{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:23:45Z","timestamp":1783700625400,"version":"3.55.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T00:00:00Z","timestamp":1600387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Our aim was to describe the electrocardiographic features of critical COVID-19 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We carried out a multicentric, cross-sectional, retrospective analysis of 431 consecutive COVID-19 patients hospitalized between 10 March and 14 April 2020 who died or were treated with invasive mechanical ventilation. This project is registered on ClinicalTrials.gov (identifier: NCT04367129). Standard ECG was recorded at hospital admission. ECG was abnormal in 93% of the patients. Atrial fibrillation\/flutter was detected in 22% of the patients. ECG signs suggesting acute right ventricular pressure overload (RVPO) were detected in 30% of the patients. In particular, 43 (10%) patients had the S1Q3T3 pattern, 38 (9%) had incomplete right bundle branch block (RBBB), and 49 (11%) had complete RBBB. ECG signs of acute RVPO were not statistically different between patients with (n = 104) or without (n=327) invasive mechanical ventilation during ECG recording (36% vs. 28%, P = 0.10). Non-specific repolarization abnormalities and low QRS voltage in peripheral leads were present in 176 (41%) and 23 (5%), respectively. In four patients showing ST-segment elevation, acute myocardial infarction was confirmed with coronary angiography. No ST-T abnormalities suggestive of acute myocarditis were detected. In the subgroup of 110 patients where high-sensitivity troponin I was available, ECG features were not statistically different when stratified for above or below the 5 times upper reference limit value.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The ECG is abnormal in almost all critically ill COVID-19 patients and shows a large spectrum of abnormalities, with signs of acute RVPO in 30% of the patients. Rapid and simple identification of these cases with ECG at hospital admission can facilitate classification of the patients and provide pathophysiological insights.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa258","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T19:28:17Z","timestamp":1596569297000},"page":"1848-1854","source":"Crossref","is-referenced-by-count":67,"title":["Electrocardiographic features of 431 consecutive, critically ill COVID-19 patients: an insight into the mechanisms of cardiac involvement"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5285-7140","authenticated-orcid":false,"given":"Matteo","family":"Bertini","sequence":"first","affiliation":[{"name":"Cardiological Center, University of Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2046-9175","authenticated-orcid":false,"given":"Roberto","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Cardiological Center, University of Ferrara, Italy"},{"name":"Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Guardigli","sequence":"additional","affiliation":[{"name":"Cardiological Center, University of Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Malag\u00f9","sequence":"additional","affiliation":[{"name":"Cardiological Center, University of Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0667-7616","authenticated-orcid":false,"given":"Francesco","family":"Vitali","sequence":"additional","affiliation":[{"name":"Cardiological Center, University of Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0564-7578","authenticated-orcid":false,"given":"Ottavio","family":"Zucchetti","sequence":"additional","affiliation":[{"name":"Cardiological Center, University of Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"D\u2019Aniello","sequence":"additional","affiliation":[{"name":"Cardiological Center, University of Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3533-6121","authenticated-orcid":false,"given":"Carlo Alberto","family":"Volta","sequence":"additional","affiliation":[{"name":"U.O. Terapia Intensiva Universitaria, Azienda Ospedaliero-Universitaria di Ferrara \u2018Arcispedale S. Anna\u2019, Cona, Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Cimaglia","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Piovaccari","sequence":"additional","affiliation":[{"name":"Ospedale degli Infermi, Rimini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1762-0260","authenticated-orcid":false,"given":"Alessandro","family":"Corzani","sequence":"additional","affiliation":[{"name":"Ospedale Bufalini, Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Galvani","sequence":"additional","affiliation":[{"name":"Ospedale Morgagni-Pierantoni, Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Ortolani","sequence":"additional","affiliation":[{"name":"Ospedale S. 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