Electrocardiographic Findings in Patients Hospitalized With COVID‐19: Retrospective Study

Background: COVID‐19 can involve the heart, which is associated with an increase in morbidity and mortality and can detected by electrocardiogram (ECG). So, in this study, we assess ECG changes in COVID‐19‐infected patients during hospitalization. Methods: In this study, we examined the ECGs of 474 patients with COVID‐19 positive at Birjand Vali‐Asr Hospital (east of Iran). All the ECGs were taken by a single device and interpreted by a cardiologist. Demographic information, past medical history, and severity of COVID disease (in terms of oxygen saturation, respiratory distress, and need for emergency care) were entered in the checklist. Data were entered into SPSS Version 22 and analyzed. A p value of ≤ 0.05 was considered as a significant level. Results: The patient’s mean age was 57.13 ± 18.7 years, and 55% of them were men; 428 (89.5%) patients survived and 49 (10.5%) died. About 78% of patients had abnormal ECG, which was higher in deceased patients significantly (91.8%, p = 0.03). Most frequent abnormalities include 40.3% of dysrhythmia (sinus tachycardia, atrial fibrillation, and sinus bradycardia), 30.1% of abnormal rate (tachycardia, bradycardia), and 30% of low‐voltage ECG. Statistical analysis showed that after multivariable logistic regression, tachycardia (OR = 2.65 [1.2–5.8]; p = 0.015) and ST‐segment elevation (OR = 2.9 [1.2–7.2]; p = 0.023) were directly related to the disease severity and mortality. Conclusion: ECG changes are very common in COVID‐19 patients, especially rate and rhythm changes. Tachycardia and ST segment elevation were associated with mortality. ECG changes are very common in COVID‐19 patients, especially changes in rate and rhythm. Tachycardia and ST segment elevation were associated with mortality. Since the ECG is a simple, cheap, and safe diagnostic method, it is necessary to take an initial ECG from the patient in acute upper respiratory infections such as COVID‐19, at least for patients with severe disease. In our study, the significant point was the presence of low voltage in ECG in one‐third of the patients with COVID‐19, which requires further research in this field.