Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19



Savelloni, Giulia, Gatto, Maria Chiara, Cancelli, Francesca, Barbetti, Anna, Cogliati Dezza, Francesco, Franchi, Cristiana, Carnevalini, Martina, Galardo, Gioacchino, Bucci, Tommaso ORCID: 0000-0003-2895-6234, Alessandroni, Maria
et al (show 3 more authors) (2022) Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19. JOURNAL OF CLINICAL MEDICINE, 11 (9). 2537-.

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Abstract

<h4>Background</h4>Electrocardiogram (ECG) offers a valuable resource easily available in the emergency setting.<h4>Objective</h4>Aim of the study was to describe ECG alterations on emergency department (ED) presentation or that developed during hospitalization in SARS-CoV-2-infected patients and their association with 28-day mortality.<h4>Methods</h4>A retrospective, single-center study including hospitalized patients with SARS-CoV-2 was conducted. ECG was recorded on ED admission to determine: heart rhythm, rate, and cycle; atrio-ventricular and intra-ventricular conduction; right ventricular strain; and ventricular repolarization. A specialized cardiologist blinded for the outcomes performed all 12-lead ECG analyses and their interpretation.<h4>Results</h4>190 patients were included, with a total of 24 deaths (12.6%). Age (<i>p</i> &lt; 0.0001) and comorbidity burden were significantly higher in non-survivors (<i>p</i> &lt; 0.0001). Atrial fibrillation (AF) was more frequent in non-survivors (<i>p</i> &lt; 0.0001), alongside a longer QTc interval (<i>p</i> = 0.0002), a lower Tp-e/QTc ratio (<i>p</i> = 0.0003), and right ventricular strain (<i>p</i> = 0.013). Remdesivir administration was associated with bradycardia development (<i>p</i> = 0.0005) but no increase in mortality rates. In a Cox regression model, AF (aHR 3.02 (95% CI 1.03-8.81); <i>p</i> = 0.042), QTc interval above 451 ms (aHR 3.24 (95% CI 1.09-9.62); <i>p</i> = 0.033), and right ventricular strain (aHR 2.94 (95% CI 1.01-8.55); <i>p</i> = 0.047) were associated with higher 28-day mortality risk.<h4>Conclusions</h4>QTc interval &gt; 451 ms, right ventricular strain, and AF are associated with higher mortality risk in SARS-CoV-2 hospitalized patients. ECG recording and its appropriate analysis offers a simple, quick, non-expensive, and validated approach in the emergency setting to guide COVID-19 patients' stratification.

Item Type: Article
Uncontrolled Keywords: COVID-19, electrocardiogram, SARS-CoV-2, electrocardiography, right ventricular strain, heart rhythm disorders, atrial fibrillation, emergency department
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 26 Oct 2022 13:47
Last Modified: 18 Jan 2023 19:49
DOI: 10.3390/jcm11092537
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3165791