Abstract
Introduction: Prolonged QT intervals have been reported in patients with COVID-19. Virus particles have been demonstrated in heart tissue and direct effects on cardiac function have been noted. We hypothesize that cardiac electrophysiologic abnormalities may be a direct effect of COVID-19.Methods: 814 patients with RT-PCR proven COVID-19 were admitted and 614 discharged home from St. Francis Hospital Emergency Room (ER) between March-May 2020. Corrected QT (QTc) and QRS intervals were measured from ECG’s performed in the ER prior to intervention or administration of QT prolonging drugs. QTc and QRS intervals were evaluated as a function of disease severity (patients admitted versus discharged home; inpatients admitted to medical vs critical care unit) and cardiac involvement (troponin elevation >0·03 ng/ml, elevated B-natriuretic peptide (BNP) or NT pro-BNP >500 pg/ml). Multivariable analysis was used to test for significance (pResults: Average age was 66 ± 16 years, 45% female, 46% hypertensive, 28% diabetic, average body mass index of 28·7 ± 6·4 kg/m 2 . Baseline QTc of inpatients was prolonged compared to patients discharged home (450·1 ± 30·2 msec versus 423·4 ± 21·7msec, pConclusion: Abnormalities of cardiac activation (QRS) and repolarization (QTc) are direct manifestations of COVID-19 and early markers for progression to severe disease. The ECG, a readily accessible tool, identifies cardiac involvement and can be used to predict disease course and mortality.Funding Statement: Funding provided by the research foundation at Catholic Health of Long Island.Declaration of Interests: None.Ethics Approval Statement: The study was submitted for expedited Internal Review Board Review and received a waiver given its retrospective nature of data analysis in anonymized subjects.
Published Version
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