Conduction system disorders and electrocardiographic findings in COVID-19 deceased patients in 2021, Shiraz, Iran

• Published in: World journal of cardiology 2022-12, Vol.14 (12), p.617-625
• Main Authors: Nikoo, Mohammad Hossein, Sadeghi, Alireza, Estedlal, Alireza, Fereidooni, Reza, Dehdari Ebrahimi, Niloofar, Maktabi, Amirhossein, Kamgar, Mahtab, Mehran, Fatemeh, Mehdibeygi, Omid, Esfandiari, Haleh, Taherinezhad Tayebi, Mohammadamir, Heydari, Seyed Taghi
• Format: Article
• Language: English
• Subjects: Observational Study
• ISSN: 1949-8462; 1949-8462
• DOI: 10.4330/wjc.v14.i12.617

Cardiac conduction disorders and electrocardiographic (ECG) changes may occur as a manifestation of coronavirus disease 2019 (COVID-19), especially in severe cases. To describe conduction system disorders and their association with other electrocardiographic parameters in patients who died of COVID-19. In this cross-sectional study, electrocardiographic and clinical data of 432 patients who expired from COVID-19 between August 1 , 2021, and December 1 , 2021, in a tertiary hospital were reviewed. Among 432 patients who died from COVID-19, atrioventricular block (AVB) was found in 40 (9.3%). Among these 40 patients, 28 (6.5%) suffered from 1st degree AVB, and 12 (2.8%) suffered from complete heart block (CHB). Changes in ST-T wave, compatible with myocardial infarction or localized myocarditis, appeared in 189 (59.0%). Findings compatible with myocardial injury, such as fragmented QRS and prolonged QTc, were found in 91 patients (21.1%) and 28 patients (6.5%), respectively. In patients who died of COVID-19, conduction disorder was unrelated to any underlying medical condition. Fragmented QRS, axis deviation, and ST-T changes were significantly related to conduction system disorder in patients who died of COVID-19 ( value < 0.05). Conduction system disorders are associated with several other ECG abnormalities, especially those indicative of myocardial ischemia or inflammation. Most patients (73.14%) who died of COVID-19 demonstrated at least one ECG abnormality parameter. Since a COVID-19 patient's ECG gives important information regarding their cardiac health, our findings can help develop a risk stratification method for at-risk COVID-19 patients in future studies.