Evaluation of the Prognostic Value of the Admission ECG in COVID-19 Patients: A Meta-Analysis

Abstract

COVID-19 can impact the cardiovascular system leading to abnormal electrocardiographic (ECG) findings that can be easily identified on admission. The purpose of this meta-analysis was to assess the prognostic value of the admission ECG (specifically of the duration of the PR and QTc intervals, the QRS complex and the heart rate[HR]) in COVID-19 patients.

A literature selection was performed in PubMed database for the articles up to April 9, 2021. Nine observational studies concerning ECG alterations in COVID-19 were selected bringing the total number of examined patients to 1424. They were then divided into two groups: group I with favourable and group II with unfavourable clinical outcome - MACE, transfer to ICU, death.

Mean duration of the PR interval, QRS complex and QTc interval in group I were respectively (values with standard deviation in parentheses): 157.87mm (± 28.57mm), 94.88mm (± 16.20mm) and 423,52mm (± 32.25mm) while in group II those were 159.98mm (± 31.69mm), 98.43mm(± 22.44mm) and 446.76mm (± 45.99mm). The difference between mean durations of the PR interval turned out to be irrelevant (p≈0.25), however mean durations of QRS complex and QTc interval were significantly different (p<0.001 for QRS and p<0.000001 for QTc). The mean HR in the group I was 82.11mm (± 16.41mm) and in the group II it was 88.29mm (± 23.56mm). The difference between those means was significant (p<0.0001).

The results suggest that relatively long duration of the QTc interval and QRS complex is linked to the severe course of the COVID-19.

Note:
Funding: The authors of this paper received no grant support.

Declaration of Interests: None.

Keywords: ECG alterations in COVID-19, QTc interval and QRS complex prognostic value in COVID-19