The effect of the severity of COVID-19 infection on electrocardiographic findings

ABSTRACT

Background and Aim: Acute myocardial damage is detected in a significant portion of patients with coronavirus 2019 disease (COVID-19) infection, with a reported prevalence of between 7% and 28%. The aim of this study was to investigate the relationship between electrocardiographic findings and the indicators of the severity of COVID-19 detected on electrocardiography (ECG). Method(s) A total of 219 patients that were hospitalized due to COVID-19 between April 15 and May 5, 2020 were enrolled in this study. Patients were divided into two groups according to the severity of COVID-19 infection severe (n = 95) and non-severe (n = 124). ECG findings at the time of admission were recorded for each patient. Clinical characteristics and laboratory findings were retrieved from electronic medical records. Result(s) Mean age was 65.2 +/- 13.8 years in the severe group and was 57.9 +/- 16.0 years in the non-severe group. ST depression (28% vs 14%), T-wave inversion (29% vs 16%), ST-T changes (36% vs 21%), and the presence of fragmented QRS (fQRS) (17% vs 7%) were more frequent in the severe group compared to the non-severe group. Multivariate analysis revealed that hypertension (odds ratio [OR] 2.42, 95% confidence interval [CI]1.03-5.67;P = .041), the severity of COVID-19 infection (OR 1.87, 95% CI 1.09-2.65;p=0.026), presence of cardiac injury (OR 3.32, 95% CI 1.45-7.60;p=0.004), and d-dimer (OR 3.60, 95% CI 1.29-10.06;p=0.014) were independent predictors of ST-T changes on ECG. Conclusion(s) ST depression, T-wave inversion, ST-T changes, and the presence of fQRS on admission ECG are closely associated with the severity of COVID-19 infection.