Are Pre-Hospitalization ECG Abnormalities Associated With Increased Mortality in COVID-19 Patients? A Quantitative...

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• COVID-19, primarily a respiratory illness, presents significant cardiovascular complications linked to adverse outcomes.
• Electrocardiogram (ECG) abnormalities are common in hospitalized COVID-19 patients, with some linked to higher mortality.
• The association between pre-hospital ECG changes and COVID-19 mortality remains unclear.

Approach:

• A systematic literature review and quantitative synthesis of eight cohort studies involving COVID-19 patients with pre-hospitalization ECGs.
• Data were collected on the prevalence of ECG changes in survivors versus non-survivors.
• Odds and hazard ratios for ECG abnormalities associated with mortality were analyzed.

Key Points:

• Pre-hospital electrocardiogram (ECG) abnormalities are significantly associated with increased mortality in COVID-19 patients.
• Specific ECG findings linked to higher mortality include non-sinus rhythm, QTc prolongation, left bundle branch block, axis deviation, atrial fibrillation/flutter, right ventricular strain, ST segment changes, T wave abnormalities, and left ventricular hypertrophy.
• These ECG markers can help stratify risk in the pre-hospital setting.

Conclusions:

• Electrocardiogram (ECG) assessment prior to hospitalization can be a valuable tool for evaluating COVID-19 patients.
• Identifying pre-hospital ECG abnormalities may assist in identifying individuals at higher risk of mortality.
• This approach can potentially improve pre-hospital care and decision-making for COVID-19 patients.