The relation between changes in electrocardiography and disease severity in SARS-CoV2 infected patients

Coronavirus disease 2019 (COVID-19) may lead to myocardial damage and arrhythmia. Patients with ECG changes have shown an increased risk of mortality.

We aimed to study the changes in the electrocardiogram, which may be of great significance for risk stratification of COVID-19-positive patients.

A retrospective study was conducted to compare electrocardiogram changes and disease severity markers in COVID-19-positive patients admitted to a referral hospital between February 20 and March 20, 2020.

Our study consisted of 201 cases, including 123 males and 78 females. Ages ranged between 16 and 97 years old. Fifty-two (25.9%) cases had a history of ICU admission. Multivariate logistic regression analysis showed that a low O2 saturation level (OR = 0.920, 95% CI 0.868–0.976, p=0.005), several lab tests, ECG changes (OR = 46.84, 95% CI 3.876– 566.287, p = .002) and Age (OR = 1.03, 95% CI 1.000– 1.065, p = .048) were the independent risk factors for predicting mortality rate. In addition, we utilized multivariate logistic regression analysis, demonstrating that LBBB (OR = 4.601, 95%CI: 1.357–15.600, p=0.014) is the only ECG risk factor associated with morbidity in elderly patients with ECG changes.

ECG changes are strong indicators of high mortality rates in elderly COVID-19 patients. ECG interpretations should therefore be used for risk stratification and predicting the need for ICU admission.