Electrocardiographic markers of increased risk of sudden cardiac death in patients with COVID-19 pneumonia

[摘要] Background Little is known about the role of ECG markers of increased risk of sudden cardiac death during the acute period of coronavirus disease 2019 ( COVID-19) pneumonia. Objectives To evaluate ECG markers of sudden cardiac death on admission, including the index of cardiac electrophysiological balance (iCEB) (QTc/QRS) and transmural dispersion of repolarization (TDR) (T from peak to end (Tp-e) interval and Tp-e/QTc), in patients with COVID-19 pneumonia. Patients and methods This cross-sectional study included 63 patients with newly diagnosed COVID-19 pneumonia who presented to the outpatient clinic or admitted to the respiratory care unit between August 20 and September 15, 2020. Forty-six persons matched for sex and age were selected from data collected before COVID-19 pandemic. Results QRS and QTc showed a significant prolongation in patients with COVID-19 pneumonia compared to the controls (87 vs. 78, p  < .00, and 429 versus. 400, p  < .00, respectively). After categorization of patients with COVID-19 pneumonia into 3 groups according to the severity of pneumonia as mild-moderate, severe, and critical groups, a decreased values of QRS were observed in the critical COVID-19 pneumonia group compared to severe and mild-moderate COVID-19 pneumonia groups ( p  = .04) while increased values of QTc and iCEB(QTc/QRS) were noted in critical COVID-19 pneumonia group compared to other 2 groups( p  < .00). Conclusions Patients with COVID-19 pneumonia showed significant changes in repolarization and conduction parameters compared to controls. Patients with mild to severe COVID-19 pneumonia may be at low risk for torsades de pointes development.

[关键词] COVID-19;ECG;markers;pneumonia;sudden death