Ann Noninvasive Electrocardiol. 2020 Sep 20:e12805. doi: 10.1111/anec.12805. Online ahead of print.
BACKGROUND: A global outbreak of coronavirus disease (COVID-19), caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), has emerged since December 2019, in Wuhan, China. However, electrocardiograhic (ECG) manifestations of patients with COVID-19 have not been fully described. We aim to investigate ECG characteristics in COVID-19 patients and risk factors of intensive care unit (ICU) admission.
METHODS: This retrospective observational study included the patients with COVID-19 at the Wuhan Asia General hospital between February 10, and 26, 2020. Demographic, clinical, and ECG characteristics were collected, and comparisons were made between the ICU and non-ICU admission groups. Logistic regression was used to identify risk factors of ICU admission.
RESULTS: Among 135 included patients (median age: 64 years [interquartile range: 48-72]), ST-T abnormalities (40%) were the most common ECG feature, followed by arrhythmias (38%). Cardiovascular disease (CVD) was presented in 48% of the patients. Six (4.4%) died during hospitalization, and 23 (17.0%) were admitted to the ICU. Compared with non-ICU group, the ICU group showed higher heart rate (p = .019) and P-wave duration (p = .039) and was more frequently associated with CVD (p < .001), ST-T abnormalities (p = .007), arrhythmias (p = .003), QTc interval prolongation (p = .003), and pathological Q waves (p < .001). Twenty-seven patients were re-examined ECG during admission, and 17 of them presented new findings compared with their initial ECG presentations. ST-T abnormalities (p = .040) and history of CVD (p = .0047) were associated with increased risk of ICU hospitalization.
CONCLUSIONS: COVID-19 is frequently related to cardiovascular manifestations including ECG abnormalities and cardiovascular comorbidities. ST-T abnormalities and CVD at admission were associated with increased odds of ICU admission.