Electrocardiographic findings in non-critical patients with coronavirus disease-2019



Electrocardiography, Troponin, ST segment pathology, COVID-19


Background/Aim: Cardiovascular involvement in patients with coronavirus disease 2019 (COVID-19) is closely related to the course of the disease; however, this issue has not been adequately studied in Turkey. Thus, we aimed to investigate the electrocardiography (ECG) findings in noncritical patients with COVID-19 in Turkey. Methods: This retrospective cohort study was conducted on non-critical patients with COVID-19 with no history of any cardiac disease. The laboratory parameters and ECG findings of the patients at the time of admission were analyzed. Results: In total, 100 patients with a mean age of 56.8 (16.7) years were included in the study, among which 54 were males. The rate of patients having at least one abnormal ECG finding, ST segment pathology, and elevated troponin level were 58%, 26%, and 48%, respectively. The respiratory rate and mean troponin level were higher and the mean lymphocyte count was lower in patients with ST segment pathology than in patients without. The respiratory rate, fibrinogen level, and incidence of T negativity and abnormal ECG findings were higher, and the lymphocyte count was lower in patients with elevated troponin levels than in patients with normal troponin levels (P<0.05 for all). Troponin level was significantly negatively correlated with lymphocyte count and significantly positively correlated with respiratory rate and C-reactive protein (P=0.003, r = −0.298; P=0.031, r = 0.215; and P=0.02, r = 0.233, respectively). In the receiver operating characteristic analysis, it was found that ST segment pathologies were more common in patients with a troponin level >0.03 mg/mL (P<0.001, area under the curve: 0.763, sensitivity: 61.5%, and specificity: 90.5%). Conclusion: Cardiac involvement is very common in patients with COVID-19, and elevated cardiac troponin levels and pathological ECG findings are observed.


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Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020;14(3):247-50. doi: 10.1016/j.dsx.2020.03.013.

Santoso A, Pranata R, Wibowo A, Al-Farabi MJ, Huang I, Antariksa B. Cardiac injury is associated with mortality and critically ill pneumonia in COVID-19: A meta-analysis. Am J Emerg Med. 2020 Apr 19:S0735-6757(20)30280-1. doi: 10.1016/j.ajem.2020.04.052

Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7):802-10. doi: 10.1001/jamacardio.2020.0950.

Xiong TY, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long-term implications. Eur Heart J. 2020;41(19):1798-800. doi: 10.1093/eurheartj/ehaa231

Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109(5):531-8. doi: 10.1007/s00392-020-01626-9

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. doi: 10.1016/S0140-6736(20)30566-3

Chen D, Li X, Song Q, Hu C, Su F, Dai J, et al. Assessment of Hypokalemia and Clinical Characteristics in Patients With Coronavirus Disease 2019 in Wenzhou, China. JAMA Netw Open. 2020;3(6):e2011122. doi: 10.1001/jamanetworkopen.2020.11122.

Wang Y, Chen L, Wang J, He X, Huang F, Chen J, et al. Electrocardiogram analysis of patients with different types of COVID-19. Ann Noninvasive Electrocardiol. 2020;25(6):e12806. doi: 10.1111/anec.12806.

McCullough SA, Goyal P, Krishnan U, Choi JJ, Safford MM, Okin PM. Electrocardiographic Findings in Coronavirus Disease-19: Insights on Mortality and Underlying Myocardial Processes. J Card Fail. 2020;26(7):626-32. doi: 10.1016/j.cardfail.2020.06.005.

Barman HA, Atici A, Alici G, Sit O, Tugrul S, Gungor B, et al. The effect of the severity COVID-19 infection on electrocardiography. Am J Emerg Med. 2020 Oct 7:S0735-6757(20)30889-5. doi: 10.1016/j.ajem.2020.10.005.

Angeli F, Spanevello A, De Ponti R, Visca D, Marazzato J, Palmiotto G, et al. Electrocardiographic features of patients with COVID-19 pneumonia. Eur J Intern Med. 2020 Aug;78:101-6. doi: 10.1016/j.ejim.2020.06.015

Deng Q, Hu B, Zhang Y, Wang H, Zhou X, Hu W, et al. Suspected myocardial injury in patients with COVID-19: Evidence from front-line clinical observation in Wuhan, China. Int J Cardiol. 2020 Jul 15;311:116-21. doi: 10.1016/j.ijcard.2020.03.087.

Bangalore S, Sharma A, Slotwiner A, Yatskar L, Harari R, Shah B, et al. ST-Segment Elevation in Patients with Covid-19 - A Case Series. N Engl J Med. 2020 Jun 18;382(25):2478-80. doi: 10.1056/NEJMc2009020.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. doi: 10.1001/jama.2020.1585

Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2020;5(7):811-8. doi: 10.1001/jamacardio.2020.1017






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How to Cite

Ekinci İskender, Cinar A, Kirac Utku İrem, Ozkan H, Buyukkaba M, Kumbasar A, Tabak O. Electrocardiographic findings in non-critical patients with coronavirus disease-2019. J Surg Med [Internet]. 2021 May 1 [cited 2024 Apr. 19];5(5):523-8. Available from: https://jsurgmed.com/article/view/879464