Significance and Usefulness of High‐Resolution 24‐h Electrocardiographic Parameters in Patients With Coronavirus Disease 2019 After Admission: A Prospective Cohort Study
Motohiro Kimata, Kenichi Hashimoto, Naomi Harada, Yusuke Kawamura, Yoshifumi Kimizuka, Mayuko Kaneko, Nobuaki Kiriu, Yasumasa Sekine, Natsumi Iwabuchi, Tetsuro Kiyozumi, Susumu Matsukuma, Yuji Tanaka, Nobutaka HirookaABSTRACT
Background
This study aimed to explore the predictors of disease severity in patients with coronavirus disease 2019 (COVID‐19) using ambulatory electrocardiographic markers (AECG‐Ms), which are prognostic predictors of cardiac death, as well as echocardiography and laboratory parameters.
Methods
A prospective cohort study was conducted using data from 70 patients diagnosed with COVID‐19 and admitted to the National Defense Medical College Hospital between January 2021 and December 2023. A high‐resolution Holter electrocardiogram recorder was attached to all patients for 24 h within 48 h of admission, and AECG‐Ms were measured. Laboratory tests and echocardiography were also performed.
Results
Logistic univariate analysis revealed that the T‐wave alternans (TWA) positivity rate was significantly higher in the fatal event group (all‐cause mortality and onset of sustained ventricular tachycardia or ventricular fibrillation) than in the non‐fatal event group. Kaplan–Meier curves at 30 days after admission showed a significant worsening in the survival rate of the TWA and late potential positive groups (log‐rank test, p < 0.0001) compared with the other groups.
Conclusion
In patients with COVID‐19 without obvious cardiac disease, AECG‐Ms were highly positive. The study findings may allow easy and rapid prediction of prognosis at the bedside of patients with COVID‐19.