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EnglishBackground: There is growing evidence of cardiac injury in COVID-19. Our purpose was to assess the prognostic value of serial electrocardiograms in COVID-19 patients. Methods: We evaluated 269 consecutive patients admitted to our center with confirmed SARS-CoV-2 infection. ECGs available at admission and after 1 week from hospitalization were assessed. We evaluated the correlation between ECGs findings and major adverse events (MAE) as the composite of intra-hospital all-cause mortality or need for invasive mechanical ventilation. Abnormal ECGs were defined if primary ST-T segment alterations, left ventricular hypertrophy, tachy or bradyarrhythmias and any new AV, bundle blocks or significant morphology alterations (e.g., new Q pathological waves) were present. Results: Abnormal ECG at admission (106/216) and elevated baseline troponin values were more common in patients who developed MAE (p =.04 and p =.02, respectively). Concerning ECGs recorded after 7 days (159), abnormal findings were reported in 53.5% of patients and they were more frequent in those with MAE (p =.001). Among abnormal ECGs, ischemic alterations and left ventricular hypertrophy were significantly associated with a higher MAE rate. The multivariable analysis showed that the presence of abnormal ECG at 7 days of hospitalization was an independent predictor of MAE (HR 3.2; 95% CI 1.2–8.7; p =.02). Furthermore, patients with abnormal ECG at 7 days more often required transfer to the intensive care unit (p =.01) or renal replacement therapy (p =.04). Conclusions: Patients with COVID-19 should receive ECG at admission but also during their hospital stay. Indeed, electrocardiographic alterations during hospitalization are associated with MAE and infection severity
| Titolo: | The value of ECG changes in risk stratification of COVID-19 patients | |
| Autore/i: | Bergamaschi L.; D’Angelo E. C.; Paolisso P.; Toniolo S; Fabrizio M.; Angeli F.; Donati F.; Magnani I.; Rinaldi A.; Bartoli L.; Chiti C.; Biffi M.; Pizzi C.; Viale P; Galié N. | |
| Autore/i Unibo: | ||
| Anno: | 2021 | |
| Rivista: | ||
| Abstract: | Background: There is growing evidence of cardiac injury in COVID-19. Our purpose was to assess the prognostic value of serial electrocardiograms in COVID-19 patients. Methods: We evaluated 269 consecutive patients admitted to our center with confirmed SARS-CoV-2 infection. ECGs available at admission and after 1 week from hospitalization were assessed. We evaluated the correlation between ECGs findings and major adverse events (MAE) as the composite of intra-hospital all-cause mortality or need for invasive mechanical ventilation. Abnormal ECGs were defined if primary ST-T segment alterations, left ventricular hypertrophy, tachy or bradyarrhythmias and any new AV, bundle blocks or significant morphology alterations (e.g., new Q pathological waves) were present. Results: Abnormal ECG at admission (106/216) and elevated baseline troponin values were more common in patients who developed MAE (p =.04 and p =.02, respectively). Concerning ECGs recorded after 7 days (159), abnormal findings were reported in 53.5% of patients and they were more frequent in those with MAE (p =.001). Among abnormal ECGs, ischemic alterations and left ventricular hypertrophy were significantly associated with a higher MAE rate. The multivariable analysis showed that the presence of abnormal ECG at 7 days of hospitalization was an independent predictor of MAE (HR 3.2; 95% CI 1.2–8.7; p =.02). Furthermore, patients with abnormal ECG at 7 days more often required transfer to the intensive care unit (p =.01) or renal replacement therapy (p =.04). Conclusions: Patients with COVID-19 should receive ECG at admission but also during their hospital stay. Indeed, electrocardiographic alterations during hospitalization are associated with MAE and infection severity | |
| Data stato definitivo: | 2021-03-22T19:43:03Z | |
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