Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran.
Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
Indian Heart J. 2020 Nov-Dec;72(6):500-507. doi: 10.1016/j.ihj.2020.11.007. Epub 2020 Nov 13.
Since the epidemic of COVID-19 attracted the attention, reports were surrounding electrocardiographic changes in the infected individuals. We aimed at pinpointing different observed ECG findings and discussing their clinical significance.
We conducted a systematic search in PubMed, Embase, and Scopus databases. We included eligible original papers, reports, letters to the editors, and case reports published from December 2019 to May 10, 2020.
The team identified 20 articles related to this topic. We divided them into articles discussing drug-induced and non-drug-induced changes. Studies reported an increased risk of QTc interval prolongations influenced by different therapies based on chloroquine, hydroxychloroquine, and azithromycin. Although these medications increased risks of severe QTc prolongations, they induced no arrhythmia-related deaths. In the non-drug-induced group, ST-T abnormalities, notably ST elevation, accounted for the most observed ECG finding in the patients with COVID-19, but their relation with myocardial injuries was under dispute.
This systematic review suggests that identifying ECG patterns that might be related to COVID-19 is vital. Provided that physicians do not recognize these patterns, they might erroneously risk the lives of their patients. Furthermore, important drug-induced ECG changes provide awareness to the health-care workers on the risks of possible therapies.
自 COVID-19 疫情引起关注以来，已有大量关于感染个体心电图变化的报告。我们旨在明确不同观察到的心电图表现，并讨论其临床意义。
我们在 PubMed、Embase 和 Scopus 数据库中进行了系统检索。纳入 2019 年 12 月至 2020 年 5 月 10 日发表的符合条件的原始论文、报告、给编辑的信件和病例报告。
研究小组确定了 20 篇与该主题相关的文章。我们将它们分为讨论药物引起和非药物引起变化的文章。研究报告称，基于氯喹、羟氯喹和阿奇霉素的不同疗法会增加 QTc 间期延长的风险。尽管这些药物增加了严重 QTc 延长的风险，但它们并未引起与心律失常相关的死亡。在非药物引起的组中，ST-T 异常，特别是 ST 段抬高，是 COVID-19 患者中最常见的心电图表现，但它们与心肌损伤的关系存在争议。
本系统评价表明，识别可能与 COVID-19 相关的心电图模式至关重要。如果医生没有识别出这些模式，他们可能会错误地危及患者的生命。此外，重要的药物引起的心电图变化使医护人员意识到可能治疗方法的风险。
