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冠状病毒感染患者的心电图特征:一项单中心观察性研究。

Electrocardiograhic characteristics in patients with coronavirus infection: A single-center observational study.

作者信息

Li Yi, Liu Tong, Tse Gary, Wu Mingxiang, Jiang Jingjing, Liu Ming, Tao Liang

机构信息

Department of Cardiothoracic Surgery, Wuhan Asia Heart Hospital Affiliated to Wuhan University of Science and Technology, Hubei, China.

Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.

出版信息

Ann Noninvasive Electrocardiol. 2020 Nov;25(6):e12805. doi: 10.1111/anec.12805. Epub 2020 Sep 20.

Abstract

BACKGROUND

A global outbreak of coronavirus disease (COVID-19), caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), has emerged since December 2019, in Wuhan, China. However, electrocardiograhic (ECG) manifestations of patients with COVID-19 have not been fully described. We aim to investigate ECG characteristics in COVID-19 patients and risk factors of intensive care unit (ICU) admission.

METHODS

This retrospective observational study included the patients with COVID-19 at the Wuhan Asia General hospital between February 10, and 26, 2020. Demographic, clinical, and ECG characteristics were collected, and comparisons were made between the ICU and non-ICU admission groups. Logistic regression was used to identify risk factors of ICU admission.

RESULTS

Among 135 included patients (median age: 64 years [interquartile range: 48-72]), ST-T abnormalities (40%) were the most common ECG feature, followed by arrhythmias (38%). Cardiovascular disease (CVD) was presented in 48% of the patients. Six (4.4%) died during hospitalization, and 23 (17.0%) were admitted to the ICU. Compared with non-ICU group, the ICU group showed higher heart rate (p = .019) and P-wave duration (p = .039) and was more frequently associated with CVD (p < .001), ST-T abnormalities (p = .007), arrhythmias (p = .003), QTc interval prolongation (p = .003), and pathological Q waves (p < .001). Twenty-seven patients were re-examined ECG during admission, and 17 of them presented new findings compared with their initial ECG presentations. ST-T abnormalities (p = .040) and history of CVD (p = .0047) were associated with increased risk of ICU hospitalization.

CONCLUSIONS

COVID-19 is frequently related to cardiovascular manifestations including ECG abnormalities and cardiovascular comorbidities. ST-T abnormalities and CVD at admission were associated with increased odds of ICU admission.

摘要

背景

自2019年12月起,由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的冠状病毒病(COVID-19)在全球爆发,首发于中国武汉。然而,COVID-19患者的心电图表现尚未得到充分描述。我们旨在研究COVID-19患者的心电图特征及入住重症监护病房(ICU)的危险因素。

方法

这项回顾性观察性研究纳入了2020年2月10日至26日期间武汉亚洲总医院的COVID-19患者。收集了人口统计学、临床和心电图特征,并对入住ICU组和未入住ICU组进行了比较。采用逻辑回归分析确定入住ICU的危险因素。

结果

在纳入的135例患者中(中位年龄:64岁[四分位间距:48 - 72岁]),ST-T异常(40%)是最常见的心电图特征,其次是心律失常(38%)。48%的患者存在心血管疾病(CVD)。6例(4.4%)患者在住院期间死亡,23例(17.0%)患者入住ICU。与未入住ICU组相比,入住ICU组心率更高(p = 0.019)、P波时限更长(p = 0.039),且更常合并CVD(p < 0.001)、ST-T异常(p = 0.007)、心律失常(p = 0.003)、QTc间期延长(p = 0.003)及病理性Q波(p < 0.001)。27例患者在住院期间复查了心电图,其中17例与初始心电图表现相比有新发现。ST-T异常(p = 0.040)和CVD病史(p = 0.0047)与入住ICU的风险增加相关。

结论

COVID-19常与心血管表现相关,包括心电图异常和心血管合并症。入院时的ST-T异常和CVD与入住ICU的几率增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/693d/7679837/04613aa45ee8/ANEC-25-e12805-g001.jpg

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