Abstract 15615: Association of Covid-19 With QTc Prolongation: A Need for Routine Ecg Screening

Abstract

Introduction: Coronavirus Disease 2019 (COVID-19) has a high risk of death due to respiratory and cardiac complications. Internalization of the virus in the heart may derange myocyte functions such as repolarization, manifesting as QT prolongation on surface electrocardiograms (ECGs). Long QT is associated with cardiac arrhythmias, including sudden arrhythmic death. Previous studies of corrected QT (QTc) in Covid-19 have not controlled for other QTc prolonging comorbidities. Hypothesis: This study investigates whether COVID-19 is associated with prolonged QTc independent of other causes of QTc prolongation. Methods: QTc values were taken from ECGs of 36 patients with COVID-19 admitted to intensive care and 70 healthy age- and gender-matched control subjects. Patients were excluded if they received QTc-prolonging drugs, had hypokalemia, hypocalcemia, or hypomagnesemia, or history of excessive alcohol use. QTc values of COVID-19 patients were compared against normal control subjects. Results: The COVID-19 group included 15 females and 21 males with hypertension (n=11) and diabetes mellitus (n=5) as the most common comorbidities. Electrolytes were normal (K, 3.97 ± 0.41 mEq/L; Mg, 2.41 ± 0.38 mg/dL; and corrected Ca, 10.60 ± 0.60 mg/dL). QTc (msec) was significantly prolonged in COVID-19 compared with control subjects (total 469 ± 36.1 vs 418 ± 17.8; females, 475±29.2 vs 424 ± 11.4, and males 465 ± 40.5 vs 416 ± 19.9; all p<0.001). Conclusions: COVID-19 alone, without an associated QT prolonging etiology, is associated with QTc prolongation. Ventricular arrhythmias may be more likely to affect women with COVID-19 than men with the disease. Therefore, it is recommended that, in COVID-19 patients, electrolytes be maintained within normal limits and QT prolonging drugs be avoided.