J-waves in acute COVID-19: A novel disease characteristic and predictor of mortality?

• Published in: PloS one 2021-10, Vol.16 (10), p.e0257982-e0257982
• Main Authors: Zagidullin, Naufal Shamilevich, Motloch, Lukas J, Musin, Timur Ilgamovich, Bagmanova, Zilya Adibovna, Lakman, Irina Alexandrovna, Tyurin, Anton Viktorovich, Gumerov, Ruslan Mansurovich, Enikeev, Dinar, Cai, Benzhi, Gareeva, Diana Firdavisovna, Davtyan, Paruir Artakovich, Gareev, Damir Aidarovich, Talipova, Halima Malikovna, Badykov, Marat Rifkatovich, Jirak, Peter, Kopp, Kristen, Hoppe, Uta C, Pistulli, Rudin, Pavlov, Valentin Nikolaevich
• Format: Article
• Language: English
• Subjects: Aviation; Biology and Life Sciences; Biomedical engineering; Blood pressure; Bombast von Hohenheim, Philippus Aureolus Theophrastus (Paracelsus) (1493-1541); Cardiac arrhythmia; Cardiovascular disease; Congestive heart failure; Coronaviruses; COVID-19; Disease transmission; EKG; Electrocardiogram; Electrocardiography; Funding; Health risks; Heart diseases; Heart failure; Hospitalization; Hospitals; Internal medicine; Medicine; Medicine and Health Sciences; Methods; Mortality; Pandemics; Patients; Pharmacy; Pneumonia; Regression models; Research and Analysis Methods; Risk factors; Severe acute respiratory syndrome coronavirus 2; Software; Statistics; Tachycardia; Ventricle
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0257982

J-waves represent a common finding in routine ECGs (5-6%) and are closely linked to ventricular tachycardias. While arrhythmias and non-specific ECG alterations are a frequent finding in COVID-19, an analysis of J-wave incidence in acute COVID-19 is lacking. A total of 386 patients consecutively, hospitalized due to acute COVID-19 pneumonia were included in this retrospective analysis. Admission ECGs were analyzed, screened for J-waves and correlated to clinical characteristics and 28-day mortality. J-waves were present in 12.2% of patients. Factors associated with the presence of J-waves were old age, female sex, a history of stroke and/or heart failure, high CRP levels as well as a high BMI. Mortality rates were significantly higher in patients with J-waves in the admission ECG compared to the non-J-wave cohort (J-wave: 14.9% vs. non-J-wave 3.8%, p = 0.001). After adjusting for confounders using a multivariable cox regression model, the incidence of J-waves was an independent predictor of mortality at 28-days (OR 2.76 95% CI: 1.15-6.63; p = 0.023). J-waves disappeared or declined in 36.4% of COVID-19 survivors with available ECGs for 6-8 months follow-up. J-waves are frequently and often transiently found in the admission ECG of patients hospitalized with acute COVID-19. Furthermore, they seem to be an independent predictor of 28-day mortality.