Gunduz R.Yildiz B.S.Ozgur S.Ozen M.B.Bakir E.O.Ozdemir I.H.Cetin N.Usalp S.Duman S.2024-07-222024-07-22202207356757http://akademikarsiv.cbu.edu.tr:4000/handle/123456789/12647Aims: The frontal QRS-T (fQRS) angle has been investigated in the general population, including healthy people and patients with heart failure. The fQRS angle can predict mortality due to myocarditis, ischaemic and non-ischaemic cardiomyopathies, idiopathic dilated cardiomyopathy, and chronic heart failure in the general population. Moreover, no studies to date have investigated fQRS angle in coronavirus disease 2019 (COVID-19) patients. Thus, the purpose of this retrospective multicentre study was to evaluate the fQRS angle of COVID-19 patients to predict in-hospital mortality and the need for mechanical ventilation. Methods and results: An electrocardiogram was performed for 327 COVID-19 patients during admission, and the fQRS angle was calculated. Mechanical ventilation was needed in 119 patients; of them, 110 died in the hospital. The patients were divided into two groups according to an fQRs angle >90° versus an fQRS angle ≤90°. The percentages of mortality and the need for mechanical ventilation according to fQRS angle were 67.8% and 66.1%, respectively, in the fQRs >90° group and 26.1% and 29.9% in the fQRS ≤90°group. Heart rate, oxygen saturation, fQRS angle, estimated glomerular filtration rate, and C-reactive protein level were predictors of mortality on the multivariable analysis. The mortality risk increased 2.9-fold on the univariate analysis and 1.6-fold on the multivariate analysis for the fQRS >90° patient group versus the fQRS ≤90° group. Conclusion: In conclusion, a wide fQRS angle >90° was a predictor of in-hospital mortality and associated with the need for mechanical ventilation among COVID-19 patients. © 2022 Elsevier Inc.EnglishAll Open Access; Green Open AccessCOVID-19ElectrocardiographyHeart FailureHumansPrognosisRetrospective Studiesantiarrhythmic agentazithromycinC reactive proteincreatinineD dimerenoxaparinfavipiravirhemoglobinhydroxychloroquineoseltamivirtocilizumabtroponin IadultagedanamnesisArticleartificial ventilationatrial fibrillationcardiomyopathychronic obstructive lung diseasecomputer assisted tomographycongestive cardiomyopathycoronavirus disease 2019coughingdiabetes mellitusdyspneaelectrocardiogramestimated glomerular filtration ratefasting blood glucose levelfemalefeverheadacheheart failureheart ratehospital patienthumanhyperlipidemiahypertensionin-hospital mortalityischemic heart diseaselymphocyte countmalaisemalemortalitymulticenter studymyocarditisneutrophil countneutrophil lymphocyte ratiooxygen saturationP waveQRS complexQRS intervalQT intervalretrospective studyreverse transcription polymerase chain reactionsore throatclinical trialelectrocardiographyheart failureproceduresprognosisArticle10.1016/j.ajem.2022.05.034