ABSTRACT
Introduction: Cardiovascular complications of novel SARS-CoV-2 infection remain poorly understood with outcomes limited to index hospitalizations. Methods: This retrospective cohort study included patients with proven COVID-19 who received care at a single hospital network in Massachusetts from March 11, 2020 to May 23, 2020 and received an electrocardiogram (ECG) within 24 hours of hospital presentation. We investigated mortality and cardiovascular complications within 90 days from initial COVID-19 diagnosis. Data were electronically ed and confirmed by manual chart review. Results: A total of 1,744 patients tested positive within the hospital network during the study period. Nearly half of them (49.3%) were hospitalized and 15.5% died within 90 days. A total of 278 patients received an ECG within 24 hours, representing 23.6% of all hospitalized patients. These patients were disproportionately older (38.5 vs 58.1% over the age of 60, p < 0.01), male (49.6 vs 56.2%, p = 0.05), and white (48.1 vs 56.2, p < 0.01). Admission ECGs demonstrating ischemic changes (STelevations, ST-depressions, and T-wave inversions) or new arrhythmias (atrial fibrillation/flutter, bradyarrhythmia, supraventricular tachycardia) were identified among 10.1% and 9.0% of the patients, respectively. Heart failure and cardiomyopathy were rare findings (<1%). After adjusting for age, sex, and past medical history, ischemic changes or new-onset arrhythmias were associated with nearly five-times greater risk of death (OR: 4.9;95% CI 1.7-14.4). Conclusions: In this retrospective study among hospitalized adults with a proven COVID-19 infection, admission ECGs demonstrating ischemic changes or new-onset dysrhythmia predict a higher risk of death in the short-term.