Analyzing Electrocardiography Abnormalities in COVID-19 Patients Admitting to Emergency Department
Abstract
Background: One of the groups affected at the highest level by the outbreak with the highest mortality rate is individuals with known cardiovascular diseases. Proinflammatory mediators play an important role in the pathophysiology of the disease cause cardiac and arrhythmic complications. This article aims to provide practical recommendations by evaluating ECG data in the follow-up and management of the disease to the Emergency Medicine workers to whom patients affected by COVID-19 first apply.
Methods: We randomly collected the ECG data of the patients applying to our Hospital Emergency Medicine Clinic green, yellow and red areas who were positive for viral RNA in throat swabs were carried out.
Results: The ECGs of 502 patients diagnosed with COVID-19 were collected in the 2-week period between June 15, 2020, and July 15, 2020. The study included 287 males (57.17%) and 215 females (42.83%). Normal sinus rhythm was detected in 241 patients (48.01%) at ECG. A total of 3 ECG patterns, which suggested ST elevation, and 11 ECG patterns, which suggested ST depression, were decisive in terms of emergency intervention. The number of patients with atrial fibrillation was 17 (3.39%).
Conclusions: This infection was associated with multiple, direct, and indirect cardiovascular complications, including acute myocardial damage, myocarditis, arrhythmias. Sinus tachycardia was determined to be 30.08%, LVH 5.38%, and VES 4.18% in our study. As a result, we believe that our initial ECG recommendation is that cardiac monitoring will play an important role in treatment planning.
Keywords
COVID-19 , Electrocardiogram , Comorbidity , Emergency Department.
Kaynakça
- 1- American College of Cardiology. Troponin and BNP use in COVID-19. Available at: https://www.acc.org/latest-in-cardiology/ articles/2020/03/18/15/25/troponin-and-bnp-use-in-covid19?utm_ source=accupdate&utm_medium=email_newsletter&utm_ content=20200320&utm_campaign=accupdate. Accessed March 23, 2020
- 2- Azevedo RB, Botelho BG, Hollanda JVG, Ferreira LVL, Junqueira de Andrade LZ, et al. Covid-19 and the cardiovascular system: a comprehensive review. J Hum Hypertens. 2021;35(1):4-11.
- 3- Kochi AN, Tagliari AP, Forleo GB, Fassini GM, Tondo C. Cardiac and arrhythmic complications in patients with COVID-19. J Cardiovasc Electrophysiol. 2020;31(5):1003-1008.
- 4- Jankelson L, Karam G, Becker ML, Chinitz LA, Tsai MC. QT prolongation, torsades de pointes, and sudden death with short courses of chloroquine or hydroxychloroquine as used in COVID-19: A systematic review. Heart Rhythm. 2020;17(9):1472-1479.
- 5- Chorin E, Wadhwani L, Magnani S, Dai M, Shulman E, Nadeau- Routhier C, et al. QT interval prolongation and torsade de pointes in patients with COVID-19 treated with hydroxychloroquine/ azithromycin. Heart Rhythm. 2020;17(9):1425-1433.
- 6- van den Broek MPH, Möhlmann JE, Abeln BGS, Liebregts M, van Dijk VF, van de Garde EMW. Chloroquine-induced QTc prolongation in COVID-19 patients. Neth Heart J. 2020;28(78):406-409.
- 7- Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nat Med. 2020;26(4):450-452.
- 8- Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, Azman AS, Reich NG, Lessler J. The incubation period of Coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application. Ann Intern Med. 2020;172(9):577-582.
- 9- Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of Coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720.
- 10- Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323(20):2052-2059.