Wide QRS Complex and Lateral ST-T Segment Abnormality Are Associated With Worse Clinical Outcomes in COVID-19 Patients

Sonsöz, Mehmet Rasih; Öncül, Aytaç; Çevik, Erdem; Orta, Huseyin; Yılmaz, Mustafa; Gövdeli, Elif Ayduk; Nalbant, Aslı; Demirtakan, Zeynep Gizem; Tonyali, Mirac; Durmus, Damla; Anaklı, İlkay; Polat, Özlem; Çatma, Yunus; Şenkal, Naci; Medetalibeyoğlu, Alpay; Köse, Murat; Emet, Samim; Tükek, Tufan

doi:10.1016/j.amjms.2020.12.012

Cited by 6 publications

(9 citation statements)

References 16 publications

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“…QRS duration longer than 120 ms was associated with worse clinical outcomes and higher levels of myocardial injury biomarkers in COVID-19. 28 Prolonged QRS could reflect active myocardial injury during CV events caused by the direct impact of SARS-CoV-2 on the cells. 29 A wide QRS complex has been previously associated with increased mortality risk in non-COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic Features and Outcome: Correlations in 124 Hospitalized Patients With COVID-19 and Cardiovascular Events

Nathala

Salunkhe

Samanapally

et al. 2022

Journal of Cardiothoracic and Vascular Anesthesia

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 99%

Electrocardiographic Features and Outcome: Correlations in 124 Hospitalized Patients With COVID-19 and Cardiovascular Events

Nathala

Salunkhe

Samanapally

et al. 2022

Journal of Cardiothoracic and Vascular Anesthesia

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“…Regarding the localization of the repolarization abnormality, lateral and antero-lateral changes on the ECG were the most frequently described, being also associated with worse clinical outcomes [ 92 , 93 , 94 ].…”

Section: Electrocardiographic Changes In Myocardial Ischemia In Covid...mentioning

confidence: 99%

“…We found in literature some cases of subacute myocardial infarction in COVID-19 patients, with Q wave being observed on ECG in approximately 4% of cases. The location was in both the anterior and inferior territories, and the patients maintained the ST-segment elevation on ECG [ 20 , 92 ]. Because the Q wave remains the only sign of myocardial infarction on ECG, a remote myocardial infarction is more difficult to recognize.…”

Section: Electrocardiographic Changes In Myocardial Ischemia In Covid...mentioning

confidence: 99%

Myocardial Ischemia in Patients with COVID-19 Infection: Between Pathophysiological Mechanisms and Electrocardiographic Findings

Duca

Ion

Miftode

et al. 2022

Life

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Given the possible pathophysiological links between myocardial ischemia and SARS-CoV-2 infection, several studies have focused attention on acute coronary syndromes in order to improve patients’ morbidity and mortality. Understanding the pathophysiological aspects of myocardial ischemia in patients infected with SARS-CoV-2 can open a broad perspective on the proper management for each patient. The electrocardiogram (ECG) remains the easiest assessment of cardiac involvement in COVID-19 patients, due to its non-invasive profile, accessibility, low cost, and lack of radiation. The ECG changes provide insight into the patient’s prognosis, indicating either the worsening of an underlying cardiac illnesses or the acute direct injury by the virus. This indicates that the ECG is an important prognostic tool that can affect the outcome of COVID-19 patients, which important to correlate its aspects with the clinical characteristics and patient’s medical history. The ECG changes in myocardial ischemia include a broad spectrum in patients with COVID-19 with different cases reported of ST-segment elevation, ST-segment depression, and T wave inversion, which are associated with severe COVID-19 disease.

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“…Additionally, elevated hs-TnI levels are associated with the presence of longer QTc interval, conduction disturbances and other ECG abnormalities, but not atrial fibrillation [48]. Wide QRS complex and abnormal lateral ST-T segment are more common in patients with elevated cardiac biomarkers [49].…”

Section: Paraclinical Findingsmentioning

confidence: 99%

Cardiac biomarkers alterations in patients with SARS-CoV-2 infection

Oikonomou

Paraskevas

Velissaris

2022

Romanian Journal of Internal Medicine

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Reliable biomarkers are necessary for the risk stratification of patients infected with SARS-CoV-2. This novel coronavirus is now established to affect several organs in addition to the lungs, most prominently the heart. This is achieved through direct damage to the myocardium and indirect immune-associated effects during the cytokine storm. We performed a literature review aiming to identify the prognostic value of alterations of cardiac biomarkers in SARS-CoV-2 infection. Cardiac biomarkers are significantly elevated in patients with severe COVID-19 and are independent predictors of mortality. High-sensitivity troponin I and T are correlated with multiple inflammatory indexes and poor outcomes. Although cut-off values have been established for most of cardiac biomarkers, lower limits for troponins may have better prognostic values and longitudinal monitoring of cardiac biomarkers can help the clinician assess the patient’s course. Additional measurements of NT-proBNP, can detect the subgroup of patients with poor prognosis.

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Wide QRS Complex and Lateral ST-T Segment Abnormality Are Associated With Worse Clinical Outcomes in COVID-19 Patients

Cited by 6 publications

References 16 publications

Electrocardiographic Features and Outcome: Correlations in 124 Hospitalized Patients With COVID-19 and Cardiovascular Events

Electrocardiographic Features and Outcome: Correlations in 124 Hospitalized Patients With COVID-19 and Cardiovascular Events

Myocardial Ischemia in Patients with COVID-19 Infection: Between Pathophysiological Mechanisms and Electrocardiographic Findings

Cardiac biomarkers alterations in patients with SARS-CoV-2 infection

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