Pakistan Science Abstracts
Article details & metrics
No Detail Found!!
The relationship between morphological electrocardiographic characteristics and survival in critical COVID-19 patients
Author(s):
1. Mihrican SAYAN: Barbaros Mahallesi Prof. Dr. Sevim BULUÇ Sokak, 17020 Çanakkale,Turkey
2. Hatice Betul ALTINISIK: Barbaros Mahallesi Prof. Dr. Sevim BULUÇ Sokak, 17020 Çanakkale,Turkey
Abstract:
Background: Myocardial damage is a sign of poor prognosis in coronavirus disease 2019 (COVID-19). Electrocardiography (ECG) would be useful to evaluate the effects of ECG findings on survival in severe COVID-19. We studied the relationship of pathological ECG findings in patients of COVID-19 admitted in ICU with other adverse physiological parameters as well as the mortality. Methodology: The study population comprised critical COVID-19 patients in the intensive care unit (ICU). Patients with findings other than normal sinus rhythm, atrial extra beat, and ventricular extra beat were defined as patients with pathological ECG findings. Two groups were formed: patients with pathological ECG findings (n = 109) and patients without pathological ECG findings (n = 84). Data were compared and analysed between the groups. The relationship among the risk factors, and ECG findings with mortality was investigated. Results: The presence of hypertension (69% vs. 40%, OR 5.49, CI 1.71-17.66, P = 0.004), peripheral oxygen saturation (SpO2) (88 vs. 95, OR 0.8, CI 0.7-0.9, P < 0.001) were found to be related to mortality in multivariable analyses. Patients with pathological ECG finding were older [74 (27-98) vs. 61 (22-89); P < 0.001], and more likely to have hypertension (68% vs. 44%, P = 0.001). Pathological ECG findings (66% vs. 51%, P = 0.02), atrial fibrillation (AF) (37% vs. 20%, P = 0.01), right branch bundle block (RBBB) (10% vs. 3%, P = 0.048) were associated with higher mortality in univariable analyses. Conclusion: Although abnormal findings on ECG, especially AF and RBBB, are associated with a poor prognosis, they are not primary effective in increasing the mortality of critical COVID-19 patients. 
Page(s): 139-150
Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 28, Issue: 1, Year: 2024
Keywords:
Mortality , biomarkers , COVID19 , Atrial Fibrillation , COVID19 , ECG , Covid19 , Right BundleBranch Block
References:
[1] Zhu H,Wei L,Niu P. .2020 .The novel coronavirus outbreak in Wuhan, China. Glob Health Res Policy, 5 : 6.
[2] .2020 .. World Health Organization. Director General's remarks at the media briefing on 2019-nCoV on 11 March, : .
[3] Kwenandar F,Japar KV,Damay V,Hariyanto TI,Tanaka M,Lugito NPH .2020 .Coronavirus disease 2019 and cardiovascular system: A narrative review. Int J Cardiol Heart Vasc, 29 : 100557.
[4] Wang D,Hu B,Hu C,Zhu F,Liu X,Zhang J .2020 .Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. , 1585(11) : 1061-1069.
[5] Oudit GY,Kassiri Z,Jiang C,Liu PP,Poutanen SM,Penninger JM .2009 .SARS-coronavirus modulation of myocardial ACE2 expression and inflammation in patients with SARS. Eur J Clin Invest, 02153(7) : 2362-25.
[6] Minno Di,Ambrosino A,Calcaterra P,I P . .Di Minno MND. COVID19 and Venous Thromboembolism: A Meta-analysis of Literature Studies. Semin Thromb Hemost, 46(7) : 763-771.
[7] Khawaja SA,Mohan P,Jabbour R,Bampouri T,Bowsher G,Hassan AMM .2021 .-19 and its impact on the cardiovascular system. -001472, 8 : e001472.
[8] Nemati R,Ganjoo M,Jadidi F,Tanha A,Baghbani R. .2021 .Electrocardiography in early diagnosis of cardiovascular complications of COVID-19: A systematic literature review. Arch Acad Emerg Med, 9(1) : 957.
[9] Garcia-Zamora S,Lee S,Haseeb S,Bazoukis G,Tse G,Alvarez-Garcia J .2021 .Arrhythmias and electrocardiographic findings in Coronavirus disease 2019: A systematic review and meta-analysis. Pacing Clin Electrophysiol, 44(6) : 1062-1074.
[10] Angeli F,Spanevello A,De Ponti R,Visca D,Marazzato J,Palmiotto G .2020 .Electrocardiographic features of patients with COVID-19 pneumonia. Eur J Intern Med, 06 : 101-106.
[11] McCullough SA,Goyal P,Krishnan U,Choi JJ,Safford MM,Okin PM .2020 .. Electrocardiographic Findings in Coronavirus Disease-19: Insights on Mortality and Underlying Myocardial Processes. J Card Fail, 06(7) : 626-632.
[12] Dalia T,Lahan S,Ranka S,Acharya P,Gautam A,Goyal A .2020 .Impact of congestive heart failure and role of cardiac biomarkers in COVID-19 patients: A systematic review and meta-analysis. Indian Heart J, 12(1) : 91-98.
[13] Susca N,Solimando AG,Borrelli P,Marziliano D,Monitillo F,Raimondo P .2023 .Electrocardiographic pathological findings caused by the sars-cov-2 virus infection: Evidence from a retrospective multicenter international cohort longitudinal pilot study of 548 subjects. J Cardiovasc Dev Dis, 10(2) : 58.
[14] Yang D,Li J,Gao P,Chen T,Cheng K,Deng H .2021 .The prognostic significance of electrocardiography findings in patients with coronavirus disease 2019: A retrospective study. Clin Cardiol, 44(7) : 963-970.
[15] Yuan M,Zathar Z,Nihaj F,Apostolakis S,Abdul F,Connolly D .2021 .ECG changes in hospitalised patients with COVID-19 infection. Br J Cardiol, 28(2) : 24.
[16] Bertini M,Ferrari R,Guardigli G,Malagù M,Vitali F,Zucchetti O .2020 .Electrocardiographic features of 431 consecutive, critically ill COVID-19 patients: An insight into the mechanisms of cardiac involvement. Europace, 22(12) : 1848-1854.
[17] Basu-Ray I,Almaddah NK,Adeboye A,Island (FL): StatPearls Publishing A .2022 .Cardiac manifestations of coronavirus (COVID-19). , : .
[18] Bergamaschi L,D'Angelo EC,Paolisso P,Toniolo S,Fabrizio M,Angeli F .2021 .The value of ECG changes in risk stratification of COVID-19 patients. , 26(3) : e12815.
[19] Wang Y,Chen L,Wang J,He X,Huang F,Chen J .2020 .Electrocardiogram analysis of patients with different types of COVID-19. , 25(6) : e12806.
[20] Elias P,Poterucha TJ,Jain SS,Sayer G,Raikhelkar J,Fried J .2020 .The prognostic value of electrocardiogram at presentation to emergency department in patients with COVID-19. Mayo Clin Proc, 07(10) : 2099-2109.
[21] Rosén J,Noreland M,Stattin K,Lipcsey M,Frithiof R,Malinovschi A .2021 .ECG pathology and its association with death in critically ill COVID-19 patients, a cohort study. PLoS One, 16(12) : e0261315.
[22] De Carvalho H,Leonard-Pons L,Segard J,Goffinet N,Javaudin F,Martinage A .2021 .Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: A multicenter retrospective study. BMC Emerg Med, 21(1) : 141.
[23] Raad M,Gorgis S,Dabbagh M,Chehab O,Parikh S,Singh G .2020 .Right heart strain on presenting 12-lead electrocardiogram predicts critical illness in COVID-19. , 09(4) : 485-493.
[24] Özdemir İH,Özlek B,Özen MB,Gündüz R,Çetin N,Özlek E .2021 .Fragmented QRS is a marker of mortality in patients with severe COVID-19: A retrospective observational study. Anatol J Cardiol, 25(11) : 811-820.
[25] Santoro F,Monitillo F,Raimondo P,Lopizzo A,Brindicci G,Gilio M .2021 .QTc interval prolongation and life-threatening arrhythmias during hospitalization in patients with coronavirus disease 2019 (COVID-19): Results from a multicenter prospective registry. Clin Infect Dis, 73(11) : e4031-e4038.
[26] Gopinathannair R,Merchant FM,Lakkireddy DR,Etheridge SP,Feigofsky S,Han JK .2020 .-19 and cardiac arrhythmias: A global perspective on arrhythmia characteristics and management strategies. J Interv Card Electrophysiol, 59(2) : 329-336.
[27] Inciardi RM,Adamo M,Lupi L,Cani DS,Di Pasquale M,Tomasoni D .2020 .Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy. Eur Heart J, 41(19) : 1821-1829.
[28] Kelesoglu S,Yilmaz Y,Ozkan E,Calapkorur B,Gok M,Dursun ZB .2020 .New onset atrial fibrillation and risk factors in COVID19. J Electrocardiol, 12 : 76-81.
[29] Abdulrahman A,Hussain T,Nawaz S,AlShaikh S,Almadani A,Bardooli F .2021 .Is atrial fibrillation a risk factor for worse outcomes in severe COVID-19 patients: A single center retrospective cohort. J Saudi Heart Assoc, 33(2) : 1255-5043.
[30] Colon CM,Barrios JG,Chiles JW,McElwee SK,Russell DW,Maddox WR .2020 .Atrial arrhythmias in COVID-19 patients. JACC Clin Electrophysiol, 05(9) : 1189-1190.
[31] Ip RJ,Ali A,Baloch ZQ,Al-Abcha A,Jacob C,Arnautovic J .2021 .Atrial fibrillation as a predictor of mortality in high risk COVID19 patients: A multicentre study of 171 patients. Heart Lung Circ, 02(8) : 1151-1156.
[32] Spinoni EG,Mennuni M,Rognoni A,Grisafi L,Colombo C,Lio V .2021 .Contribution of atrial fibrillation to in-hospital mortality in patients with COVID-19. , 14(2) : e0093752.
[33] Xu P,Sriramula S,Lazartigues E. .2011 .ACE2/ANG-(1-7)/Mas pathway in the brain: The axis of good. Am J Physiol Regul Integr Comp Physiol, 300(4) : R804-17.
[34] Simões E Silva AC,Teixeira MM .2016 .ACE inhibition, ACE2 and angiotensin-(1-7) axis in kidney and cardiac inflammation and fibrosis. Pharmacol Res, 03 : 154-162.
[35] Ratajczak MZ,Kucia M. .2020 .SARS-CoV-2 infection and overactivation of Nlrp3 inflammasome as a trigger of cytokine "storm" and risk factor for damage of hematopoietic stem cells. Leukemia, 34(7) : 1726-1729.
[36] Yao C,Veleva T,Scott L,Cao S,Li L,Chen G .2018 .Enhanced cardiomyocyte NLRP3 inflammasome signaling promotes atrial fibrillation. Circulation, 138(20) : 2227-2242.
[37] Gawałko M,Kapłon-Cieślicka A,Hohl M,Dobrev D,Linz D. COVID D .2020 .-19 associated atrial fibrillation: Incidence, putative mechanisms and potential clinical implications. Int J Cardiol Heart Vasc, 30 : 100631.
[38] Bader F,Manla Y,Atallah B,Starling RC .2021 .. Heart failure and COVID-19. Heart Fail Rev, 26(1) : 1-10.
[39] Argulian E,Sud K,Vogel B,Bohra C,Garg VP,Talebi S .2020 .Right ventricular dilation in hospitalized patients with COVID-19 infection. JACC Cardiovasc Imaging, 05(11) : 2459-2461.
[40] Corica B,Marra AM,Basili S,Cangemi R,Cittadini A,Proietti M .2021 .Prevalence of right ventricular dysfunction and impact on all-cause death in hospitalized patients with COVID-19: A systematic review and meta-analysis. Sci Rep, 11(1) : 17774.
[41] Barman HA,Atici A,Sahin I,Dogan O,Okur O,Tugrul S .2021 .Prognostic value of right ventricular strain pattern on ECG in COVID-19 patients. Am J Emerg Med, 05 : 1-5.
[42] Zuin M,Rigatelli G,Roncon L,Zuliani G .2021 .Mortality risk in COVID19 patients with right bundle branch block. Rev Esp Cardiol (Engl Ed), 06(12) : 1122-1124.
[43] Cron RQ .2020 .Coronavirus is the trigger, but the immune response is deadly. Lancet Rheumatol, 9913(20) : 30165-e371.
[44] Yang AP,Liu JP,Tao WQ,Li HM .2020 .The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol, 84 : 106504.
[45] Lagunas-Rangel FA .2020 .Neutrophil-to-lymphocyte ratio and lymphocyteto-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. J Med Virol, 92(10) : 1733-1734.
Citations
Citations are not available for this document.
0

Citations

0

Downloads

1

Views