Value of electrocardiography in coronavirus disease 2019 (COVID-19)

Abstract

In December 2019, reports of an unknown pneumonia not responsive to traditional treatments arose in Wuhan, China. The pathogen was subsequently identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known to be responsible for the coronavirus disease-2019 (COVID-19) illness, and public health emergency of international concern was declared by the World Health Organization. There is increasing awareness of the cardiovascular manifestations of COVID-19 disease, and the adverse impact of cardiovascular involvement on its prognosis. In this setting, the electrocardiogram (ECG) is one of the leading tools to assess the extent of cardiac involvement in COVID-19 patients, due to its wide disponibility, low cost, and the possibility of remote evaluation. In this article, we review the role of the ECG in the identification of cardiac involvement in COVID-19, highlighting relevant clinical implications.

Keywords: Arrhythmia; COVID-19; Electrocardiogram; Pandemics; QT interval; SARS-CoV-2.

Fig. 1

Postulated cardiovascular involvement in COVID-19.

Fig. 2

Proposed flow diagram concerning the arrhythmic vulnerability related to QTc prolongation from potential QTc-prolonging drugs.