• Am J Emerg Med · Aug 2021

    The effect of the severity COVID-19 infection on electrocardiography.

    • Hasan Ali Barman, Adem Atici, Gokhan Alici, Omer Sit, Sevil Tugrul, Baris Gungor, Ertugrul Okuyan, and Irfan Sahin.
    • University of Health Sciences, Okmeydani Training and Research Hospital, Department of Cardiology, Istanbul, Turkey. Electronic address: drhasanali@hotmail.com.
    • Am J Emerg Med. 2021 Aug 1; 46: 317322317-322.

    ObjectiveAcute myocardial damage is detected in a significant portion of patients with coronavirus 2019 disease (COVID-19) infection, with a reported prevalence of 7-28%. The aim of this study was to investigate the relationship between electrocardiographic findings and the indicators of the severity of COVID-19 detected on electrocardiography (ECG).MethodsA total of 219 patients that were hospitalized due to COVID-19 between April 15 and May 5, 2020 were enrolled in this study. Patients were divided into two groups according to the severity of COVID-19 infection: severe (n = 95) and non-severe (n = 124). ECG findings at the time of admission were recorded for each patient. Clinical characteristics and laboratory findings were retrieved from electronic medical records.ResultsMean age was 65.2 ± 13.8 years in the severe group and was 57.9 ± 16.0 years in the non-severe group. ST depression (28% vs. 14%), T-wave inversion (29% vs. 16%), ST-T changes (36% vs. 21%), and the presence of fragmented QRS (fQRS) (17% vs. 7%) were more frequent in the severe group compared to the non-severe group. Multivariate analysis revealed that hypertension (odds ratio [OR]: 2.42, 95% confidence interval [CI]:1.03-5.67; p = 0.041), the severity of COVID-19 infection (OR: 1.87, 95% CI: 1.09-2.65; p = 0.026), presence of cardiac injury (OR: 3.32, 95% CI: 1.45-7.60; p = 0.004), and d-dimer (OR: 3.60, 95% CI: 1.29-10.06; p = 0.014) were independent predictors of ST-T changes on ECG.ConclusionST depression, T-wave inversion, ST-T changes, and the presence of fQRS on admission ECG are closely associated with the severity of COVID-19 infection.Copyright © 2020 Elsevier Inc. All rights reserved.

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