Heart: Predictive effect of delayed cardiac repolarization on in-hospital mortality in patients with new coronary pneumonia

Background: COVID-19, caused by SARS-CoV-2, has been declared a global pandemic by WHO and has resulted in widespread mortality
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Cardiac complications and malignant arrhythmias, exacerbated by myocardial damage, have been widely reported in these patients and are associated with increased in-hospital mortality and sudden out-of-hospital death

Multiple mechanisms have been shown to enhance arrhythmia formation in patients with COVID-19, including metabolic and electrolyte disturbances, cytokine storm, hypoxia, and certain drug treatments

Methods: This was a retrospective cohort study of subjects admitted to one of 13 Northwell Health hospitals in the wider New York metropolitan area between March 1, 2020 and April 27, 2020 patients
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Inclusion criteria included a positive nasal swab for SARS-CoV-2, a 12-lead ECG within 48 hours, and a complete basal metabolic panel within 96 hours of diagnosis

Results: The all-cause in-hospital mortality rate was 27.
1% in 7098 patients
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Independent predictors of death included demographic characteristics (male sex, race, and increasing age), major signs (oxygen saturation <92% and heart rate >120 bpm), metabolomic values ​​(serum lactate >2.

Table 1 Final multivariate logistic regression model

Table 1 Final multivariate logistic regression model

Figure 1 Risk prediction calculator and graph depicting in-hospital mortality and risk prediction scores
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Figure 1 Risk prediction calculator and graph depicting in-hospital mortality and risk prediction scores
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Figure 2 Graph of observed versus expected probability of in-hospital mortality by risk level
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Figure 2 Graph of observed versus expected probability of in-hospital mortality by risk level
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Conclusion: In the largest cohort with complete ECG data at the onset of COVID-19, in addition to demographic characteristics, major vital signs, clinical history, and basic metabolic indicators, QTc>500ms was an independent risk factor for in-hospital mortality
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In the largest cohort with complete ECG data at the onset of COVID-19, in addition to demographic characteristics, major vital signs, clinical history, and basic metabolic indicators, QTc >500 ms was an independent risk factor for in-hospital mortality
.

Original source: Fishbein J, Coleman KM, Bhullar A, et al.

Delayed cardiac repolarisation as a predictor of in-hospital mortality in patients with COVID-19 .
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