Kocaeli Med J. 2021; 10(1): 41-46 | DOI: 10.5505/ktd.2021.49140

Evaluation of Cardiac Stress Due to COVID-19 Infection by Electrocardiography Score

Veli Polat¹, Kadriye Kart Yaþar^2
1Department Of Cardiology, Bakirkoy Dr. Sadi Konuk Training And Research Hospital, Istanbul, Turkey
²Department Of Infectious Diseases And Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Training And Research Hospital, Istanbul, Turkey

INTRODUCTION: Novel coronavirus disease (COVID-19) may lead to diffuse pulmonary intravascular thrombosis that can lead a sudden right ventricular stress by causing an acute elevation in pulmonary artery pressure. We aim to evaluate this right ventricular stress due to COVID-19 with the electrocardiography (ECG) score.
METHODS: One hundred and forty-one patients hospitalized with COVID-19, whose ECGs were obtained ECG at admission, were included in the study. ECG score was calculated for each patient from the ECGs taken during admission.
RESULTS: In-hospital mortality was significantly higher in COVID-19 patients with an ECG score of ≥10 (15% vs 0%, p=0.001). Univariate regression analysis reveals neutrophil and lymphocyte counts, creatinine kinase, D-dimer, fibrinogen, C-reactive protein (CRP), cardiac biomarkers, ferritin and procalcitonin levels as significant predictors of ECG score of ≥10. The ECG score was found as a significant predictor of mortality (odds ratio 0.33, 95% confidence interval 0.14- 0.77, p=0.01) in COVID-19 patients. According to multivariate regression analysis, CRP (odds ratio 1.03, 95% confidence interval 1.00- 1.05, p=0.02) and high-sensitive cardiac troponin I (odds ratio 1.00, 95% confidence interval 0.99- 1.00, p=0.009) are significant independent predictors of ECG score of ≥10 and mortality in COVID-19 patients, respectively.
DISCUSSION AND CONCLUSION: ECG score appears to be associated with the severity and mortality of the COVID-19 infection.

Keywords: COVID-19, Electrocardiography score, Right ventricular stress, Pulmonary hypertension

---

COVID-19 Enfeksiyonuna Baðlý Kardiyak Stresin Elektrokardiyografi Skoru ile Deðerlendirilmesi

Veli Polat¹, Kadriye Kart Yaþar^2
1Bakýrköy Dr. Sadi Konuk Eðitim Ve Araþtýrma Hastanesi, Kardiyoloji Bölümü, Istanbul, Türkiye
²Bakýrköy Dr. Sadi Konuk Eðitim Ve Araþtýrma Hastanesi, Enfeksiyon Hastalýklarý Ve Klinik Mikrobiyoloji Bölümü, Istanbul, Türkiye

GÝRÝÞ ve AMAÇ: Yeni koronavirüs hastalýðý (COVID-19), pulmoner arter basýncýnda akut yükselmeye neden olarak ani bir sað ventrikül yüklenmesine yol açabilen yaygýn pulmoner intravasküler tromboza yol açabilir. COVID-19'a baðlý bu sað ventrikül yüklenmesini elektrokardiyografi (EKG) skoru ile deðerlendirmeyi hedefledik.
YÖNTEM ve GEREÇLER: Çalýþmaya COVID-19 ile hastaneye yatýrýlan ve baþvuru anýnda EKG'si çekilen yüz kýrk bir hasta dahil edildi. Baþvuru sýrasýnda çekilen EKG'lerden her hasta için EKG skoru hesaplandý.
BULGULAR: Hastane içi mortalite, EKG skoru ≥10 olan COVID-19 hastalarýnda anlamlý olarak daha yüksekti (% 15 vs % 0, p = 0.001). Tek deðiþkenli regresyon analizi, nötrofil ve lenfosit sayýlarýný, kreatinin kinaz, D-dimer, fibrinojen, C-reaktif protein (CRP), kardiyak biyobelirteçler, ferritin ve prokalsitonin düzeylerini EKG skoru ≥10' nun önemli prediktörleri olarak ortaya koymaktadýr. EKG skoru, COVID-19 hastalarýnda mortalitenin anlamlý bir prediktörü olarak bulundu (olasýlýk oraný 0.33,% 95 güven aralýðý 0.14-0.77, p = 0.01). Çok deðiþkenli regresyon analizine göre, CRP (olasýlýk oraný 1.03,% 95 güven aralýðý 1.00 -1.05, p = 0.02) ve yüksek duyarlý kardiyak troponin I (olasýlýk oraný 1.00,% 95 güven aralýðý 0.99-1.00, p = 0.009) COVID-19 hastalarýnda sýrasýyla EKG skoru ≥10' nun ve mortalitenin anlamlý baðýmsýz prediktörleridir.
TARTIÞMA ve SONUÇ: EKG skoru, COVID-19 enfeksiyonunun ciddiyeti ve mortalitesi ile iliþkili görünmektedir.

Anahtar Kelimeler: COVID-19, elektrokardiyografi skoru, sað ventrikül yüklenmesi, pulmoner hipertansiyon

---

CITE