Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study
Dublin Core
Title
Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study
Subject
Electrocardiogram, In-hospital mortality, Patterns, COVID-19
Description
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be associated with myocardial
injury. Identification of at-risk patients and mechanisms underlying cardiac involvement in COVID-19 remains
unclear. During hospitalization for COVID-19, high troponin level has been found to be an independent variable
associated with in-hospital mortality and a greater risk of complications. Electrocardiographic (ECG) abnormalities
could be a useful tool to identify patients at risk of poor prognostic. The aim of our study was to assess if specific
ECGs patterns could be related with in-hospital mortality in COVID-19 patients presenting to the ED in a European
country.
Methods: From February 1st to May 31st, 2020, we conducted a multicenter study in three hospitals in France. We
included adult patients (≥ 18 years old) who visited the ED during the study period, with ECG performed at ED
admission and diagnosed with COVID-19. Demographic, comorbidities, drug exposures, signs and symptoms
presented, and outcome data were extracted from electronic medical records using a standardized data collection
form. The relationship between ECG abnormalities and in-hospital mortality was assessed using univariate and
multivariable logistic regression analyses.
Results: An ECG was performed on 275 patients who presented to the ED. Most of the ECGs were in normal sinus
rhythm (87%), and 26 (10%) patients had atrial fibrillation/flutter on ECG at ED admission. Repolarization
abnormalities represented the most common findings reported in the population (40%), with negative T waves
representing 21% of all abnormalities. We found that abnormal axis (adjusted odds ratio: 3.9 [95% CI, 1.1–11.5],
p = 0.02), and left bundle branch block (adjusted odds ratio: 7.1 [95% CI, 1.9–25.1], p = 0.002) were significantly
associated with in-hospital mortality.
Conclusions: ECG performed at ED admission may be useful to predict death in COVID-19 patients. Our data
suggest that the presence of abnormal axis and left bundle branch block on ECG indicated a higher risk of inhospital mortality in COVID-19 patients who presented to the ED. We also confirmed that ST segment elevation
was rare in COVID-19 patients.
injury. Identification of at-risk patients and mechanisms underlying cardiac involvement in COVID-19 remains
unclear. During hospitalization for COVID-19, high troponin level has been found to be an independent variable
associated with in-hospital mortality and a greater risk of complications. Electrocardiographic (ECG) abnormalities
could be a useful tool to identify patients at risk of poor prognostic. The aim of our study was to assess if specific
ECGs patterns could be related with in-hospital mortality in COVID-19 patients presenting to the ED in a European
country.
Methods: From February 1st to May 31st, 2020, we conducted a multicenter study in three hospitals in France. We
included adult patients (≥ 18 years old) who visited the ED during the study period, with ECG performed at ED
admission and diagnosed with COVID-19. Demographic, comorbidities, drug exposures, signs and symptoms
presented, and outcome data were extracted from electronic medical records using a standardized data collection
form. The relationship between ECG abnormalities and in-hospital mortality was assessed using univariate and
multivariable logistic regression analyses.
Results: An ECG was performed on 275 patients who presented to the ED. Most of the ECGs were in normal sinus
rhythm (87%), and 26 (10%) patients had atrial fibrillation/flutter on ECG at ED admission. Repolarization
abnormalities represented the most common findings reported in the population (40%), with negative T waves
representing 21% of all abnormalities. We found that abnormal axis (adjusted odds ratio: 3.9 [95% CI, 1.1–11.5],
p = 0.02), and left bundle branch block (adjusted odds ratio: 7.1 [95% CI, 1.9–25.1], p = 0.002) were significantly
associated with in-hospital mortality.
Conclusions: ECG performed at ED admission may be useful to predict death in COVID-19 patients. Our data
suggest that the presence of abnormal axis and left bundle branch block on ECG indicated a higher risk of inhospital mortality in COVID-19 patients who presented to the ED. We also confirmed that ST segment elevation
was rare in COVID-19 patients.
Creator
Hugo De Carvalho, Lucas Leonard-Pons, Julien Segard, Nicolas Goffinet, François Javaudin, Arnaud Martinage, Guillaume Cattin, Severin Tiberghien, Dylan Therasse, Marc Trotignon, Fabien Arabucki, Simon Ribes, Quentin Le Bastard and Emmanuel Montassier
Publisher
BMC Emergency Medicine
Date
(2021) 21:141
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Hugo De Carvalho, Lucas Leonard-Pons, Julien Segard, Nicolas Goffinet, François Javaudin, Arnaud Martinage, Guillaume Cattin, Severin Tiberghien, Dylan Therasse, Marc Trotignon, Fabien Arabucki, Simon Ribes, Quentin Le Bastard and Emmanuel Montassier, “Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study,” Repository Horizon University Indonesia, accessed February 6, 2025, https://repository.horizon.ac.id/items/show/3902.