Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Cardiology, Intervention Cardiology Center, Wuhan No.1 Hospital, No.215 Zhongshan Avenue, QiaoKou District, Wuhan, China.
Clin Cardiol. 2021 Jul;44(7):963-970. doi: 10.1002/clc.23628. Epub 2021 May 11.
Coronavirus disease 2019 (COVID-19) has reached a pandemic level. Cardiac injury is not uncommon among COVID-19 patients. We sought to describe the electrocardiographic characteristics and to identify the prognostic significance of electrocardiography (ECG) findings of patients with COVID-19.
ECG abnormality was associated with higher risk of death.
Consecutive patients with laboratory-confirmed COVID-19 and definite in-hospital outcome were retrospectively included. Demographic characteristics and clinical data were extracted from medical record. Initial ECGs at admission or during hospitalization were reviewed. A point-based scoring system of abnormal ECG findings was formed, in which 1 point each was assigned for the presence of axis deviation, arrhythmias, atrioventricular block, conduction tissue disease, QTc interval prolongation, pathological Q wave, ST-segment change, and T-wave change. The association between abnormal ECG scores and in-hospital mortality was assessed in multivariable Cox regression models.
A total of 306 patients (mean 62.84 ± 14.69 years old, 48.0% male) were included. T-wave change (31.7%), QTc interval prolongation (30.1%), and arrhythmias (16.3%) were three most common found ECG abnormalities. 30 (9.80%) patients died during hospitalization. Abnormal ECG scores were significantly higher among non-survivors (median 2 points vs 1 point, p < 0.001). The risk of in-hospital death increased by a factor of 1.478 (HR 1.478, 95% CI 1.131-1.933, p = 0.004) after adjusted by age, comorbidities, cardiac injury and treatments.
ECG abnormality was common in patients admitted for COVID-19 and was associated with adverse in-hospital outcome. In-hospital mortality risk increased with increasing abnormal ECG scores.
2019 年冠状病毒病（COVID-19）已达到大流行水平。COVID-19 患者中心脏损伤并不少见。我们旨在描述心电图特征，并确定 COVID-19 患者心电图检查结果的预后意义。
心电图异常与死亡风险增加相关。
回顾性纳入连续确诊为 COVID-19 且住院期间有明确结局的患者。从病历中提取人口统计学特征和临床数据。回顾入院时或住院期间的初始心电图。形成异常心电图发现的点计分系统，其中轴偏移、心律失常、房室传导阻滞、传导组织疾病、QTc 间期延长、病理性 Q 波、ST 段改变和 T 波改变各记 1 分。在多变量 Cox 回归模型中评估异常心电图评分与住院死亡率之间的关系。
共纳入 306 例患者（平均年龄 62.84±14.69 岁，48.0%为男性）。T 波改变（31.7%）、QTc 间期延长（30.1%）和心律失常（16.3%）是三种最常见的心电图异常。30 例（9.80%）患者住院期间死亡。非幸存者的异常心电图评分明显更高（中位数 2 分与 1 分，p<0.001）。校正年龄、合并症、心脏损伤和治疗后，住院死亡的风险增加了 1.478 倍（HR 1.478，95%CI 1.131-1.933，p=0.004）。
COVID-19 住院患者中常见心电图异常，与不良住院结局相关。异常心电图评分越高，住院死亡率风险越高。
