University of Health Sciences, Okmeydani Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
Eur Rev Med Pharmacol Sci. 2021 Apr;25(8):3272-3278. doi: 10.26355/eurrev_202104_25736.
Ventricular arrhythmias were the most frequent manifestations in patients with COVID-19. Both the natural course of the disease and the treatment drugs used have effects on ventricular repolarization. The objective of this study was to evaluate the effects of repolarization parameters obtained from surface electrocardiography (ECG) on prognosis.
Participants were 205 consecutive patients hospitalized with COVID-19 diagnosis. The 12-lead surface ECG was obtained from each patient on admission. The ECG results were evaluated against the patients' clinical characteristics and outcomes by experienced cardiology specialists.
The mean age was higher in the non-survivor group compared to the survivor group (57.4 ± 15.7 vs. 65.6 ± 16.6; p = 0.001). The demographical characteristics were similar between the survivor and non-survivor groups. Multivariate analyses demonstrated that age (OR: 1.041; p = 0.009), D-dimer (OR: 1.002; p = 0.031), high-sensitivity troponin I (hs-TnI) (OR: 1.010; p = 0.041), pneumonia on computed tomography (CT) (OR: 4.985; p < 0.001), the peak-to-end interval of the T wave (Tp-e) (OR: 3.421; p < 0.001), and Tp-e/QTc ratio (OR: 1.978; p = 0.013) were statistically significant independent predictors in terms of determining mortality.
Prolonged Tp-e interval and increased Tp-e/QTc ratio on admission are decent predictors and linked with mortality. ECG is a practical study to evaluate prognosis and potential arrhythmias, as well as initiating suitable treatment.
COVID-19 患者最常见的临床表现为室性心律失常。疾病的自然病程和所用治疗药物都会对心室复极产生影响。本研究旨在评估体表心电图(ECG)复极参数对预后的影响。
连续纳入 205 例确诊 COVID-19 的住院患者。每位患者入院时均接受 12 导联体表心电图检查。由经验丰富的心脏病专家根据心电图结果和患者的临床特征及结局进行评估。
与幸存者组相比,非幸存者组的平均年龄更高(57.4 ± 15.7 岁 vs. 65.6 ± 16.6 岁;p = 0.001)。幸存者组和非幸存者组的人口统计学特征相似。多变量分析显示,年龄(OR:1.041;p = 0.009)、D-二聚体(OR:1.002;p = 0.031)、高敏肌钙蛋白 I(hs-TnI)(OR:1.010;p = 0.041)、胸部 CT 显示肺炎(OR:4.985;p < 0.001)、T 波峰末间期(Tp-e)(OR:3.421;p < 0.001)和 Tp-e/QTc 比值(OR:1.978;p = 0.013)是预测死亡率的独立危险因素。
入院时 Tp-e 间期延长和 Tp-e/QTc 比值增加是较好的预测指标,与死亡率相关。心电图是评估预后和潜在心律失常并启动合适治疗的实用研究方法。