COVID-19 Enfeksiyonuna Bağlı Kardiyak Stresin Elektrokardiyografi Skoru ile Değerlendirilmesi

GİRİŞ ve AMAÇ: Yeni koronavirüs hastalığı (COVID-19), pulmoner arter basıncında akut yükselmeye neden olarak ani bir sağ ventrikül yüklenmesine yol açabilen yaygın pulmoner intravasküler tromboza yol açabilir. COVID-19'a bağlı bu sağ ventrikül yüklenmesini elektrokardiyografi (EKG) skoru ile değerlendirmeyi hedefledik. YÖNTEM ve GEREÇLER: Çalışmaya COVID-19 ile hastaneye yatırılan ve başvuru anında EKG'si çekilen yüz kırk bir hasta dahil edildi. Başvuru sırasında çekilen EKG'lerden her hasta için EKG skoru hesaplandı. BULGULAR: Hastane içi mortalite, EKG skoru ≥10 olan COVID-19 hastalarında anlamlı olarak daha yüksekti (% 15 vs % 0, p = 0.001). Tek değişkenli regresyon analizi, nötrofil ve lenfosit sayılarını, kreatininkinaz, D-dimer, fibrinojen, Creaktif protein (CRP), kardiyak biyobelirteçler, ferritin ve prokalsitonin düzeylerini EKG skoru ≥10' nun önemli prediktörleri olarak ortaya koymaktadır. EKG skoru, COVID19 hastalarında mortalitenin anlamlı bir prediktörü olarak bulundu (olasılık oranı 0.33,% 95 güven aralığı 0.14-0.77, p = 0.01). Çok değişkenli regresyon analizine göre, CRP (olasılık oranı 1.03,% 95 güven aralığı 1.00 -1.05, p = 0.02) ve yüksek duyarlı kardiyak troponin I (olasılık oranı 1.00,% 95 güven aralığı 0.99-1.00, p = 0.009) COVID-19 hastalarında sırasıyla EKG skoru ≥10' nun ve mortalitenin anlamlı bağımsız prediktörleridir. TARTIŞMA ve SONUÇ: EKG skoru, COVID-19 enfeksiyonunun ciddiyeti ve mortalitesi ile ilişkili görünmektedir.

Evaluation of Cardiac Stress Due to COVID-19 Infection by Electrocardiography Score

INTRODUCTION: Novel coronavirus disease (COVID-19) may lead to diffuse pulmonary intravascular thrombosis that can lead a sudden right ventricular stress by causing an acute elevation in pulmonary artery pressure. We aim to evaluate this right ventricular stress due to COVID-19 with the electrocardiography (ECG) score METHODS: One hundred and forty-one patients hospitalized with COVID-19, whose ECGs were obtained ECG at admission, were included in the study. ECG score was calculated for each patient from the ECGs taken during admission. RESULTS: In-hospital mortality was significantly higher in COVID-19 patients with an ECG score of ≥10 (15% vs 0%, p=0.001). Univariate regression analysis reveals neutrophil and lymphocyte counts, creatinine kinase, D-dimer, fibrinogen, C-reactive protein (CRP), cardiac biomarkers, ferritin and procalcitonin levels as significant predictors of ECG score of ≥10. The ECG score was found as a significant predictor of mortality (odds ratio 0.33, 95% confidence interval 0.14- 0.77, p=0.01) in COVID-19 patients. According to multivariate regression analysis, CRP (odds ratio 1.03, 95% confidence interval 1.00- 1.05, p=0.02) and high-sensitive cardiac troponin I (odds ratio 1.00, 95% confidence interval 0.99- 1.00, p=0.009) are significant independent predictors of ECG score of ≥10 and mortality in COVID-19 patients, respectively. DISCUSSION AND CONCLUSION: ECG score appears to be associated with the severity and mortality of the COVID-19 infection.

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