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

Abstract

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.