Electrocardiographic findings and mortality in covid-19 patients hospitalized in different clinical settings.
Marco Mele, Lucia Tricarico, Enrica Vitale and 7 others
PMID 35248799WHAT IT FOUND
ICU and IMU patients had more arrhythmias and longer QTc than RCU patients, and age, care setting, heart rate plus ECG findings were linked to in-hospital death.
Key findings
01ICU and IMU patients had more arrhythmias and longer QTc intervals than RCU patients.
02Deaths were most frequent in ICU patients (43%), while IMU and RCU mortality rates were 20% and 21%.
03The multivariable model identified age, intensity of care, heart rate, ST elevation, QTc prolongation, Q waves, right bundle branch block and atrial fibrillation as independent predictors of in-hospital death.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Single-center retrospective study, so findings may not apply to other hospitals. Many variables that can affect ECG and mortality were not recorded, including oxygen levels, pre-admission ECG, pre-existing atrial fibrillation, baseline QT, drug therapy, sedation, antibiotics, diabetes, cardiovascular disease, thyroid disease, heart failure and COPD. No echocardiographic data were recorded. The derived score was not externally validated and the authors state it needs further validation. 51 patients were missed at follow-up. The study is observational, so ECG findings are associated with death but not shown to cause it.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not use the derived score to make monitoring or discharge decisions. It was created from retrospective single-center data, several important confounders were not recorded, and the authors state that it still needs validation.