Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients

Background: ECG abnormalities in COVID-19 have been widely reported, however data after discharge is limited. The aim was to describe ECG abnormalities on admission and following recovery of COVID-19, and their associated mortality. Methods: All patients hospitalized in a tertiary care hospital betw...

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Autores principales: Bert Vandenberk, Matthias M. Engelen, Greet Van De Sijpe, Jonas Vermeulen, Stefan Janssens, Thomas Vanassche, Peter Verhamme, Paul De Munter, Natalie Lorent, Rik Willems
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Publicado: Elsevier 2021
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spelling oai:doaj.org-article:346b31eca5d0421a993df0577b3748da2021-11-06T04:31:55ZRepolarization abnormalities on admission predict 1-year outcome in COVID-19 patients2352-906710.1016/j.ijcha.2021.100912https://doaj.org/article/346b31eca5d0421a993df0577b3748da2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352906721002001https://doaj.org/toc/2352-9067Background: ECG abnormalities in COVID-19 have been widely reported, however data after discharge is limited. The aim was to describe ECG abnormalities on admission and following recovery of COVID-19, and their associated mortality. Methods: All patients hospitalized in a tertiary care hospital between March 7th and July 1st 2020 with COVID-19 were included in a retrospective registry. The first ECG on admission was collected, together with an ECG after hospital discharge in the absence of acute pathology. Automated measures and clinical ECG interpretations were collected. Multivariate Cox regression analysis was performed to predict 1-year all-cause mortality. Results: In total 420 patients were included, of which 83 patients (19.8%) died during the 1-year follow-up period. Repolarization abnormalities were present in 189 patients (45.0%). The extent of repolarization abnormalities was an independent predictor of 1-year all-cause mortality (HR per region 1.30, 95%CI 1.04–1.64) together with age (/year HR 1.06, 95%CI 1.04–1.08), heart rate (/bpm HR 1.02, 95%CI 1.01–1.03), neurological disorders (HR 2.41, 95%CI 1.47–3.93), active cancer (HR 2.75, 95%CI 1.57–4.82), CRP (per 10 mg/L HR 1.05, 95%CI 1.02–1.08) and eGFR (per 10 mg/L HR 0.90, 95%CI 0.83–0.98).In 245 patients (68.1%) an ECG post discharge was available. New repolarization abnormalities were more frequent in patients who died after discharge (4.7% versus 41.7%, p < 0.001) and 8 (3.3%) had new ventricular conduction defects, none of whom died during follow-up. Conclusions: The presence and extent of repolarization abnormalities predicted outcome in patients with COVID-19. New repolarization abnormalities after discharge were associated with post-discharge mortality.Bert VandenberkMatthias M. EngelenGreet Van De SijpeJonas VermeulenStefan JanssensThomas VanasschePeter VerhammePaul De MunterNatalie LorentRik WillemsElsevierarticleCOVID-19ElectrocardiographyRepolarizationMortalityDiseases of the circulatory (Cardiovascular) systemRC666-701ENInternational Journal of Cardiology: Heart & Vasculature, Vol 37, Iss , Pp 100912- (2021)
institution DOAJ
collection DOAJ
language EN
topic COVID-19
Electrocardiography
Repolarization
Mortality
Diseases of the circulatory (Cardiovascular) system
RC666-701
spellingShingle COVID-19
Electrocardiography
Repolarization
Mortality
Diseases of the circulatory (Cardiovascular) system
RC666-701
Bert Vandenberk
Matthias M. Engelen
Greet Van De Sijpe
Jonas Vermeulen
Stefan Janssens
Thomas Vanassche
Peter Verhamme
Paul De Munter
Natalie Lorent
Rik Willems
Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients
description Background: ECG abnormalities in COVID-19 have been widely reported, however data after discharge is limited. The aim was to describe ECG abnormalities on admission and following recovery of COVID-19, and their associated mortality. Methods: All patients hospitalized in a tertiary care hospital between March 7th and July 1st 2020 with COVID-19 were included in a retrospective registry. The first ECG on admission was collected, together with an ECG after hospital discharge in the absence of acute pathology. Automated measures and clinical ECG interpretations were collected. Multivariate Cox regression analysis was performed to predict 1-year all-cause mortality. Results: In total 420 patients were included, of which 83 patients (19.8%) died during the 1-year follow-up period. Repolarization abnormalities were present in 189 patients (45.0%). The extent of repolarization abnormalities was an independent predictor of 1-year all-cause mortality (HR per region 1.30, 95%CI 1.04–1.64) together with age (/year HR 1.06, 95%CI 1.04–1.08), heart rate (/bpm HR 1.02, 95%CI 1.01–1.03), neurological disorders (HR 2.41, 95%CI 1.47–3.93), active cancer (HR 2.75, 95%CI 1.57–4.82), CRP (per 10 mg/L HR 1.05, 95%CI 1.02–1.08) and eGFR (per 10 mg/L HR 0.90, 95%CI 0.83–0.98).In 245 patients (68.1%) an ECG post discharge was available. New repolarization abnormalities were more frequent in patients who died after discharge (4.7% versus 41.7%, p < 0.001) and 8 (3.3%) had new ventricular conduction defects, none of whom died during follow-up. Conclusions: The presence and extent of repolarization abnormalities predicted outcome in patients with COVID-19. New repolarization abnormalities after discharge were associated with post-discharge mortality.
format article
author Bert Vandenberk
Matthias M. Engelen
Greet Van De Sijpe
Jonas Vermeulen
Stefan Janssens
Thomas Vanassche
Peter Verhamme
Paul De Munter
Natalie Lorent
Rik Willems
author_facet Bert Vandenberk
Matthias M. Engelen
Greet Van De Sijpe
Jonas Vermeulen
Stefan Janssens
Thomas Vanassche
Peter Verhamme
Paul De Munter
Natalie Lorent
Rik Willems
author_sort Bert Vandenberk
title Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients
title_short Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients
title_full Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients
title_fullStr Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients
title_full_unstemmed Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients
title_sort repolarization abnormalities on admission predict 1-year outcome in covid-19 patients
publisher Elsevier
publishDate 2021
url https://doaj.org/article/346b31eca5d0421a993df0577b3748da
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