Electrocardiographic Findings in Patients with Severe COVID-19: Characterisation and Clinical Correlations

In a prospective study of 200 COVID-19 patients, categorised into mild symptoms (category A; n=39), mild symptoms with cardiopulmonary comorbidities (category B; n=68) and severe symptoms with haemodynamic compromise (category C), category C showed higher incidences of left axis deviations, left atrial enlargement, prolonged QRS, elevated left ventricular amplitude, poor R wave progression and T inversion in V1–V6. A novel marker, rS complex – R/S ratio >1 in lead III, was noted. Univariate analysis revealed left atrial enlargement, left axis deviation, left ventricular amplitude and poor R wave progression as mortality predictors. Multivariate analysis identified age and left atrial enlargement as independent predictors. These findings suggest possible elevated left ventricular end-diastolic pressure, which will help in categorising disease severity and predicting outcomes.