Dehghani Mohammad Reza, Moeini Mehdi, Masoumi Mehdi, Rezaei Yousef
Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia.
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences.
Acta Cardiol Sin. 2025 May;41(3):323-334. doi: 10.6515/ACS.202505_41(3).20241111D.
The novel coronavirus disease 2019 (COVID-19) is associated with life-threatening complications. Electrocardiogram (ECG) changes associated with COVID-19 have also been reported in the majority of critically ill patients.
In this study, we aimed to investigate the prevalence of fragmented QRS (fQRS) and its prognostic value in hospitalized patients with COVID-19. In addition, we performed a systematic review and meta-analysis of the literature to evaluate the effect of fQRS on the outcomes of COVID-19 patients.
A total of 310 patients with a mean age of 65.7 ± 14.5 years were followed up for 3 months, of whom 139 (44.8%) had fQRS on their ECGs. The rates of in-hospital mortality (8.8% vs. 8.6%), rehospitalization during follow- up (13.7% vs. 12.3%), and 90-day mortality (6.5% vs. 5.3%) were comparable between the patients with and without fQRS, respectively. In the meta-analysis, 9 studies in addition to our study reported outcomes, with a total of 2928 patients with a mean age of 53.8 years, and 1431 (48.9%) were males. The rate of fQRS was 0.31 (95% confidence interval [CI], 0.23-0.38; I = 95.21%). In addition, the pooled proportion of in-hospital mortality reported by 5 studies was 0.31 (95% CI, 0.12-0.51; I = 98.36). The rate of in-hospital mortality was higher among patients with fQRS compared to those without fQRS (odds ratio, 2.33; 95% CI, 1.52-3.58; p = 0.0001; I = 74%).
The rate of fQRS on ECG was relatively high in COVID-19 patients, and according to the meta-analysis, it was associated with worse outcomes in hospitalized COVID-19 patients.
2019年新型冠状病毒病（COVID-19）与危及生命的并发症相关。大多数危重症患者也报告了与COVID-19相关的心电图（ECG）变化。
在本研究中，我们旨在调查COVID-19住院患者中碎裂QRS波（fQRS）的发生率及其预后价值。此外，我们对文献进行了系统评价和荟萃分析，以评估fQRS对COVID-19患者预后的影响。
共对310例平均年龄为65.7±14.5岁的患者进行了3个月的随访，其中139例（44.8%）心电图存在fQRS。有fQRS和无fQRS的患者的住院死亡率（8.8%对8.6%）、随访期间再次住院率（13.7%对12.3%）和90天死亡率（6.5%对5.3%）分别相当。在荟萃分析中，除我们的研究外，还有9项研究报告了结果，共有2928例患者，平均年龄为53.8岁，其中1431例（48.9%）为男性。fQRS发生率为0.31（95%置信区间[CI]，0.23-0.38；I²=95.21%）。此外，5项研究报告的住院死亡率合并比例为0.31（95%CI，0.12-0.51；I²=98.36%）。与无fQRS的患者相比，有fQRS的患者住院死亡率更高（优势比，2.33；95%CI，1.52-3.58；p=0.0001；I²=74%）。
COVID-19患者心电图fQRS发生率相对较高，根据荟萃分析，其与COVID-19住院患者较差的预后相关。
