Background:
- COVID-19 infection can lead to severe respiratory illness requiring intensive care unit (ICU) admission.
- Electrocardiography (ECG) is a standard diagnostic tool that can reveal cardiac abnormalities.
Purpose of the Study:
- To evaluate the association between specific P wave indices on ECG and the severity of COVID-19.
- To determine if these P wave indices can predict ICU admission in COVID-19 patients.
Main Methods:
- A cohort of 247 hospitalized COVID-19 patients underwent standard 12-lead ECG upon admission.
- P wave dispersion (Pdis), P wave peak time in V1 lead (PWPTV1), and D2 lead (PWPTD2) were measured.
- Patients were categorized into ICU admission and non-ICU admission groups for comparison.
Main Results:
- ICU-admitted patients showed significantly prolonged Pdis, PWPTV1, and PWPTD2 compared to non-ICU patients.
- PWPTV1 and PWPTD2 were identified as independent predictors of ICU admission via logistic regression.
- Specific cut-off values for PWPTV1 (67.5 ms) and PWPTD2 (62.5 ms) demonstrated predictive capabilities for ICU admission.
Conclusions:
- Admission ECG P wave indices, specifically Pdis and PWPT, are associated with ICU admission in COVID-19 patients.
- These ECG findings may serve as valuable biomarkers for assessing COVID-19 severity and predicting the need for intensive care.
Objective:
With this study, we aimed at evaluating the association between electrocardiographic P wave indices and the severity of COVID-19 infection indicated as intensive care unit (ICU) admission.
Patients And Methods:
We included 247 patients who were hospitalized with a diagnosis of COVID-19 infection and underwent 12 lead standard Electrocardiography (ECG). P wave indices, P wave dispersion (Pdis), P wave peak time in V1 lead (PWPTV1), and D2 lead (PWPTD2) were measured using admission ECG. Comparisons were performed between ICU admitting and non-ICU admitting patients.
Results:
160 patients were hospitalized in normal wards, and 87 patients were admitted to ICU. Pdis, PWPTV1, and PWPTD2 were prolonged in ICU admitted patients compared with the normal ward admitted patients [40 (30-50) ms vs. 50 (40-55) ms; p<0.001, 61±9 ms vs. 68±9 ms; p<0.001, and 55±7 ms vs. 64±7 ms; p<0.001, respectively]. In multiple logistic regression analysis, PWPTV1 and PWPTD2 were independent predictors of ICU admission. A cut-off point of 67.5 ms PWPTv1 has a sensitivity of 62.1% and a specificity of 69.4% (AUC=0.710, 95% CI: 0.642-0.777, p<0.001) and a cut-off point of 62.5 ms PWPTD2 has a sensitivity of 60.9% and a specificity of 83.6% (AUC=0.819, 95% CI: 0.777-0.871, p<0.001).
Conclusions:
Admission ECG atrial indices Pdis and PWPT were associated with intensive care unit admission in newly diagnosed COVID-19 patients.
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