• Ramazan Gunduz, Bekir Serhat Yildiz, Su Ozgur, Mehmet Burak Ozen, Eren Ozan Bakir, Ibrahim Halil Ozdemir, Nurullah Cetin, Songul Usalp, and Soner Duman.
• Department of Cardiology, Manisa City Hospital, Manisa, Turkey. Electronic address: ramazankard@yahoo.com.
• Am J Emerg Med. 2022 Aug 1; 58: 667266-72.

AimsThe frontal QRS-T (fQRS) angle has been investigated in the general population, including healthy people and patients with heart failure. The fQRS angle can predict mortality due to myocarditis, ischaemic and non-ischaemic cardiomyopathies, idiopathic dilated cardiomyopathy, and chronic heart failure in the general population. Moreover, no studies to date have investigated fQRS angle in coronavirus disease 2019 (COVID-19) patients. Thus, the purpose of this retrospective multicentre study was to evaluate the fQRS angle of COVID-19 patients to predict in-hospital mortality and the need for mechanical ventilation.Methods And ResultsAn electrocardiogram was performed for 327 COVID-19 patients during admission, and the fQRS angle was calculated. Mechanical ventilation was needed in 119 patients; of them, 110 died in the hospital. The patients were divided into two groups according to an fQRs angle >90° versus an fQRS angle ≤90°. The percentages of mortality and the need for mechanical ventilation according to fQRS angle were 67.8% and 66.1%, respectively, in the fQRs >90° group and 26.1% and 29.9% in the fQRS ≤90°group. Heart rate, oxygen saturation, fQRS angle, estimated glomerular filtration rate, and C-reactive protein level were predictors of mortality on the multivariable analysis. The mortality risk increased 2.9-fold on the univariate analysis and 1.6-fold on the multivariate analysis for the fQRS >90° patient group versus the fQRS ≤90° group.ConclusionIn conclusion, a wide fQRS angle >90° was a predictor of in-hospital mortality and associated with the need for mechanical ventilation among COVID-19 patients.Copyright © 2022 Elsevier Inc. All rights reserved.

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