TY - JOUR
T1 - An electrophysiological substrate of COVID-19
AU - Tereshchenko, Larisa G.
AU - Pourbemany, Jafar
AU - Haq, Kazi T.
AU - Patel, Hetal
AU - Hyde, Jessica
AU - Quadri, Suha
AU - Ibrahim, Habiba
AU - Tongpoon, Aaron
AU - Pourbemany, Reyhane
AU - Khan, Akram
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - SARS-CoV-2 infection is associated with an increased risk of late cardiovascular (CV) outcomes. However, more data is needed to describe the electrophysiologic (EP) manifestation of post-acute CV sequelae of COVID-19. We compared two cohorts of adult patients with SARS-CoV-2 polymerase chain reaction (PCR) test and an electrocardiogram (ECG) performed between March 1, 2020, and September 13, 2020, in a retrospective double-cohort study, “Cardiovascular Risk Stratification in Covid-19” (CaVaR-Co19; NCT04555187). Patients with positive PCR comprised a COVID-19(+) cohort (n = 41; 61% women; 80% symptomatic), whereas patients with negative tests formed the COVID-19(−) cohort (n = 155; 56% women). In longitudinal analysis, comparing 3 ECGs recorded before, during, and on average 40 days after index COVID-19 episode, after adjustment for demographic and socioeconomic characteristics, baseline CV risk factors and comorbidities, use of prescription medications (including QT-prolonging drugs) before and during index COVID-19 episode, and the longitudinal changes in RR’ intervals, heart rhythm, and ventricular conduction type, only in the COVID-19(+) cohort QTc increased by +30.2(95% confidence interval [CI] 0.1–60.3) ms and the spatial ventricular gradient (SVG) elevation increased by +13.5(95%CI 1.2–25.9)°. In contrast, much smaller, statistically nonsignificant changes were observed in the COVID-19(−) cohort. In conclusion, post-acute CV sequelae of SARS-CoV-2 infection manifested on ECG by QTc prolongation and rotation of the SVG vector upward.
AB - SARS-CoV-2 infection is associated with an increased risk of late cardiovascular (CV) outcomes. However, more data is needed to describe the electrophysiologic (EP) manifestation of post-acute CV sequelae of COVID-19. We compared two cohorts of adult patients with SARS-CoV-2 polymerase chain reaction (PCR) test and an electrocardiogram (ECG) performed between March 1, 2020, and September 13, 2020, in a retrospective double-cohort study, “Cardiovascular Risk Stratification in Covid-19” (CaVaR-Co19; NCT04555187). Patients with positive PCR comprised a COVID-19(+) cohort (n = 41; 61% women; 80% symptomatic), whereas patients with negative tests formed the COVID-19(−) cohort (n = 155; 56% women). In longitudinal analysis, comparing 3 ECGs recorded before, during, and on average 40 days after index COVID-19 episode, after adjustment for demographic and socioeconomic characteristics, baseline CV risk factors and comorbidities, use of prescription medications (including QT-prolonging drugs) before and during index COVID-19 episode, and the longitudinal changes in RR’ intervals, heart rhythm, and ventricular conduction type, only in the COVID-19(+) cohort QTc increased by +30.2(95% confidence interval [CI] 0.1–60.3) ms and the spatial ventricular gradient (SVG) elevation increased by +13.5(95%CI 1.2–25.9)°. In contrast, much smaller, statistically nonsignificant changes were observed in the COVID-19(−) cohort. In conclusion, post-acute CV sequelae of SARS-CoV-2 infection manifested on ECG by QTc prolongation and rotation of the SVG vector upward.
KW - Biostatistics
KW - COVID-19
KW - Electrocardiogram
KW - Vectorcardiography
UR - http://www.scopus.com/inward/record.url?scp=85150394403&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85150394403&partnerID=8YFLogxK
U2 - 10.1016/j.jelectrocard.2023.03.010
DO - 10.1016/j.jelectrocard.2023.03.010
M3 - Article
C2 - 36963283
AN - SCOPUS:85150394403
SN - 0022-0736
VL - 79
SP - 61
EP - 65
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
ER -