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. 2021 May-Jun:66:108-112.
doi: 10.1016/j.jelectrocard.2021.03.001. Epub 2021 Mar 17.

Fragmented QRS on surface electrocardiography as a predictor of cardiac mortality in patients with SARS-CoV-2 infection

Arzu Yildirim  1 , I Oguz Karaca  2 , Filiz Kizilirmak Yilmaz  2 , H Murat Gunes  2 , Beytullah Cakal  2
Affiliations

Fragmented QRS on surface electrocardiography as a predictor of cardiac mortality in patients with SARS-CoV-2 infection

Arzu Yildirim et al. J Electrocardiol. 2021 May-Jun.

Abstract

Aims: Although severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is mainly a respiratory system disease, recent studies reported that cardiac injury is associated with poor outcomes in this population. There are few studies which assessed standard electrocardiogram (ECG) as a prognostic tool during the course of SARS-CoV-2 infection. The aim of this study is to identify the relationship between of ECG parameters and prognosis of patients infected with SARS-CoV-2.

Method and results: A total of 114 consecutive patients with a confirmed diagnosis of SARS-CoV-2 infection between March 2020 and May 2020 were included in the study. Standard 12‑lead surface ECG was reviewed for presence of fragmented QRS (fQRS), abnormal Q wave, T wave inversion, and duration of QRS. fQRS was observed in 36.8% (n = 42) of the patients who had SARS-CoV-2. Patient groups with and without fQRS did not differ in terms of age, gender, the presence of comorbid diseases and medical treatment. Hospitalization duration, intensive care unit(ICU) requirement, all-cause mortality, and cardiac mortality were found to be higher in patients with fQRS (all p values <0.05). There was a positive correlation between QRS duration and duration of hospital stay (p < 0.001, r = 0.421). QRS duration was also found to be associated with intensive care need, all-cause mortality, and cardiac mortality.

Conclusion: Our data shows that QRS duration and the presence of fQRS on standard ECG can help to identify patients with worse clinical outcome admitted for SARS-CoV-2 infection.

Keywords: COVID-19; Cardiac mortality; Electrocardiography; Fragmented QRS; SARS-CoV-2 infection.

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Conflict of interest statement

Declaration of competing interest The author(s) declare(s) that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
The box-plot graphs that show the association of QRS duration with both all-cause mortality (A) and cardiac mortality (B).
Fig. 2
Fig. 2
The scatted-dot graph showing the correlation of QRS duration and hospital stay.
Fig. 3
Fig. 3
ROC curve analysis for QRS duration to predict all-cause mortality with 80% sensitivity and 70% specificity.
See this image and copyright information in PMC

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