Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis.
Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis.
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DOI：
10.3390/jcm9092712
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发表时间：
2020-08-21
影响因子：
3.9
通讯作者：
Vaquerizo B
中科院分区：
文献类型：
--
作者：
Farré N;Mojón D;Llagostera M;Belarte-Tornero LC;Calvo-Fernández A;Vallés E;Negrete A;García-Guimaraes M;Bartolomé Y;Fernández C;García-Duran AB;Marrugat J;Vaquerizo B
背景：QT间期延长对SARS-Cov 2感染的预后价值尚不清楚。目的：确定入院时QT间期延长是否是SARS-Cov 2住院患者死亡的独立因素。研究方法：2020年2月27日至4月7日招募的623名SARS Cov 2聚合酶链反应检测（PCR）阳性的连续患者的单中心队列。在诊断后的前48小时内和给予任何已知对QT间期有影响的药物之前，对这些患者进行心电图检查。QT间期延长定义为校正QT（QTc）间期>480毫秒。患者随访至2020年5月10日。结果：61例（9.8%）患者有QTc延长，只有3.2%的患者基线QTc > 500毫秒。QTc间期延长的患者年龄较大，合并症较多，免疫炎症标志物水平较高。住院期间未发生室性心动过速或室颤。QTc间期延长患者的全因死亡率较高（41.0% vs. 8.7%，p < 0.001，多变量HR 2.68（1.58-4.55），p < 0.001）。结论：近10%的COVID-19感染患者入院时QTc间期延长。QTc延长与较高的死亡率独立相关，即使在校正了年龄、合并症以及羟氯喹和阿奇霉素治疗后。入院时应包括心电图，以识别高风险的SARS-CoV-2患者。
Background: The prognostic value of a prolonged QT interval in SARS-Cov2 infection is not well known. Objective: To determine whether the presence of a prolonged QT on admission is an independent factor for mortality in SARS-Cov2 hospitalized patients. Methods: Single-center cohort of 623 consecutive patients with positive polymerase-chain-reaction test (PCR) to SARS Cov2, recruited from 27 February to 7 April 2020. An electrocardiogram was taken on these patients within the first 48 h after diagnosis and before the administration of any medication with a known effect on QT interval. A prolonged QT interval was defined as a corrected QT (QTc) interval >480 milliseconds. Patients were followed up with until 10 May 2020. Results: Sixty-one patients (9.8%) had prolonged QTc and only 3.2% had a baseline QTc > 500 milliseconds. Patients with prolonged QTc were older, had more comorbidities, and higher levels of immune-inflammatory markers. There were no episodes of ventricular tachycardia or ventricular fibrillation during hospitalization. All-cause death was higher in patients with prolonged QTc (41.0% vs. 8.7%, p < 0.001, multivariable HR 2.68 (1.58–4.55), p < 0.001). Conclusions: Almost 10% of patients with COVID-19 infection have a prolonged QTc interval on admission. A prolonged QTc was independently associated with a higher mortality even after adjustment for age, comorbidities, and treatment with hydroxychloroquine and azithromycin. An electrocardiogram should be included on admission to identify high-risk SARS-CoV-2 patients.
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