Electrocardiographic markers of increased risk of sudden cardiac death in patients with COVID‐19 pneumonia

Abstract

Background: LittleisknownabouttheroleofECGmarkersofincreasedriskofsud-dencardiacdeathduringtheacuteperiodofcoronavirusdisease2019(COVID-19) pneumonia. Objectives: ToevaluateECGmarkersofsuddencardiacdeathonadmission,includingtheindexofcardiacelectrophysiologicalbalance(iCEB)(QTc/QRS)andtransmuraldispersionofrepolarization(TDR)(Tfrompeaktoend(Tp-e)intervalandTp-e/ QTc),inpatientswithCOVID-19pneumonia. Patients and methods: This cross-sectional study included 63 patients with newly diagnosedCOVID-19pneumoniawhopresentedtotheoutpatientclinicoradmitted totherespiratorycareunitbetweenAugust20andSeptember15,2020.Forty-six personsmatchedforsexandagewereselectedfromdatacollectedbeforeCOVID-19 pandemic.Results: QRS and QTc showed a significant prolongation in patients with COVID-19 pneumonia compared to the controls (87 vs. 78, p < .00, and 429 versus. 400, p < .00, respectively). After categorization of patients with COVID-19 pneumonia into3groupsaccordingtotheseverityofpneumoniaasmild-moderate,severe,and criticalgroups,adecreasedvaluesofQRSwereobservedinthecriticalCOVID-19 pneumonia group compared to severe and mild-moderate COVID-19 pneumonia groups (p = .04) while increased values of QTc and iCEB(QTc/QRS) were noted in criticalCOVID-19pneumoniagroupcomparedtoother2groups(p <.00).

A new predictor for indicating clinical severity and prognosis in COVID-19 patients: Frontal QRS-T angle

“…Previous studies reported that prolonged QT is associated with ventricular arrhythmias and cardiovascular mortality [ 19 ]. It was also reported that QRS time and QT/QTc are increased in COVID-19 patients [ [20] , [21] , [22] ]. In the present study, we found that QT/QTc and QRS time increased significantly in the patient group compared to the control group.…”

Altered cardiac autonomic function after recovery from COVID‐19

“…Coronavirus disease 2019 (COVID‐19), the illness caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), mainly affects the respiratory system and shows wide range of clinical presentations varying from asymptomatic/mild symptoms to severe viral pneumonia with respiratory failure, systemic inflammatory syndrome, and death (Gorbalenya et al, 2020 ; Wang et al, 2020 ; Zhou et al, 2020 ). Although the respiratory tract is the primary target for SARS‐CoV‐2 virus, cardiovascular involvement has been documented in acute phase of the disease in different studies (Alareedh et al, 2020 ; Madjid et al, 2020 ). In recovered patients, palpitations and dyspnea on exertion may prolong and adversely affect health even after full recovery from COVID‐19.…”

Letter to the Editor regarding article “Electrocardiographic markers of increased risk of sudden cardiac death in patients with COVID‐19 pneumonia”

“…We have read with great interest the article “Electrocardiographic markers of increased risk of sudden cardiac death in patients with COVID‐19 pneumonia” by Alareedh et al, ( 2021 ).…”