ECG markers of malignant arrhythmias and in‐hospital outcome of COVID‐19 pneumonia

BACKGROUND: ECG abnormalities associated with COVID‐19 pneumonia and adverse outcome are undefined and poorly described in prior studies. OBJECTIVES: To assess the predictive role of baseline ECG markers of increased risk of malignant arrhythmias and cardiac death for adverse in‐hospital outcomes. PATIENTS AND METHODS: A retrospective study included 93 patients of newly diagnosed COVID‐19 with features consistent with pneumonia who were admitted to the hospital from August 20 to September 20, 2020. The main outcomes were defined as receiving mechanical ventilation, in‐hospital cardiac arrest, length of ICU stay, and degree of lung damage according to computed tomography (CT) score. RESULTS: Increased QTc (QT corrected) interval, Tp‐e (T from peak to end) interval, and transmural dispersion of repolarization (TDR) were independent predictors of prolonged ICU stay (P < .0001) after adjustment for baseline clinical characteristics. Increasing age (P < .0001) followed by increased QTc interval (P = .02) and history of chronic lung disease (P = .04) were independent predictors of extensive lung damage. The independent predictors for in‐hospital cardiac arrest were increased QTc (P = .02) followed by increasing age (P = .04) and increased Tp‐e interval (P = .04). CONCLUSION: Repolarization abnormalities on baseline ECG may be useful prognostic markers in patients with COVID‐19 pneumonia.