P wave peak time and P wave dispersion in severe COVID-19 infection.

Abstract

With this study, we aimed at evaluating the association between electrocardiographic P wave indices and the severity of COVID-19 infection indicated as intensive care unit (ICU) admission. We included 247 patients who were hospitalized with a diagnosis of COVID-19 infection and underwent 12 lead standard Electrocardiography (ECG). P wave indices, P wave dispersion (Pdis), P wave peak time in V1 lead (PWPTV1), and D2 lead (PWPTD2) were measured using admission ECG. Comparisons were performed between ICU admitting and non-ICU admitting patients. 160 patients were hospitalized in normal wards, and 87 patients were admitted to ICU. Pdis, PWPTV1, and PWPTD2 were prolonged in ICU admitted patients compared with the normal ward admitted patients [40 (30-50) ms vs. 50 (40-55) ms; p<0.001, 61±9 ms vs. 68±9 ms; p<0.001, and 55±7 ms vs. 64±7 ms; p<0.001, respectively]. In multiple logistic regression analysis, PWPTV1 and PWPTD2 were independent predictors of ICU admission. A cut-off point of 67.5 ms PWPTv1 has a sensitivity of 62.1% and a specificity of 69.4% (AUC=0.710, 95% CI: 0.642-0.777, p<0.001) and a cut-off point of 62.5 ms PWPTD2 has a sensitivity of 60.9% and a specificity of 83.6% (AUC=0.819, 95% CI: 0.777-0.871, p<0.001). Admission ECG atrial indices Pdis and PWPT were associated with intensive care unit admission in newly diagnosed COVID-19 patients.