Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be associated with myocardial injury. Identification of at-risk patients and mechanisms underlying cardiac involvement in COVID-19 remains unclear. During hospitalization for COVID-19, high troponin level has been f...

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Autores principales:	Hugo De Carvalho, Lucas Leonard-Pons, Julien Segard, Nicolas Goffinet, François Javaudin, Arnaud Martinage, Guillaume Cattin, Severin Tiberghien, Dylan Therasse, Marc Trotignon, Fabien Arabucki, Simon Ribes, Quentin Le Bastard, Emmanuel Montassier
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Electrocardiogram In-hospital mortality Patterns COVID-19 Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/7be1f1b5c2c24af782f4012c5fcbfac1
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spelling	oai:doaj.org-article:7be1f1b5c2c24af782f4012c5fcbfac12021-11-21T12:14:34ZElectrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study10.1186/s12873-021-00539-81471-227Xhttps://doaj.org/article/7be1f1b5c2c24af782f4012c5fcbfac12021-11-01T00:00:00Zhttps://doi.org/10.1186/s12873-021-00539-8https://doaj.org/toc/1471-227XAbstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be associated with myocardial injury. Identification of at-risk patients and mechanisms underlying cardiac involvement in COVID-19 remains unclear. During hospitalization for COVID-19, high troponin level has been found to be an independent variable associated with in-hospital mortality and a greater risk of complications. Electrocardiographic (ECG) abnormalities could be a useful tool to identify patients at risk of poor prognostic. The aim of our study was to assess if specific ECGs patterns could be related with in-hospital mortality in COVID-19 patients presenting to the ED in a European country. Methods From February 1st to May 31st, 2020, we conducted a multicenter study in three hospitals in France. We included adult patients (≥ 18 years old) who visited the ED during the study period, with ECG performed at ED admission and diagnosed with COVID-19. Demographic, comorbidities, drug exposures, signs and symptoms presented, and outcome data were extracted from electronic medical records using a standardized data collection form. The relationship between ECG abnormalities and in-hospital mortality was assessed using univariate and multivariable logistic regression analyses. Results An ECG was performed on 275 patients who presented to the ED. Most of the ECGs were in normal sinus rhythm (87%), and 26 (10%) patients had atrial fibrillation/flutter on ECG at ED admission. Repolarization abnormalities represented the most common findings reported in the population (40%), with negative T waves representing 21% of all abnormalities. We found that abnormal axis (adjusted odds ratio: 3.9 [95% CI, 1.1–11.5], p = 0.02), and left bundle branch block (adjusted odds ratio: 7.1 [95% CI, 1.9–25.1], p = 0.002) were significantly associated with in-hospital mortality. Conclusions ECG performed at ED admission may be useful to predict death in COVID-19 patients. Our data suggest that the presence of abnormal axis and left bundle branch block on ECG indicated a higher risk of in-hospital mortality in COVID-19 patients who presented to the ED. We also confirmed that ST segment elevation was rare in COVID-19 patients.Hugo De CarvalhoLucas Leonard-PonsJulien SegardNicolas GoffinetFrançois JavaudinArnaud MartinageGuillaume CattinSeverin TiberghienDylan TherasseMarc TrotignonFabien ArabuckiSimon RibesQuentin Le BastardEmmanuel MontassierBMCarticleElectrocardiogramIn-hospital mortalityPatternsCOVID-19Special situations and conditionsRC952-1245Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENBMC Emergency Medicine, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Electrocardiogram In-hospital mortality Patterns COVID-19 Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Electrocardiogram In-hospital mortality Patterns COVID-19 Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Hugo De Carvalho Lucas Leonard-Pons Julien Segard Nicolas Goffinet François Javaudin Arnaud Martinage Guillaume Cattin Severin Tiberghien Dylan Therasse Marc Trotignon Fabien Arabucki Simon Ribes Quentin Le Bastard Emmanuel Montassier Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study
description	Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be associated with myocardial injury. Identification of at-risk patients and mechanisms underlying cardiac involvement in COVID-19 remains unclear. During hospitalization for COVID-19, high troponin level has been found to be an independent variable associated with in-hospital mortality and a greater risk of complications. Electrocardiographic (ECG) abnormalities could be a useful tool to identify patients at risk of poor prognostic. The aim of our study was to assess if specific ECGs patterns could be related with in-hospital mortality in COVID-19 patients presenting to the ED in a European country. Methods From February 1st to May 31st, 2020, we conducted a multicenter study in three hospitals in France. We included adult patients (≥ 18 years old) who visited the ED during the study period, with ECG performed at ED admission and diagnosed with COVID-19. Demographic, comorbidities, drug exposures, signs and symptoms presented, and outcome data were extracted from electronic medical records using a standardized data collection form. The relationship between ECG abnormalities and in-hospital mortality was assessed using univariate and multivariable logistic regression analyses. Results An ECG was performed on 275 patients who presented to the ED. Most of the ECGs were in normal sinus rhythm (87%), and 26 (10%) patients had atrial fibrillation/flutter on ECG at ED admission. Repolarization abnormalities represented the most common findings reported in the population (40%), with negative T waves representing 21% of all abnormalities. We found that abnormal axis (adjusted odds ratio: 3.9 [95% CI, 1.1–11.5], p = 0.02), and left bundle branch block (adjusted odds ratio: 7.1 [95% CI, 1.9–25.1], p = 0.002) were significantly associated with in-hospital mortality. Conclusions ECG performed at ED admission may be useful to predict death in COVID-19 patients. Our data suggest that the presence of abnormal axis and left bundle branch block on ECG indicated a higher risk of in-hospital mortality in COVID-19 patients who presented to the ED. We also confirmed that ST segment elevation was rare in COVID-19 patients.
format	article
author	Hugo De Carvalho Lucas Leonard-Pons Julien Segard Nicolas Goffinet François Javaudin Arnaud Martinage Guillaume Cattin Severin Tiberghien Dylan Therasse Marc Trotignon Fabien Arabucki Simon Ribes Quentin Le Bastard Emmanuel Montassier
author_facet	Hugo De Carvalho Lucas Leonard-Pons Julien Segard Nicolas Goffinet François Javaudin Arnaud Martinage Guillaume Cattin Severin Tiberghien Dylan Therasse Marc Trotignon Fabien Arabucki Simon Ribes Quentin Le Bastard Emmanuel Montassier
author_sort	Hugo De Carvalho
title	Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study
title_short	Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study
title_full	Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study
title_fullStr	Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study
title_full_unstemmed	Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study
title_sort	electrocardiographic abnormalities in covid-19 patients visiting the emergency department: a multicenter retrospective study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7be1f1b5c2c24af782f4012c5fcbfac1
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Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study

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