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Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19
Background: Electrocardiogram (ECG) offers a valuable resource easily available in the emergency setting. Objective: Aim of the study was to describe ECG alterations on emergency department (ED) presentation or that developed during hospitalization in SARS-CoV-2-infected patients and their associati...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9100038/ https://www.ncbi.nlm.nih.gov/pubmed/35566664 http://dx.doi.org/10.3390/jcm11092537 |
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author | Savelloni, Giulia Gatto, Maria Chiara Cancelli, Francesca Barbetti, Anna Cogliati Dezza, Francesco Franchi, Cristiana Carnevalini, Martina Galardo, Gioacchino Bucci, Tommaso Alessandroni, Maria Pugliese, Francesco Mastroianni, Claudio Maria Oliva, Alessandra |
author_facet | Savelloni, Giulia Gatto, Maria Chiara Cancelli, Francesca Barbetti, Anna Cogliati Dezza, Francesco Franchi, Cristiana Carnevalini, Martina Galardo, Gioacchino Bucci, Tommaso Alessandroni, Maria Pugliese, Francesco Mastroianni, Claudio Maria Oliva, Alessandra |
author_sort | Savelloni, Giulia |
collection | PubMed |
description | Background: Electrocardiogram (ECG) offers a valuable resource easily available in the emergency setting. Objective: Aim of the study was to describe ECG alterations on emergency department (ED) presentation or that developed during hospitalization in SARS-CoV-2-infected patients and their association with 28-day mortality. Methods: A retrospective, single-center study including hospitalized patients with SARS-CoV-2 was conducted. ECG was recorded on ED admission to determine: heart rhythm, rate, and cycle; atrio-ventricular and intra-ventricular conduction; right ventricular strain; and ventricular repolarization. A specialized cardiologist blinded for the outcomes performed all 12-lead ECG analyses and their interpretation. Results: 190 patients were included, with a total of 24 deaths (12.6%). Age (p < 0.0001) and comorbidity burden were significantly higher in non-survivors (p < 0.0001). Atrial fibrillation (AF) was more frequent in non-survivors (p < 0.0001), alongside a longer QTc interval (p = 0.0002), a lower Tp-e/QTc ratio (p = 0.0003), and right ventricular strain (p = 0.013). Remdesivir administration was associated with bradycardia development (p = 0.0005) but no increase in mortality rates. In a Cox regression model, AF (aHR 3.02 (95% CI 1.03–8.81); p = 0.042), QTc interval above 451 ms (aHR 3.24 (95% CI 1.09–9.62); p = 0.033), and right ventricular strain (aHR 2.94 (95% CI 1.01–8.55); p = 0.047) were associated with higher 28-day mortality risk. Conclusions: QTc interval > 451 ms, right ventricular strain, and AF are associated with higher mortality risk in SARS-CoV-2 hospitalized patients. ECG recording and its appropriate analysis offers a simple, quick, non-expensive, and validated approach in the emergency setting to guide COVID-19 patients’ stratification. |
format | Online Article Text |
id | pubmed-9100038 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91000382022-05-14 Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19 Savelloni, Giulia Gatto, Maria Chiara Cancelli, Francesca Barbetti, Anna Cogliati Dezza, Francesco Franchi, Cristiana Carnevalini, Martina Galardo, Gioacchino Bucci, Tommaso Alessandroni, Maria Pugliese, Francesco Mastroianni, Claudio Maria Oliva, Alessandra J Clin Med Article Background: Electrocardiogram (ECG) offers a valuable resource easily available in the emergency setting. Objective: Aim of the study was to describe ECG alterations on emergency department (ED) presentation or that developed during hospitalization in SARS-CoV-2-infected patients and their association with 28-day mortality. Methods: A retrospective, single-center study including hospitalized patients with SARS-CoV-2 was conducted. ECG was recorded on ED admission to determine: heart rhythm, rate, and cycle; atrio-ventricular and intra-ventricular conduction; right ventricular strain; and ventricular repolarization. A specialized cardiologist blinded for the outcomes performed all 12-lead ECG analyses and their interpretation. Results: 190 patients were included, with a total of 24 deaths (12.6%). Age (p < 0.0001) and comorbidity burden were significantly higher in non-survivors (p < 0.0001). Atrial fibrillation (AF) was more frequent in non-survivors (p < 0.0001), alongside a longer QTc interval (p = 0.0002), a lower Tp-e/QTc ratio (p = 0.0003), and right ventricular strain (p = 0.013). Remdesivir administration was associated with bradycardia development (p = 0.0005) but no increase in mortality rates. In a Cox regression model, AF (aHR 3.02 (95% CI 1.03–8.81); p = 0.042), QTc interval above 451 ms (aHR 3.24 (95% CI 1.09–9.62); p = 0.033), and right ventricular strain (aHR 2.94 (95% CI 1.01–8.55); p = 0.047) were associated with higher 28-day mortality risk. Conclusions: QTc interval > 451 ms, right ventricular strain, and AF are associated with higher mortality risk in SARS-CoV-2 hospitalized patients. ECG recording and its appropriate analysis offers a simple, quick, non-expensive, and validated approach in the emergency setting to guide COVID-19 patients’ stratification. MDPI 2022-04-30 /pmc/articles/PMC9100038/ /pubmed/35566664 http://dx.doi.org/10.3390/jcm11092537 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Savelloni, Giulia Gatto, Maria Chiara Cancelli, Francesca Barbetti, Anna Cogliati Dezza, Francesco Franchi, Cristiana Carnevalini, Martina Galardo, Gioacchino Bucci, Tommaso Alessandroni, Maria Pugliese, Francesco Mastroianni, Claudio Maria Oliva, Alessandra Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19 |
title | Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19 |
title_full | Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19 |
title_fullStr | Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19 |
title_full_unstemmed | Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19 |
title_short | Prognostic Value of 12-Leads Electrocardiogram at Emergency Department in Hospitalized Patients with Coronavirus Disease-19 |
title_sort | prognostic value of 12-leads electrocardiogram at emergency department in hospitalized patients with coronavirus disease-19 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9100038/ https://www.ncbi.nlm.nih.gov/pubmed/35566664 http://dx.doi.org/10.3390/jcm11092537 |
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