Isakadze Nino, Engels Marc C, Beer Dominik, McClellan Rebecca, Yanek Lisa R, Mondaloo Bahareh, Hays Allison G, Metkus Thomas S, Calkins Hugh, Barth Andreas S
Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Front Cardiovasc Med. 2022 Jun 23;9:866146. doi: 10.3389/fcvm.2022.866146. eCollection 2022.
The relationship between inflammation and corrected QT (QTc) interval prolongation is currently not well defined in patients with COVID-19.
This study aimed to assess the effect of marked interval changes in the inflammatory marker C-reactive protein (CRP) on QTc interval in patients hospitalized with COVID-19.
In this retrospective cohort study of hospitalized adult patients admitted with COVID-19 infection, we identified 85 patients who had markedly elevated CRP levels and serial measurements of an ECG and CRP during the same admission. We compared mean QTc interval duration, and other clinical and ECG characteristics between times when CRP values were high and low. We performed mixed-effects linear regression analysis to identify associations between CRP levels and QTc interval in univariable and adjusted models.
Mean age was 58 ± 16 years, of which 39% were women, 41% were Black, and 25% were White. On average, the QTc interval calculated the Bazett formula was 15 ms higher when the CRP values were "high" vs. "low" [447 ms (IQR 427-472 ms) and 432 ms (IQR 412-452 ms), respectively]. A 100 mg/L increase in CRP was associated with a 1.5 ms increase in QTc interval [β coefficient 0.15, 95% CI (0.06-0.24). In a fully adjusted model for sociodemographic, ECG, and clinical factors, the association remained significant (β coefficient 0.14, 95% CI 0.05-0.23).
An interval QTc interval prolongation is observed with a marked elevation in CRP levels in patients with COVID-19.
目前，新型冠状病毒肺炎（COVID-19）患者炎症与校正QT（QTc）间期延长之间的关系尚不明确。
本研究旨在评估炎症标志物C反应蛋白（CRP）的显著变化对COVID-19住院患者QTc间期的影响。
在这项对因COVID-19感染入院的成年住院患者的回顾性队列研究中，我们确定了85例CRP水平显著升高且在同一住院期间进行了连续心电图和CRP测量的患者。我们比较了CRP值高和低时的平均QTc间期持续时间以及其他临床和心电图特征。我们进行了混合效应线性回归分析，以确定单变量和校正模型中CRP水平与QTc间期之间的关联。
平均年龄为58±16岁，其中39%为女性，41%为黑人，25%为白人。平均而言，当CRP值为“高”时，根据Bazett公式计算的QTc间期比“低”时高15 ms[分别为447 ms（四分位间距427 - 472 ms）和432 ms（四分位间距412 - 452 ms）]。CRP每升高100 mg/L，QTc间期增加1.5 ms[β系数0.15，95%置信区间（0.06 - 0.24）]。在对社会人口统计学、心电图和临床因素进行完全校正的模型中，这种关联仍然显著（β系数0.14，95%置信区间0.05 - 0.23）。
COVID-19患者CRP水平显著升高时，可观察到QTc间期延长。
