ECG Prediction of Mortality in COVID-19 Patients by Sokolow-Lyon Voltage

 Different electrocardiographic (ECG) results, seen in coronavirus disease 2019 (COVID-19) patients are most likely due to the combined impact of acute COVID-19 and chronic heart disease. Few studies have addressed the effects of hypoxemia, the hallmark of the pandemic disease, on ECG.

 The present study discusses the prevalence of arrhythmias and disorders of conduction system in demised and survived COVID-19 patients, using ECG and Sokolow-Lyon voltage as a sign of hypoxemia to predict mortality in the admitted patients and after discharge.

 We investigated the ECG, and other medical data of 960 COVID-19 patients admitted to Faghihi hospital in Shiraz, Iran, from August 2021 to December 2021.

 Most of the patients were male (541 or 56.4%) and older than 65 years old (462 or 48.1%). A total of 475 (49.5%) patients died. Multiple logistic regression revealed an independent association between the COVID-19 death rate and cardiovascular disease (OR = 3.05; 95% CI: 1.96 - 4.74), QT dispersion more than 40 (OR = 5.08; 95% CI: 3.61 - 7.15), heart rate (more than 100 versus less than 60 OR = 2.86; 95% CI: 1.03 - 7.9), ST segment elevation myocardial infarction (OR = 3.93; 95% CI: 2.63 - 5.86), poor progression (OR = 2.33; 95% CI: 1.56 - 3.49), hypertrophy (OR = 1.97; 95% CI: 1.02 - 3.81), and Sokolow-Lyon (OR = 2.91; 95% CI: 1.64 - 5.16).

 Electrocardiographic examination of COVID-19 patients is important during admission and after discharge. Sokolow-Lyon voltage less than 10 can be regarded as an independent predictor of mortality in COVID-19 patients discharged from hospital.