Electrocardiographic findings at presentation and clinical outcome in patients with SARS-CoV-2 infection

Gaetano Antonio Lanza, Antonio De Vita, Salvatore Emanuele Ravenna, Alessia D'Aiello, Marcello Covino, Francesco Franceschi, Filippo Crea

Risultato della ricerca: Contributo in rivistaArticolo in rivista

3 Citazioni (Scopus)


Aims: The main severe complications of SARS-CoV-2 infection are pneumonia and respiratory distress syndrome. Recent studies, however, reported that cardiac injury, as assessed by troponin levels, is associated with a worse outcome in these patients. No study hitherto assessed whether the simple standard electrocardiogram (ECG) may be helpful for risk stratification in these patients. Methods and results: We studied 324 consecutive patients admitted to our Emergency Department with a confirmed diagnosis of SARS-CoV-2 infection. Standard 12-lead ECG recorded on admission was assessed for cardiac rhythm and rate, atrioventricular and intraventricular conduction, abnormal Q/QS wave, ST segment and T wave changes, corrected QT interval, and tachyarrhythmias. At a mean follow-up of 31 ± 11 days, 44 deaths occurred (13.6%). Most ECG variables were significantly associated with mortality, including atrial fibrillation (P = 0.002), increasing heart rate (P = 0.002), presence of left bundle branch block (LBBB; P < 0.001), QRS duration (P <0. 001), a QRS duration of ≥110 ms (P < 0.001), ST segment depression (P < 0.001), abnormal Q/QS wave (P = 0.034), premature ventricular complexes (PVCs; P = 0.051), and presence of any ECG abnormality [hazard ratio (HR) 4.58; 95% confidence interval (CI) 2.40-8.76; P < 0.001]. At multivariable analysis, QRS duration (P = 0.002), QRS duration ≥110 ms (P = 0.03), LBBB (P = 0.014) and presence of any ECG abnormality (P = 0.04) maintained a significant independent association with mortality. Conclusion: Our data show that standard ECG can be helpful for an initial risk stratification of patients admitted for SARS-CoV-2 infectious disease.
Lingua originaleEnglish
pagine (da-a)123-129
Numero di pagine7
Stato di pubblicazionePubblicato - 2021


  • Action Potentials
  • Aged
  • Aged, 80 and over
  • COVID-19
  • Electrocardiogram
  • Electrocardiography
  • Female
  • Heart Conduction System
  • Heart Diseases
  • Heart Rate
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Mortality
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • SARS-CoV-2 infection
  • Time Factors


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