Association of electrocardiographic abnormalities and COVID-19 clinical outcomes

BACKGROUND: Alterations in the electrocardiogram (ECG) have been associated with coronavirus disease 2019 (COVID-19) severity. ECG irregularities have been linked to death from any cause. However, in previous studies, different abnormalities have been shown to be associated with COVID-19 mortality. We aimed to evaluate the association between ECG abnormalities and COVID-19 clinical outcomes. METHODS: This cross-sectional retrospectively evaluated patients with COVID-19 admitted to the emergency department of Shahid Mohammadi Hospital, Bandar Abbas, in 2021. Patients' data were extracted from their medical records, including demographics, smoking, underlying diseases, treatment, laboratory test results, and in-hospital parameters. Their admission ECGs were assessed for abnormalities. RESULTS: Of the 239 COVID-19 patients with a mean age of 55.18 ± 16.85 years, 126 (52.7%) were male. Fifty-seven patients (23.8%) died. Intensive care unit (ICU) admission and mechanical ventilation requirement were higher in patients who died (P < 0.001). Furthermore, mechanical ventilation duration and hospital and ICU length of stay were significantly longer in patients who died (P < 0.001). Multivariable logistic regression analysis revealed that a non-sinus rhythm in the admission ECG was associated with approximately eight times higher odds of mortality than a sinus rhythm (adjusted odds ratio = 7.961, 95% confidence interval 1.724; 36.759, P = 0.008). CONCLUSIONS: Among ECG findings, a non-sinus rhythm in the admission ECG appears to increase the odds of mortality in patients with COVID-19. Therefore, it is advised that COVID-19 patients be continuously monitored for ECG alterations, as this might provide crucial prognostic data.