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

Sonsoz M. R., Oncul A., Cevik E., Orta H., Yilmaz M., Ayduk Govdeli E., ...More

The American journal of the medical sciences, vol.361, no.5, pp.591-597, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 361 Issue: 5
  • Publication Date: 2021
  • Doi Number: 10.1016/j.amjms.2020.12.012
  • Journal Name: The American journal of the medical sciences
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.591-597
  • Keywords: COVID-19, Electrocardiogram, Mortality, Myocardial injury, Wide QRS complex
  • Istanbul University Affiliated: Yes


Background: The  information  on  electrocardiographic  features  of  patients  with  coronavirus  disease 2019  (COVID-19)  is  limited. Our  aim  was  to  determine  if  baseline  electrocardiographic  features  of hospitalized  COVID-19   patients   are   associated   with   markers   of   myocardial  injury   and   clinical outcomes. Methods: In  this  retrospective, single center cohort study,  we included 223 hospitalized patients with   laboratory-confirmed   COVID-19. Clinical, electrocardiographic   and   laboratory data   were collected  and analyzed. Primary  composite  endpoint  of  mortality,  need  for  invasive  mechanical ventilation, or admission to the intensive care unit was assessed. Results: Forty  patients  (17.9%)  reached  the  primary  composite  endpoint. Patients  with the primary composite endpoint were more likely to have wide QRS complex (>120 ms) and lateral ST-T segment abnormality. The  multivariable  Cox  regression  showed  increasing  odds  of the primary  composite endpoint associated with acute respiratory distress syndrome (odds ratio 7.76, 95% CI 2.67 – 22.59; P <0.001),  acute  cardiac  injury  (odds  ratio  3.14,  95%  CI  1.26 – 7.99; P =  0.016),  high  flow  oxygen therapy (odds ratio 2.43, 95% CI 1.05 – 5.62; P = 0.037) and QRS duration longer than >120 ms (odds ratio  3.62,  95%  CI  1.39 – 9.380; P =  0.008) Patients  with a wide  QRS complex (>120 ms)  had significantly  higher median  level  of troponin  T and  pro-BNP than those without it. Patients with abnormality of lateral ST-T segment had significantly higher median level of troponin T and pro-BNP than patients without. Conclusions: The presence of QRS duration longer than 120 ms and lateral ST-T segment abnormality were associated with worse clinical outcomes and higher levels of myocardial injury biomarkers.