Electrocardiography in Early Diagnosis of Cardiovascular Complications of COVID-19; a Systematic Literature Review

INTRODUCTION: Many reports have stated that patients admitted for COVID-19 may also suffer from cardiovascular diseases, suggesting cardiovascular involvement in COVID-19. Since there is direct association between electrocardiography (ECG) data and the prognosis of cardiovascular disease, a systematic literature review was performed in the present study to address this association and make a conclusive agreement on the early diagnostic and prognostic values of ECG in patients with COVID-19. METHODS: Electronic databases including PubMed, Scopus, Web of Science, Science Direct, Ovid, Embase, and Google Scholar were searched for “COVID-19” and “ECG” using all their equivalents and similar terms as search words. Afterwards, the records were limited to English articles and irrelevant documents, as well as articles that reported drug-induced cardiac dysfunction or patients with previous history of cardiovascular complications were excluded. RESULTS: Overall, 31 articles with 2379 patients were found and used for qualitative data extraction. Findings showed that there is a significant association between COVID-19 infection and ECG findings. Also, ST-segment changes, T wave inversions, QT prolongation, and atrial fibrillation were found to be early indicators of cardiac involvement of COVID-19, which were associated with worse outcomes. CONCLUSION: It is recommended to use ECG as a valuable diagnostic and prognostic tool for cardiac evaluation of patients with COVID-19.