Osman PİRHAN, Sinan AŞAR, Bahar PEHLİVAN, Önder KAYA, İbrahim Faruk AKTÜRK, Fethi KILIÇASLAN, Ercan AKŞİT

Şiddetli Coronavirüs Hastalığı 2019 Olan Hastalarda Mortaliteyi Öngörmede Düzeltilmiş QT Aralığının Önemi

Giriş: Aralık 2019'da Çin'in Wuhan kentinde başlayan Coronavirus 2019 (COVID-19) hastalığı, kısa sürede ülkelerin sağlık ve ekonomik sistemlerini ciddi şekilde etkileyen bir pandemiye dönüştü. COVID-19, özellikle akciğer tutulumu ve kalp hasarı olan hastalarda ölüme neden olabilir. COVID-19 ile yoğun bakım ünitesine (YBÜ) kabul edilen hastalarda başlangıç repolarizasyon parametrelerinin prognostik bilgi sağlayıp sağlamadığını belirlemeyi amaçladık. Yöntemler: Bu retrospektif kohort çalışmasına, YBÜ’de takip edilen ve doğrulanmış COVID-19'lu 135 yetişkin hastayı (ortanca yaş 61, %52 erkek, %51 hipertansiyon, %43 diabetes mellitus, %32 koroner arter hastalığı) dahil ettik. Hastaların verileri elektronik tıbbi kayıtlarından çıkarıldı ve hayatta kalanlar ile hayatta kalmayanlar arasında karşılaştırıldı. Bulgular: 80'i taburcu olan hastaların takiplerinde 55'i hastanede öldü. Çok değişkenli lojistik regresyon analizi, kabulde düzeltilmiş QT aralığının (QTc) ≥457 msn'den uzun olduğunu gösterdi (olasılık oranı (OR) =6.433, %95 GA 1.539-26.970, p=0.01), 65 yaşından büyük (OR= 2.848, %95 GA: 1.003-8.091, p=0.04) ve 99 bpm'den yüksek kalp hızı (OR=9.180, %95 GA: 3.037-27.749, p=0.0001) hastanede mortalite için bağımsız risk faktörleriydi. Ayrıca düzeltilmiş T dalgasının sonuna kadar T dalga aralığı (Tpec) ölen hastalarda yaşayanlara göre istatistiksel olarak daha uzundu. Sonuç: Başvuru, yaş ve kalp hızında ölçülen QTc değeri hastanede mortaliteyi tahmin etmeye yardımcı olabilir. Ayrıca Tpec, COVID-19 hastalarında ölüm riski hakkında bilgi verebilir.

Anahtar Kelimeler:

koronavirüs hastalığı 2019, mortalite, ventriküler repolarizasyon

The Importance of Corrected QT Interval for Predicting of Mortality in Patients with Severe Coronavirus Disease 2019

Background: Coronavirus disease 2019 (COVID-19), which started in Wuhan, China in December 2019, soon turned into a pandemic that severely affected the countries ' health and economic systems. COVID-19 can lead to death, especially in patients with lung involvement and cardiac injury. We aimed to determine whether baseline repolarization parameters provide prognostic information in patients admitted to intensive care unit (ICU) with COVID-19. Methods: In this retrospective cohort study, we included 135 adult patients (median age 61 years, 52% men, 51% hypertension, 43% diabetes mellitus, 32% coronary artery disease) with confirmed COVID-19 who were followed in the intensive care unit (ICU). Data of patients were extracted from the electrical medical records and compared between the survivors and the non-survivors. Results: In follow-up, of whom 80 were discharged, 55 died in hospital. Multivariate logistic regression analysis showed that the corrected QT interval (QTc) longer than ≥457 msn on admission (odds ratio (OR) =6.433, 95% CI 1.539-26.970, p=0.01), the age older than 65 years (OR=2.848, 95% CI: 1.003-8.091, p=0.04) and heart rate greater than 99 bpm (OR=9.180, 95% CI: 3.037-27.749, p=0.0001) were independent risk factors for mortality in hospital. In addition, corrected the peak of T wave to the end of T wave interval (Tpec) was statistically longer in patients who died than those who lived. Conclusion: The QTc value measured on admission, age and heart rate and can help to predict mortality in hospital. Additionally, Tpec can provide about the risk of mortality in COVID-19 patients.

Keywords:

coronavirus disease 2019, mortality, ventricular repolarization,

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