Open AccessElectrocardiography on admission is associated with poor outcomes in coronavirus disease 2019 (COVID‐19) patients: A systematic review and meta‐analysis
Author(s) -
Alsagaff Mochamad Yusuf,
Oktaviono Yudi Her,
Dharmadjati Budi Baktijasa,
Lefi Achmad,
AlFarabi Makhyan Jibril,
Gandi Parama,
Marsudi Bagas Adhimurda,
Azmi Yusuf
Publication year - 2021
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12573
Subject(s) - medicine , covid-19 , qt interval , qrs complex , cardiology , left bundle branch block , observational study , electrocardiography , incidence (geometry) , right bundle branch block , confidence interval , disease , heart failure , infectious disease (medical specialty) , physics , optics
Background Electrocardiogram (ECG) is a widely accessible diagnostic tool that can easily be obtained on admission and can reduce excessive contact with coronavirus disease 2019 (COVID‐19) patients. A systematic review and meta‐analysis were performed to evaluate the latest evidence on the association of ECG on admission and the poor outcomes in COVID‐19. Methods A literature search was conducted on online databases for observational studies evaluating ECG parameters and composite poor outcomes comprising ICU admission, severe illness, and mortality in COVID‐19 patients. Results A total of 2,539 patients from seven studies were included in this analysis. Pooled analysis showed that a longer corrected QT (QTc) interval and more frequent prolonged QTc interval were associated with composite poor outcome ([WMD 6.04 [2.62‐9.45], P = .001; I 2 :0%] and [RR 1.89 [1.52‐2.36], P < .001; I 2 :17%], respectively). Patients with poor outcome had a longer QRS duration and a faster heart rate compared with patients with good outcome ([WMD 2.03 [0.20‐3.87], P = .030; I 2 :46.1%] and [WMD 5.96 [0.96‐10.95], P = .019; I 2 :55.9%], respectively). The incidence of left bundle branch block (LBBB), premature atrial contraction (PAC), and premature ventricular contraction (PVC) were higher in patients with poor outcome ([RR 2.55 [1.19‐5.47], P = .016; I 2 :65.9%]; [RR 1.94 [1.32‐2.86], P = .001; I 2 :62.8%]; and [RR 1.84 [1.075‐3.17], P = .026; I 2 :70.6%], respectively). T‐wave inversion and ST‐depression were more frequent in patients with poor outcome ([RR 1.68 [1.31‐2.15], P < .001; I 2 :14.3%] and [RR 1.61 [1.31‐2.00], P < .001; I 2 :49.5%], respectively). Conclusion Most ECG abnormalities on admission are significantly associated with an increased composite poor outcome in patients with COVID‐19.