Effect of systemic inflammatory response syndrome on ventricular repolarization parameters in COVID-19 patients

Öz

Aim: Malignant ventricular arrhythmia is a significant cause of mortality in COVID-19 patients. We aimed to investigate ventricular repolarization parameters that predict the risk of malignant ventricular arrhythmia in COVID-19 patients who developed systemic inflammatory response syndrome (SIRS). Material and Methods: Our study included 533 COVID-19 patients, divided into two groups: those who developed SIRS (n=197) and those without SIRS (n=336). ECG measurements were taken for QRS, QT, QTc, Tp-e intervals, Tp-e/QTc, Tp-e/QT, QT/QRS (Index of Cardiac Electrophysiological Balance, İCEB) and QTc/QRS (ICEBc), and these values were compared between groups. Results: The mean age of the study population was 62 years, and 49% (261) were female. The ICEBc was 5.1 for the SIRS group and 4.98 for the non-SIRS group (p=0.004). The QTc interval was 450 ms in the SIRS group and 427 ms in the non-SIRS group (p=0.001), indicating a substantially higher QTc interval in the SIRS group. Multivariable linear regression analysis revealed a significant correlation between ICEBc and SIRS, age, gender, and C-reactive protein (CRP). ROC analysis showed that ICEBc was a more significant predictor of in-hospital mortality than QTc (ICEBc: 64.5% sensitivity, 50.4% specificity; QTc: 56.4% sensitivity, 53.9% specificity). Conclusion: ICEBc and QTc were significantly higher in COVID-19 patients with SIRS compared to those without SIRS. ICEBc, known to be related to malignant arrhythmias on ECG in SIRS patients, may aid in predicting and preventing arrhythmic events. Additionally, ICEBc was found to be a better predictor of in-hospital mortality than QTc.

Anahtar Kelimeler

• ICEB
• SIRS
• COVID-19
• ventricular arrhythmia

Etik Beyan

The study was approved by the ethics committee of University of Health Sciences Diyarbakır Gazi Yaşargil Education and Research Hospital. 02/07/2021/84).

COVID-19 hastalarında sistemik inflamatuar yanıt sendromunun ventriküler repolarizasyon parametreleri üzerindeki etkisi

Öz

Amaç: Malign ventriküler aritmi, COVID-19 hastalarında önemli bir mortalite nedenidir. Sistemik inflamatuar yanıt sendromu (SIRS) gelişen COVID-19 hastalarında malign ventriküler aritmi riskini öngören ventriküler repolarizasyon parametrelerini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmamıza 533 COVID-19 hastası dahil edildi ve hastalar iki gruba ayrıldı: SIRS gelişenler (n=197) ve gelişmeyenler (n=336). QRS, QT, QTc, Tp-e intervalleri, Tp-e/QTc, Tp-e/QT, QT/QRS (Kardiyak Elektrofizyolojik Denge İndeksi, İCEB) ve QTc/QRS (ICEBc) için EKG ölçümleri alındı ve bu değerler gruplar arasında karşılaştırıldı. Sonuçlar: Çalışma grubunun ortalama yaşı 62 olup, %49'u (261) kadındı. ICEBc, SIRS grubunda 5,1, SIRS olmayan grupta ise 4,98 olarak bulundu (p=0,004). QTc aralığı, SIRS grubunda 450 ms, SIRS olmayan grupta ise 427 ms olarak bulundu (p=0,001). Bu da SIRS grubunda önemli ölçüde daha yüksek bir QTc aralığı olduğunu göstermektedir. Çok değişkenli doğrusal regresyon analizi, ICEBc ile SIRS, yaş, cinsiyet ve C-reaktif protein (CRP) arasında anlamlı bir korelasyon olduğunu ortaya koymuştur. ROC analizi, ICEBc'nin hastane içi mortaliteyi QTc'den daha anlamlı bir öngörücü olduğunu göstermiştir (ICEBc: %64,5 duyarlılık, %50,4 özgüllük; QTc: %56,4 duyarlılık, %53,9 özgüllük). Sonuç: ICEBc ve QTc, SIRS gelişen COVID-19 hastalarında, SIRS gelişmeyen hastalara kıyasla anlamlı derecede yüksekti. SIRS hastalarında EKG'de malign aritmilerle ilişkili olduğu bilinen ICEBc, aritmik olayların öngörülmesine ve önlenmesine yardımcı olabilir. Ayrıca, ICEBc'nin QTc'den daha iyi bir hastane içi mortalite öngörücüsü olduğu bulunmuştur.

Anahtar Kelimeler

• ICEB
• SIRS
• COVID-19
• ventriküler aritmiü

Kaynakça

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