Alterations in the electrocardiogram (ECG) have been associated with coronavirus disease 2019 (COVID-19) severity. ECG irregularities have been linked to death from any cause. However, in previous studies, different abnormalities have been shown to be associated with COVID-19 mortality. We aimed to evaluate the association between ECG abnormalities and COVID-19 clinical outcomes.
MethodsThis cross-sectional retrospectively evaluated patients with COVID-19 admitted to the emergency department of Shahid Mohammadi Hospital, Bandar Abbas, in 2021. Patients' data were extracted from their medical records, including demographics, smoking, underlying diseases, treatment, laboratory test results, and in-hospital parameters. Their admission ECGs were assessed for abnormalities.
ResultsOf the 239 COVID-19 patients with a mean age of 55.18 ± 16.85 years, 126 (52.7%) were male. Fifty-seven patients (23.8%) died. Intensive care unit (ICU) admission and mechanical ventilation requirement were higher in patients who died (P < 0.001). Furthermore, mechanical ventilation duration and hospital and ICU length of stay were significantly longer in patients who died (P < 0.001). Multivariable logistic regression analysis revealed that a non-sinus rhythm in the admission ECG was associated with approximately eight times higher odds of mortality than a sinus rhythm (adjusted odds ratio = 7.961, 95% confidence interval 1.724; 36.759, P = 0.008).
ConclusionsAmong ECG findings, a non-sinus rhythm in the admission ECG appears to increase the odds of mortality in patients with COVID-19. Therefore, it is advised that COVID-19 patients be continuously monitored for ECG alterations, as this might provide crucial prognostic data.
KeywordsCOVID-19
ECG
Mortality
Rhythm
AbbreviationsCOPDchronic obstructive pulmonary disease
COVID-19coronavirus disease 2019
CVAcerebrovascular accident
ESRDend-stage renal disease
IHDischemic heart disease
LBBBleft bundle branch block
PACpremature atrial contraction
PSVCparoxysmal supraventricular contraction
PVCpremature ventricular contraction
RBBBright bundle branch block
RT-PCRreverse transcriptase-polymerase chain reation
SARS-CoV-2severe acute respiratory syndrome coronavirus 2
VHDvalvular heart disease
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