AUTHOR=Chevrot Gabriel , Hauguel-Moreau Marie , Pépin Marion , Vieillard-Baron Antoine , Lot Anne-Sophie , Ouadahi Mounir , Hergault Hélène , Aïdan Vincent , Greffe Ségolène , Costantini Adrien , Dubourg Olivier , Beaune Sébastien , Mansencal Nicolas 

TITLE=Electrocardiogram abnormalities and prognosis in COVID-19

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.993479

DOI=10.3389/fcvm.2022.993479

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>COVID-19 is a major pandemic with potential cardiovascular complications. Few studies have focused on electrocardiogram (ECG) modifications in COVID-19 patients.</p></sec><sec><title>Method and results</title><p>We reviewed from our database all patients referred to our hospital for COVID-19 between January 1st, 2020, and December 31st, 2020: 669 patients were included and 98 patients died from COVID-19 (14.6%). We systematically analyzed ECG at admission and during hospitalization if available. ECG was abnormal at admission in 478 patients (71.4%) and was more frequently abnormal in patients who did not survive (88.8 vs. 68.5%, <italic>p</italic> &lt; 0.001). The most common ECG abnormalities associated with death were left anterior fascicular block (39.8 vs. 20.0% among alive patients, <italic>p</italic> &lt; 0.001), left and right bundle branch blocks (<italic>p</italic> = 0.002 and <italic>p</italic> = 0.02, respectively), S1Q3 pattern (14.3 vs. 6.0%, <italic>p</italic> = 0.006). In multivariate analysis, at admission, the presence of left bundle branch block remained statistically related to death [OR = 3.82, 95% confidence interval (CI): 1.52–9.28, <italic>p</italic> &lt; 0.01], as well as S1Q3 pattern (OR = 3.17, 95% CI: 1.38–7.03, <italic>p</italic> &lt; 0.01) and repolarization abnormalities (OR = 2.41, 95% CI: 1.40–4.14, <italic>p</italic> &lt; 0.01).</p><p>On ECG performed during hospitalization, the occurrence of new repolarization abnormality was significantly related to death (OR = 2.72, 95% CI: 1.14–6.54, <italic>p</italic> = 0.02), as well as a new S1Q3 pattern (OR = 13.23, 95% CI: 1.49–286.56, <italic>p</italic> = 0.03) and new supraventricular arrhythmia (OR = 3.8, 95% CI: 1.11–13.35, <italic>p</italic> = 0.03).</p></sec><sec><title>Conclusion</title><p>The presence of abnormal ECG during COVID-19 is frequent. Physicians should be aware of the usefulness of ECG for risk stratification during COVID-19.</p></sec>