Baseline electrocardiographic findings as predictors of outcome in hospitalized patients with COVID-19

Introduction
The impact of coronavirus disease-2019 (COVID-19) on the heart is variable, but cardiac damage is associated with a bad prognosis. The mechanism behind the association between COVID-19 and cardiovascular diseases is not clear, but most of these patients reported with diseased immune system.


Patients and methods
This retrospective study included 70 hospitalized (moderate and severe) RT-PCR-positive COVID-19 patients. Data were retrieved from Mansoura University quarantine records from October 2020 to December 2020. The 12-lead channel conventional ECG collected at the first time after the patients were admitted to the hospital was used.


Results
About 94.3% of studied patients were in sinus rhythm, premature ventricular contractions were found in 2.9%. Atrial fibrillation was present in 4.3% and multifocal atrial tachycardia in 1.4%. Ischemic changes were found in 25.7% of the studied patients. About 14.3% had conduction defects. In this study, ECG ischemic changes only were significantly correlated with progress of respiratory support needed during hospitalization (44.4% of mechanically ventilated patients had ECG ischemic changes), mortality (P=0.04), and higher D-dimer level.


Conclusion
Baseline ECG ischemic changes associated with worse outcome of moderate and severe COVID-19 patients. Continuous monitoring of ECG changes in COVID-19 patients is recommended as it can provide an important assessment of COVID-19 severity.