Electrocardiographic Findings and Prognostic Values in Patients Hospitalised With Covid-19 in the World Heart Federation Global Study Publisher Pubmed



Pintofilho MM^{1, 2} ; Paixao GM^{2, 3} ; Gomes PR² ; Soares CPM² ; Singh K^{4, 5} ; Rossi VA⁶ ; Thienemann F⁷ ; Viljoen C^{8, 9} ; Mohan B¹⁰ ; Sarrafzadegan N¹¹ ; Chowdhury AW¹² ; Ntusi N⁸ ; Deora S¹³ ; Perel P^{14, 15} Show All Authors Show Affiliations
Source: Heart Published:2023

Abstract

Background COVID-19 affects the cardiovascular system and ECG abnormalities may be associated with worse prognosis. We evaluated the prognostic value of ECG abnormalities in individuals with COVID-19. Methods Multicentre cohort study with adults hospitalised with COVID-19 from 40 hospitals across 23 countries. Patients were followed-up from admission until 30 days. ECG were obtained at each participating site and coded according to the Minnesota coding criteria. The primary outcome was defined as death from any cause. Secondary outcomes were admission to the intensive care unit (ICU) and major adverse cardiovascular events (MACE). Multiple logistic regression was used to evaluate the association of ECG abnormalities with the outcomes. Results Among 5313 participants, 2451 had at least one ECG and were included in this analysis. The mean age (SD) was 58.0 (16.1) years, 60.7% were male and 61.1% from lower-income to middle-income countries. The prevalence of major ECG abnormalities was 21.3% (n=521), 447 (18.2%) patients died, 196 (8.0%) had MACE and 1115 (45.5%) were admitted to an ICU. After adjustment, the presence of any major ECG abnormality was associated with a higher risk of death (OR 1.39; 95% CI 1.09 to 1.78) and cardiovascular events (OR 1.81; 95% CI 1.30 to 2.51). Sinus tachycardia (>120 bpm) with an increased risk of death (OR 3.86; 95% CI 1.97 to 7.48), MACE (OR 2.68; 95% CI 1.10 to 5.85) and ICU admission OR 1.99; 95% CI 1.03 to 4.00). Atrial fibrillation, bundle branch block, ischaemic abnormalities and prolonged QT interval did not relate to the outcomes. Conclusion Major ECG abnormalities and a heart rate >120 bpm were prognostic markers in adults hospitalised with COVID-19. © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.