Whether and what abnormalities we find in ECG records and 24-hour Holter ECG in patients after COVID-19 without hospitalization with cardiac damage

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. Cardiac arrhythmias and cardiac damage (CD) are more common in hospitalized patients with COVID-19. Many studies have shown that arrhythmias are an independent risk factor for death and the course of COVID-19 in these patients. However, there are no publications on the impact of the SARS CoV-2 on patients with a domestic course of COVID-19 without a previous history of cardiovascular disease. The aim of the study was to assess whether and what arrhythmias occur in patients in the early period after the course of COVID-19 without hospitalisation and to assess which of them may be predictors of heart damage after COVID-19. METHODS: In patients, in the post-COVID period (mean 12 ± 6 weeks) a standard 12-lead ECG (ECG) and 24-h Holter ECG (Holter) were performed. Following parameters were analysed: 1. in ECG: mean heart rate (mHR); PQ interval (PQ), QRS duration (QRSd); corrected QT interval (QTc); atrial fibrillation (AF); inappropriate sinus tachycardia (ITS), QRS duration > 120ms (QRS>120); LBBB, RBBB, QRS fragmentation (QRSf); STT wave abnormalities (STTabn); presence of premature supraventricular (SVES) and ventricular (VES) complexes; 2. in 24-h Holter ECG: sinus tachycardia (STach), new atrial fibrillation (AFHolter), SVES > 1000/24h (SVES>1000); supraventricular tachycardia (TSV), VES > 1000/24h (VES>1000), Couplet VES (VEScouplet), non-sustained ventricular tachycardia (nsVT); ventricular tachycardia (VT), block A-V 2nd typ 2 and/or block A-V 3rd grade (AVdist). Cardiac damage (CardD) was defined as EF<50% and/or any contraction abnormalities in ECHO and/or MRI examination. Patients were divided into two groups depending on the cardiac damage: Gr 1 without CardD and Gr 2 with CardD. Next ECG and Holter parameters were compared between both groups. RESULTS: A total of 1032 patients, (64% women and 36% men), mean age was 47.8± 16.5 were included in the analysis, of whom 91 pts (9,28%) met the cardiac damage criteria. The most frequent ECG abnormalities QRS fragmentations in 17,3% pts – noted in 17,3%. In no one pts VT and or VF was found. Comparison between groups in analysed parameters are shown IN Table 1 and Table 2 Multivariate regression analysis showed that: age (OR 1.02, 95%Cl 1.00-1.104; p=0.028), LBBB (OR 30.82; 95%Cl 1.99-475.80; p=0,014), VES>1000/24h (OR 7.97; 95%Cl 1.68 -37.78; p=0,008), nsVT (OR 6.20; 95%Cl 1.22-31.62; p=0,028) were associated with a higher risk of cardiac injury in the post COVID period However female were lower risk of cardiac damage (OR 0,27, 95%Cl 0.14-0.41; p<0.001) CONCLUSIONS: Based on the obtained results, it can be concluded that the most common cardiac arrhythmias which predict cardiac damage in patients in the early period after the course of COVID-19 without hospitalization were LBBB, ventricular extrasystoles VES>1000/24h and non-sustained ventricular tachycardia. In addition, age (elderly people) and sex (male) predispose to myocardial damage after COVID-19. [Figure: see text] [Figure: see text]