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Electrocardiographic Findings and In-Hospital Mortality of COVID-19 Patients; a Retrospective Cohort Study

BACKGROUND: Although current evidence points to the possible prognostic value of electrocardiographic (ECG) findings for in-hospital mortality of COVID-19 patients, most of these studies have been performed on a small sample size. In this study, our aim was to investigate the ECG changes as prognost...

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Autores principales: Haji Aghajani, Mohammad, Toloui, Amirmohammad, Aghamohammadi, Moazzameh, Pourhoseingholi, Asma, Taherpour, Niloufar, Sistanizad, Mohammad, Madani Neishaboori, Arian, Asadpoordezaki, Ziba, Miri, Reza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Shahid Beheshti University of Medical Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221543/
https://www.ncbi.nlm.nih.gov/pubmed/34223190
http://dx.doi.org/10.22037/aaem.v9i1.1250
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author Haji Aghajani, Mohammad
Toloui, Amirmohammad
Aghamohammadi, Moazzameh
Pourhoseingholi, Asma
Taherpour, Niloufar
Sistanizad, Mohammad
Madani Neishaboori, Arian
Asadpoordezaki, Ziba
Miri, Reza
author_facet Haji Aghajani, Mohammad
Toloui, Amirmohammad
Aghamohammadi, Moazzameh
Pourhoseingholi, Asma
Taherpour, Niloufar
Sistanizad, Mohammad
Madani Neishaboori, Arian
Asadpoordezaki, Ziba
Miri, Reza
author_sort Haji Aghajani, Mohammad
collection PubMed
description BACKGROUND: Although current evidence points to the possible prognostic value of electrocardiographic (ECG) findings for in-hospital mortality of COVID-19 patients, most of these studies have been performed on a small sample size. In this study, our aim was to investigate the ECG changes as prognostic indicators of in-hospital mortality. METHODS: In a retrospective cohort study, the findings of the first and the second ECGs of COVID-19 patients were extracted and changes in the ECGs were examined. Any abnormal finding in the second ECG that wasn’t present in the initial ECG at the time of admission was defined as an ECG change. ECGs were interpreted by a cardiologist and the prognostic value of abnormal ECG findings for in-hospital mortality of COVID-19 patients was evaluated using multivariate analysis and the report of the relative risk (RR). RESULTS: Data of the ECGs recorded at the time of admission were extracted from the files of 893 patients; likewise, the second ECGs could be extracted from the records of 328 patients who had an initial ECG. The presence of sinus tachycardia (RR = 2.342; p <0.001), supraventricular arrhythmia (RR = 1.688; p = 0.001), ventricular arrhythmia (RR = 1.854; p = 0.011), interventricular conduction delays (RR = 1.608; p = 0.009), and abnormal R wave progression (RR = 1.766; p = 0.001) at the time of admission were independent prognostic factors for in-hospital mortality. In the second ECG, sinus tachycardia (RR = 2.222; p <0.001), supraventricular arrhythmia (RR = 1.632; p <0.001), abnormal R wave progression (RR = 2.151; p = 0.009), and abnormal T wave (RR = 1.590; p = 0.001) were also independent prognostic factors of in-hospital mortality. Moreover, by comparing the first and the second ECGs, it was found that the incidence of supraventricular arrhythmia (RR = 1.973; p = 0.005) and ST segment elevation/depression (RR = 2.296; p <0.001) during hospitalization (ECG novel changes) are two independent prognostic factors of in-hospital mortality in COVID-19 patients. CONCLUSION: Due to the fact that using electrocardiographic data is easy and accessible and it is easy to continuously monitor patients with this tool, ECGs can be useful in identifying high-risk COVID-19 patients for mortality.
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spelling pubmed-82215432021-07-02 Electrocardiographic Findings and In-Hospital Mortality of COVID-19 Patients; a Retrospective Cohort Study Haji Aghajani, Mohammad Toloui, Amirmohammad Aghamohammadi, Moazzameh Pourhoseingholi, Asma Taherpour, Niloufar Sistanizad, Mohammad Madani Neishaboori, Arian Asadpoordezaki, Ziba Miri, Reza Arch Acad Emerg Med Original Research Article BACKGROUND: Although current evidence points to the possible prognostic value of electrocardiographic (ECG) findings for in-hospital mortality of COVID-19 patients, most of these studies have been performed on a small sample size. In this study, our aim was to investigate the ECG changes as prognostic indicators of in-hospital mortality. METHODS: In a retrospective cohort study, the findings of the first and the second ECGs of COVID-19 patients were extracted and changes in the ECGs were examined. Any abnormal finding in the second ECG that wasn’t present in the initial ECG at the time of admission was defined as an ECG change. ECGs were interpreted by a cardiologist and the prognostic value of abnormal ECG findings for in-hospital mortality of COVID-19 patients was evaluated using multivariate analysis and the report of the relative risk (RR). RESULTS: Data of the ECGs recorded at the time of admission were extracted from the files of 893 patients; likewise, the second ECGs could be extracted from the records of 328 patients who had an initial ECG. The presence of sinus tachycardia (RR = 2.342; p <0.001), supraventricular arrhythmia (RR = 1.688; p = 0.001), ventricular arrhythmia (RR = 1.854; p = 0.011), interventricular conduction delays (RR = 1.608; p = 0.009), and abnormal R wave progression (RR = 1.766; p = 0.001) at the time of admission were independent prognostic factors for in-hospital mortality. In the second ECG, sinus tachycardia (RR = 2.222; p <0.001), supraventricular arrhythmia (RR = 1.632; p <0.001), abnormal R wave progression (RR = 2.151; p = 0.009), and abnormal T wave (RR = 1.590; p = 0.001) were also independent prognostic factors of in-hospital mortality. Moreover, by comparing the first and the second ECGs, it was found that the incidence of supraventricular arrhythmia (RR = 1.973; p = 0.005) and ST segment elevation/depression (RR = 2.296; p <0.001) during hospitalization (ECG novel changes) are two independent prognostic factors of in-hospital mortality in COVID-19 patients. CONCLUSION: Due to the fact that using electrocardiographic data is easy and accessible and it is easy to continuously monitor patients with this tool, ECGs can be useful in identifying high-risk COVID-19 patients for mortality. Shahid Beheshti University of Medical Sciences 2021-06-12 /pmc/articles/PMC8221543/ /pubmed/34223190 http://dx.doi.org/10.22037/aaem.v9i1.1250 Text en https://creativecommons.org/licenses/by/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/ (https://creativecommons.org/licenses/by/3.0/) ) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Article
Haji Aghajani, Mohammad
Toloui, Amirmohammad
Aghamohammadi, Moazzameh
Pourhoseingholi, Asma
Taherpour, Niloufar
Sistanizad, Mohammad
Madani Neishaboori, Arian
Asadpoordezaki, Ziba
Miri, Reza
Electrocardiographic Findings and In-Hospital Mortality of COVID-19 Patients; a Retrospective Cohort Study
title Electrocardiographic Findings and In-Hospital Mortality of COVID-19 Patients; a Retrospective Cohort Study
title_full Electrocardiographic Findings and In-Hospital Mortality of COVID-19 Patients; a Retrospective Cohort Study
title_fullStr Electrocardiographic Findings and In-Hospital Mortality of COVID-19 Patients; a Retrospective Cohort Study
title_full_unstemmed Electrocardiographic Findings and In-Hospital Mortality of COVID-19 Patients; a Retrospective Cohort Study
title_short Electrocardiographic Findings and In-Hospital Mortality of COVID-19 Patients; a Retrospective Cohort Study
title_sort electrocardiographic findings and in-hospital mortality of covid-19 patients; a retrospective cohort study
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221543/
https://www.ncbi.nlm.nih.gov/pubmed/34223190
http://dx.doi.org/10.22037/aaem.v9i1.1250
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