Is there any link between mortality from COVID-19 infection and QRS duration in healthy people?
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Abstract
Aim: Cardiac involvement in COVID-19 infection is associated with in-hospital mortality and morbidity. This study aimed to evaluate the effects of COVID-19 infection on the heart in patients without any known chronic disease using electrocardiographic (ECG) parameters. Material and Methods: The study included a total of 201 consecutive patients, including 150 survivors and 51 non-survivors, who were otherwise healthy and did not take any medication.Results: The QRS duration, heart rate, troponin I, C-reactive protein (CRP), D-dimer and procalcitonin values were higher in the non-survivor group (p<0.05). Cox regression analysis showed that QRS duration [HR 1.038 (1.006-1.071), p=0.023], troponin I [HR 1.255 (1.045-1.506), p=0.035], CRP [HR 1.004 (1.002-1.007), p=0.001], and D-dimer [HR 1.000 (1.000-1.003), p=0.014] values were associated with a high mortality rate due to COVID-19. ROC analyses indicated that the cut-off value of QRS duration predictive of COVID-19 mortality was >85 ms [AUC: 0.615, 95% CI (0.519-0.711), p=0.014]. Kaplan-Meier survival analysis showed that a patient with QRS>85 ms had a higher in-hospital mortality rate at day 30.Discussion: Patients with COVID-19 infection who were otherwise healthy and did not take any medication had a wide QRS duration and an increased risk of mortality during the first admission to the hospital. ECG may be useful for estimating COVID-19 mortality because of its quick and easy results.