COVİD-19 Hastalarında Başvuru Esnasında EKG’deki Özellikler Hastane içi Olayları Öngörebilir

Abstract

Amaç: COVID-19 hastalarında başvuru esnasındaki elektrokardiyografi (EKG) özellikleri ile tüm nedenlere bağlı hastane-içi mortalite ile tedavi üniteleri arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: 15 Mart ile 17 Haziran 2020 tarihleri arasında gerçek zamanlı ters transkripsiyon polimeraz zincir reaksiyonu metodu ile şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2) tespit edilerek COVID-19 tanısı konulan ve hastaneye yatırılan toplam 172 ardışık hasta bu çalışmaya dahil edildi. Laboratuar parametleri ve EKG bulguları başvuru sırasında kaydedildi. Hastaneye ve yoğun bakım ünitesine (YBÜ) yatış kriterleri Türkiye Cumhuriyeti Sağlık Bakanlığı’nın geçici kılavuzuna göre belirlendi. Hastalar hastane içi mortalite durumlarına ve tedavi gördükleri birime göre gruplandırıldı. Bulgular: Ortanca yaş mortalite grubunda ve YBÜ'de tedavi edilen hastalarda önemli ölçüde daha yüksekti (her ikisi için, p <0.05). P dispersiyonu, QRS süresi, QTc süresi ve QT dispersiyonu YBÜ’de tedavi edilen hastalarda önemli ölçüde daha uzundu (hepsi için, p <0.001). PR süresi, P dispersiyonu, QRS süresi, QT dispersiyonu ve QTc süresi mortalite grubunda önemli ölçüde daha uzundu (hepsi için p <0.05). QT dispersiyonu YBÜ başvurularını öngörürken QRS süresi COVID-19 hastalarında tüm nedenlere bağlı hastane-içi mortaliteyi öngördü. Sonuç: Başvuru esnasındaki EKG bulguları, COVID-19 hastalarında tedavi birimleri ve tüm nedenlere bağlı hastane-içi mortalite ile bağımsız olarak ilişkilendirilebilir.

Keywords

• EKG
• QRS süresi
• QT dispersiyonu
• COVID-19
• YBÜ başvuru

Features on ECG During Admission May Predict in-hospital Events for COVID-19 Patients

Abstract

Objective: To evaluate the association of ECG features obtained on admission with treating units and in-hospital all-cause mortality in COVID-19 patients. Methods: A total of 172 consecutive hospitalized patients with COVID-19 diagnosed by detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with real-time reverse-transcription polymerase chain reaction (RT-PCR) method between 15 May and 17 June 2020 were enrolled in the study. Laboratory parameters and findings on ECG obtained during admission were recorded. Criteria for hospitalization and intensive care unit (ICU) admission were determined in accordance with interim guidance of the Republic of Turkey Ministry of Health and the World Health Organization. Patients were grouped according to their in-hospital mortality status, survivors and non-surviors and units where patients are treated, intensive care unit and in-patient room. Results: The median age was significantly higher in the non-survivors group and, in the patients treated in ICU (p<0.05, for both). PR duration, P dispersion, QRS duration, QTc duration, and QT dispersion were significantly longer in patients treated in the ICU (p <0.001, for all), whilst PR duration, P dispersion, QRS duration, QT dispersion and QTc interval were significantly longer in the non-survivors group (p<0.05, for all). QT dispersion (OR: 1.093, 95% Cl: 1.018 + 1.174, p = 0.014) predicted admission to ICU, whereas QRS duration (OR: 1.045, 95% Cl: 1.000-1.091, p = 0.049) predicted in-hospital all-cause mortality in patients with COVID-19. Conclusion: Findings on ECG during admission could be independently associated with treating units and in-hospital all-cause mortality in COVID-19 patients.

Keywords

• ECG
• QRS duration
• QT dispersion
• COVID-19
• ICU admission

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