Significance and Usefulness of High-Resolution 24-h Electrocardiographic Parameters in Patients With Coronavirus Disease 2019 After Admission: A Prospective Cohort Study.

BACKGROUND

This study aimed to explore the predictors of disease severity in patients with coronavirus disease 2019 (COVID-19) using ambulatory electrocardiographic markers (AECG-Ms), which are prognostic predictors of cardiac death, as well as echocardiography and laboratory parameters.

METHODS

A prospective cohort study was conducted using data from 70 patients diagnosed with COVID-19 and admitted to the National Defense Medical College Hospital between January 2021 and December 2023. A high-resolution Holter electrocardiogram recorder was attached to all patients for 24 h within 48 h of admission, and AECG-Ms were measured. Laboratory tests and echocardiography were also performed.

RESULTS

Logistic univariate analysis revealed that the T-wave alternans (TWA) positivity rate was significantly higher in the fatal event group (all-cause mortality and onset of sustained ventricular tachycardia or ventricular fibrillation) than in the non-fatal event group. Kaplan-Meier curves at 30 days after admission showed a significant worsening in the survival rate of the TWA and late potential positive groups (log-rank test, p < 0.0001) compared with the other groups.

CONCLUSION

In patients with COVID-19 without obvious cardiac disease, AECG-Ms were highly positive. The study findings may allow easy and rapid prediction of prognosis at the bedside of patients with COVID-19.