Corrected QT Interval Prolongation, Elevated Troponin, and Mortality in Hospitalized COVID-19 Patients

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has risen to the level of a global pandemic. Growing evidence has proven the cardiac involvement in SARS-CoV-2 infection. This study aims to evaluate the ability of cardiovascular complications determined by elevated troponin and electrocardiogram findings (e.g., corrected QT interval (QTc)) in predicting the severity of SARS-CoV-2 infection among hospitalized patients.Methods: This is a retrospective review of medical records of 800 patients, admitted to Richmond University Medical Center in Staten Island, NY, and tested positive for SARS-CoV-2 between March 1, 2020 and July 31, 2020. A total of 339 patients met the study inclusion and exclusion criteria and were included in statistical analysis.Results: Elevated serum troponin levels on admission statistically correlated with mortality in SARS-CoV-2 patients. Prolonged QTc was shown to have an independent statistically significant association with mortality among patients hospitalized with SARS-CoV-2.Conclusions: Growing concern for cardiovascular sequelae of coronavirus disease 2019 (COVID-19) has prompted many researchers to investigate the role of cardiovascular complications in mortality due to SARS-CoV-2. Obtaining a simple electrocardiogram for hospital-ized patients with COVID-19 could provide an independent prognostic tool and prompt more coordinated treatment strategies to prevent mortality among patients hospitalized with COVID-19.

O Prolongamento do Intervalo QTc na Admissão está Associado ao Aumento da Mortalidade em Pacientes com SARS-COV-2 durante a Hospitalização

“…Além disso, Al-Zakhari et al analisaram retrospectivamente 339 pacientes e demonstraram que o intervalo QTc prolongado tem uma relação independente e estatisticamente significativa com a mortalidade em pacientes hospitalizados por SARS-COV-2 (r = -0,173, p<0,05, 95% IC: -0,277, -0,064). 25 …”

“…Also, Al-Zakhari et al retrospectively analyzed 339 patients and demonstrated that the prolonged QTc interval has an independent and statistically significant relationship with mortality in patients hospitalized for SARS-COV-2 (r = -0.173, p < 0.05, 95% CI: -0.277, -0.064). 25 …”

Significance of Cardiac Troponins as an Identification Tool in COVID-19 Patients Using Biosensors: An Update

“…Elevated serum troponin levels on admission statistically correlated with mortality in COVID-19 patients ( Al-Zakhari et al, 2021 ). In a retrospective cohort analysis, cTnI was significantly elevated in 54 subjects who died compared with 137 survivors (median [IQR] cTnI 22 [5.6–83.1] ng/L vs. 3 [1.1–5.5] ng/L, p ≤ 0.0001) ( Zhou et al, 2020 ).…”

“…Evidence of COVID-19-associated increases in circulating cardiac Troponin T (cTnT) and cardiac Troponin I (cTnI) above the 99th percentile reference limit is emerging in the literature (Wang et al, 2020a;Liu et al, 2020d;Ruan et al, 2020). Elevated serum troponin levels on admission statistically correlated with mortality in COVID-19 patients (Al-Zakhari et al, 2021). In a retrospective cohort analysis, cTnI was significantly elevated in 54 subjects who died compared with 137 survivors (median [IQR] cTnI 22 [5.6-83.1] ng/L vs. 3 [1.1-5.5] ng/L, p ≤ 0.0001) (Zhou et al, 2020).…”