Electrocardiographic findings at presentation and clinical outcome in patients with SARS-CoV-2 infection
Electrocardiographic findings at presentation and clinical outcome in patients with SARS-CoV-2 infection
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DOI：
10.1093/europace/euaa245
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发表时间：
2021-01-01
期刊：
影响因子：
6.1
通讯作者：
Crea, Filippo
中科院分区：
文献类型：
--
作者：
Lanza, Gaetano Antonio;De Vita, Antonio;Crea, Filippo
目的SARS-CoV-2感染的主要严重并发症是肺炎和呼吸窘迫综合征。然而，最近的研究报告，心脏损伤，如肌钙蛋白水平评估，与这些患者的预后较差。迄今为止，没有研究评估是否简单的标准心电图（ECG）可能有助于这些patients.Methods和结果的风险分层，我们研究了324例连续收治到我们的急诊科确诊为SARS-CoV-2感染。评估入院时记录的标准12导联ECG的心律和心率、房室和心室内传导、异常Q/QS波、ST段和T波变化、校正QT间期和快速性心律失常。平均随访31 ± 11天，发生44例死亡（13.6%）。大多数ECG变量与死亡率显著相关，包括房颤（P = 0.002），心率增加（P = 0.002），存在左束支分支阻滞（LBBB; P < 0.001），QRS时限P = 110 ms（P < 0.001），ST段压低Q/QS波异常（P < 0.001）（P = 0.034），室性早搏（PVC; P = 0.051）和存在任何ECG异常[风险比（HR）4.58; 95%置信区间（CI）2.40-8.76; P < 0.001]。在多变量分析中，QRS持续时间（P = 0.002），QRS时限>= 110 ms（P = 0.03），LBBB（P = 0.014）和存在任何ECG异常结论标准心电图对SARS冠状病毒2型感染性疾病患者的早期危险分层有一定的帮助。[图形]。
Aims The main severe complications of SARS-CoV-2 infection are pneumonia and respiratory distress syndrome. Recent studies, however, reported that cardiac injury, as assessed by troponin levels, is associated with a worse outcome in these patients. No study hitherto assessed whether the simple standard electrocardiogram (ECG) may be helpful for risk stratification in these patients.Methods and results We studied 324 consecutive patients admitted to our Emergency Department with a confirmed diagnosis of SARS-CoV-2 infection. Standard 12-lead ECG recorded on admission was assessed for cardiac rhythm and rate, atrioventricular and intraventricular conduction, abnormal Q/QS wave, ST segment and T wave changes, corrected QT interval, and tachyarrhythmias. At a mean follow-up of 31 +/- 11 days, 44 deaths occurred (13.6%). Most ECG variables were significantly associated with mortality, including atrial fibrillation (P = 0.002), increasing heart rate (P = 0.002), presence of left bundle branch block (LBBB; P < 0.001), QRS duration (P = 110 ms (P < 0.001), ST segment depression (P < 0.001), abnormal Q/QS wave (P = 0.034), premature ventricular complexes (PVCs; P = 0.051), and presence of any ECG abnormality [hazard ratio (HR) 4.58; 95% confidence interval (CI) 2.40-8.76; P < 0.001]. At multivariable analysis, QRS duration (P = 0.002), QRS duration >= 110 ms (P = 0.03), LBBB (P = 0.014) and presence of any ECG abnormality (P = 0.04) maintained a significant independent association with mortality.Conclusion Our data show that standard ECG can be helpful for an initial risk stratification of patients admitted for SARS-CoV-2 infectious disease.[GRAPHICS].