Association of electrocardiographic abnormalities and COVID-19 clinical outcomes
Latifeh Jabbari1, Saeed Hayati1, Leila Azizkhani2
1Department of Emergency Medicine, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Insights
Electrocardiogram (ECG) abnormalities, particularly a non-sinus rhythm, significantly increase mortality risk in coronavirus disease 2019 (COVID-19) patients. Continuous ECG monitoring is recommended for prognostic insights in COVID-19 care.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Electrocardiogram (ECG) alterations correlate with coronavirus disease 2019 (COVID-19) severity and mortality.
- Previous studies show varied ECG abnormalities linked to COVID-19 mortality.
- This study investigates the association between specific ECG abnormalities and COVID-19 clinical outcomes.
Purpose of the Study:
- To evaluate the association between electrocardiogram (ECG) abnormalities and clinical outcomes in COVID-19 patients.
- To identify specific ECG findings predictive of mortality in COVID-19.
Main Methods:
- Retrospective cross-sectional study of 239 COVID-19 patients admitted to Shahid Mohammadi Hospital in 2021.
- Data collected included demographics, comorbidities, treatments, and laboratory results.
- Admission ECGs were analyzed for abnormalities.
Main Results:
- A non-sinus rhythm on admission ECG was associated with an approximately eight-fold increased odds of mortality (aOR = 7.961, P = 0.008).
- Patients who died had higher rates of intensive care unit (ICU) admission and mechanical ventilation.
- Increased duration of mechanical ventilation and longer hospital/ICU stays were observed in non-survivors.
Conclusions:
- A non-sinus rhythm identified on admission ECG is a significant predictor of mortality in COVID-19 patients.
- Continuous ECG monitoring in COVID-19 patients may offer valuable prognostic information.
- ECG assessment is crucial for stratifying risk and guiding management in COVID-19 care.
Background:
Alterations in the electrocardiogram (ECG) have been associated with coronavirus disease 2019 (COVID-19) severity. ECG irregularities have been linked to death from any cause. However, in previous studies, different abnormalities have been shown to be associated with COVID-19 mortality. We aimed to evaluate the association between ECG abnormalities and COVID-19 clinical outcomes.
Methods:
This cross-sectional retrospectively evaluated patients with COVID-19 admitted to the emergency department of Shahid Mohammadi Hospital, Bandar Abbas, in 2021. Patients' data were extracted from their medical records, including demographics, smoking, underlying diseases, treatment, laboratory test results, and in-hospital parameters. Their admission ECGs were assessed for abnormalities.
Results:
Of the 239 COVID-19 patients with a mean age of 55.18 ± 16.85 years, 126 (52.7%) were male. Fifty-seven patients (23.8%) died. Intensive care unit (ICU) admission and mechanical ventilation requirement were higher in patients who died (P < 0.001). Furthermore, mechanical ventilation duration and hospital and ICU length of stay were significantly longer in patients who died (P < 0.001). Multivariable logistic regression analysis revealed that a non-sinus rhythm in the admission ECG was associated with approximately eight times higher odds of mortality than a sinus rhythm (adjusted odds ratio = 7.961, 95% confidence interval 1.724; 36.759, P = 0.008).
Conclusions:
Among ECG findings, a non-sinus rhythm in the admission ECG appears to increase the odds of mortality in patients with COVID-19. Therefore, it is advised that COVID-19 patients be continuously monitored for ECG alterations, as this might provide crucial prognostic data.
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