Prognostic value of initial electrocardiography in predicting long-term all-cause mortality in COVID-19
dc.contributor.author | Kassis, Nicholas | |
dc.contributor.author | Kumar, Ashish | |
dc.contributor.author | Gangidi, Shravani | |
dc.contributor.author | Milinovich, Alex | |
dc.contributor.author | Kalra, Ankur | |
dc.contributor.author | Bhargava, Ajay | |
dc.contributor.author | Menon, Venu | |
dc.contributor.author | Wazni, Oussama M. | |
dc.contributor.author | Rickard, John | |
dc.contributor.author | Khot, Umesh N. | |
dc.contributor.department | Medicine, School of Medicine | |
dc.date.accessioned | 2023-09-08T13:01:41Z | |
dc.date.available | 2023-09-08T13:01:41Z | |
dc.date.issued | 2022 | |
dc.description.abstract | Background: The electrocardiography (ECG) has short-term prognostic value in coronavirus disease 2019 (COVID-19), yet its ability to predict long-term mortality is unknown. This study aimed to elucidate the predictive role of initial ECG on long-term all-cause mortality in patients diagnosed with COVID-19. Methods: In this prospective cohort study, adults with COVID-19 who underwent ECG testing within a 17-hospital health system in Northeast Ohio and Florida between 03/2020-06/2020 were identified. An expert ECG reader analyzed all studies blinded to patient status. The associations of ECG characteristics with long-term all-cause mortality and intensive care unit (ICU) admission were assessed using Cox proportional hazards regression model and multivariable logistic regression models, respectively. Status of long-term mortality was adjudicated on 01/07/2022. Results: Of 837 patients (median age 65 years, 51% female, 44% Black), 683 (81.6%) were hospitalized, 281 (33.6%) required ICU admission, 67 (8.0%) died in-hospital, and 206 (24.6%) died at final follow-up after a median (IQR) of 21 (9-103) days after ECG. Overall, 179 (20.7%) patients presented with sinus tachycardia, 12 (1.4%) with atrial flutter, and 45 (5.4%) with atrial fibrillation (AF). After multivariable adjustment, sinus tachycardia (E-value for HR=3.09, lower CI=2.2) and AF (E-value for HR=3.13, lower CI=2.03) each independently predicted all-cause mortality. At final follow-up, patients with AF had 64.5% probability of death compared with 20.5% for those with normal sinus rhythm (P<.0001). Conclusions: Sinus tachycardia and AF on initial ECG strongly predict long-term all-cause mortality in COVID-19. The ECG can serve as a powerful long-term prognostic tool in COVID-19. | |
dc.eprint.version | Final published version | |
dc.identifier.citation | Kassis N, Kumar A, Gangidi S, et al. Prognostic value of initial electrocardiography in predicting long-term all-cause mortality in COVID-19. J Electrocardiol. 2022;75:1-9. doi:10.1016/j.jelectrocard.2022.10.003 | |
dc.identifier.uri | https://hdl.handle.net/1805/35489 | |
dc.language.iso | en_US | |
dc.publisher | Elsevier | |
dc.relation.isversionof | 10.1016/j.jelectrocard.2022.10.003 | |
dc.relation.journal | Journal of Electrocardiology | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Coronavirus disease 2019 | |
dc.subject | COVID-19 | |
dc.subject | Electrocardiography | |
dc.subject | ECG | |
dc.subject | Atrial fibrillation | |
dc.title | Prognostic value of initial electrocardiography in predicting long-term all-cause mortality in COVID-19 | |
dc.type | Article | |
ul.alternative.fulltext | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9554203/ |