Prognostic significance of Tp-e interval and Tp-e/QTc ratio in patients with COVID-19

Eur Rev Med Pharmacol Sci. 2021 Apr;25(8):3272-3278. doi: 10.26355/eurrev_202104_25736.

Abstract

Objective: Ventricular arrhythmias were the most frequent manifestations in patients with COVID-19. Both the natural course of the disease and the treatment drugs used have effects on ventricular repolarization. The objective of this study was to evaluate the effects of repolarization parameters obtained from surface electrocardiography (ECG) on prognosis.

Patients and methods: Participants were 205 consecutive patients hospitalized with COVID-19 diagnosis. The 12-lead surface ECG was obtained from each patient on admission. The ECG results were evaluated against the patients' clinical characteristics and outcomes by experienced cardiology specialists.

Results: The mean age was higher in the non-survivor group compared to the survivor group (57.4 ± 15.7 vs. 65.6 ± 16.6; p = 0.001). The demographical characteristics were similar between the survivor and non-survivor groups. Multivariate analyses demonstrated that age (OR: 1.041; p = 0.009), D-dimer (OR: 1.002; p = 0.031), high-sensitivity troponin I (hs-TnI) (OR: 1.010; p = 0.041), pneumonia on computed tomography (CT) (OR: 4.985; p < 0.001), the peak-to-end interval of the T wave (Tp-e) (OR: 3.421; p < 0.001), and Tp-e/QTc ratio (OR: 1.978; p = 0.013) were statistically significant independent predictors in terms of determining mortality.

Conclusions: Prolonged Tp-e interval and increased Tp-e/QTc ratio on admission are decent predictors and linked with mortality. ECG is a practical study to evaluate prognosis and potential arrhythmias, as well as initiating suitable treatment.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / epidemiology
  • Arrhythmias, Cardiac / physiopathology*
  • COVID-19 / epidemiology
  • COVID-19 / metabolism
  • COVID-19 / mortality
  • COVID-19 / physiopathology*
  • Electrocardiography
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Prognosis
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies
  • SARS-CoV-2
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Troponin I / metabolism

Substances

  • Fibrin Fibrinogen Degradation Products
  • Troponin I
  • fibrin fragment D