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体表心电图碎裂 QRS 波作为 SARS-CoV-2 感染患者心脏死亡率的预测指标。

Fragmented QRS on surface electrocardiography as a predictor of cardiac mortality in patients with SARS-CoV-2 infection.

机构信息

Medipol University Faculty of Medicine, Cardiology Department, İstanbul, Turkey.

Medipol University Faculty of Medicine, Cardiology Department, İstanbul, Turkey.

出版信息

J Electrocardiol. 2021 May-Jun;66:108-112. doi: 10.1016/j.jelectrocard.2021.03.001. Epub 2021 Mar 17.

DOI:10.1016/j.jelectrocard.2021.03.001
PMID:33906057
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7967400/
Abstract

AIMS

Although severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is mainly a respiratory system disease, recent studies reported that cardiac injury is associated with poor outcomes in this population. There are few studies which assessed standard electrocardiogram (ECG) as a prognostic tool during the course of SARS-CoV-2 infection. The aim of this study is to identify the relationship between of ECG parameters and prognosis of patients infected with SARS-CoV-2.

METHOD AND RESULTS

A total of 114 consecutive patients with a confirmed diagnosis of SARS-CoV-2 infection between March 2020 and May 2020 were included in the study. Standard 12‑lead surface ECG was reviewed for presence of fragmented QRS (fQRS), abnormal Q wave, T wave inversion, and duration of QRS. fQRS was observed in 36.8% (n = 42) of the patients who had SARS-CoV-2. Patient groups with and without fQRS did not differ in terms of age, gender, the presence of comorbid diseases and medical treatment. Hospitalization duration, intensive care unit(ICU) requirement, all-cause mortality, and cardiac mortality were found to be higher in patients with fQRS (all p values <0.05). There was a positive correlation between QRS duration and duration of hospital stay (p < 0.001, r = 0.421). QRS duration was also found to be associated with intensive care need, all-cause mortality, and cardiac mortality.

CONCLUSION

Our data shows that QRS duration and the presence of fQRS on standard ECG can help to identify patients with worse clinical outcome admitted for SARS-CoV-2 infection.

摘要

目的

尽管严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)感染主要是一种呼吸系统疾病,但最近的研究报告称,该人群的心脏损伤与不良预后相关。评估标准心电图(ECG)作为 SARS-CoV-2 感染过程中预后工具的研究较少。本研究旨在确定 ECG 参数与 SARS-CoV-2 感染患者预后之间的关系。

方法和结果

共纳入 2020 年 3 月至 2020 年 5 月期间确诊为 SARS-CoV-2 感染的连续 114 例患者。回顾标准 12 导联体表心电图,观察有无碎裂 QRS(fQRS)、异常 Q 波、T 波倒置和 QRS 时限。共有 36.8%(n=42)的 SARS-CoV-2 患者出现 fQRS。有 fQRS 和无 fQRS 的患者在年龄、性别、合并症和治疗方面无差异。fQRS 患者的住院时间、入住重症监护病房(ICU)的需求、全因死亡率和心脏死亡率均较高(所有 p 值均<0.05)。QRS 时限与住院时间呈正相关(p<0.001,r=0.421)。QRS 时限也与入住 ICU 的需求、全因死亡率和心脏死亡率相关。

结论

我们的数据表明,标准 ECG 上的 QRS 时限和 fQRS 有助于识别因 SARS-CoV-2 感染而住院且临床预后较差的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/7967400/26128f3c77ad/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/7967400/0e9aa99776a2/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/7967400/669e2d0d5c32/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/7967400/26128f3c77ad/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/7967400/0e9aa99776a2/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/7967400/669e2d0d5c32/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/7967400/26128f3c77ad/gr3_lrg.jpg

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