{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T06:08:23Z","timestamp":1776751703708,"version":"3.51.2"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T00:00:00Z","timestamp":1664928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>COVID-19 is a major pandemic with potential cardiovascular complications. Few studies have focused on electrocardiogram (ECG) modifications in COVID-19 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method and results<\/jats:title><jats:p>We reviewed from our database all patients referred to our hospital for COVID-19 between January 1st, 2020, and December 31st, 2020: 669 patients were included and 98 patients died from COVID-19 (14.6%). We systematically analyzed ECG at admission and during hospitalization if available. ECG was abnormal at admission in 478 patients (71.4%) and was more frequently abnormal in patients who did not survive (88.8 vs. 68.5%, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). The most common ECG abnormalities associated with death were left anterior fascicular block (39.8 vs. 20.0% among alive patients, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), left and right bundle branch blocks (<jats:italic>p<\/jats:italic> = 0.002 and <jats:italic>p<\/jats:italic> = 0.02, respectively), S1Q3 pattern (14.3 vs. 6.0%, <jats:italic>p<\/jats:italic> = 0.006). In multivariate analysis, at admission, the presence of left bundle branch block remained statistically related to death [OR = 3.82, 95% confidence interval (CI): 1.52\u20139.28, <jats:italic>p<\/jats:italic> &amp;lt; 0.01], as well as S1Q3 pattern (OR = 3.17, 95% CI: 1.38\u20137.03, <jats:italic>p<\/jats:italic> &amp;lt; 0.01) and repolarization abnormalities (OR = 2.41, 95% CI: 1.40\u20134.14, <jats:italic>p<\/jats:italic> &amp;lt; 0.01).<\/jats:p><jats:p>On ECG performed during hospitalization, the occurrence of new repolarization abnormality was significantly related to death (OR = 2.72, 95% CI: 1.14\u20136.54, <jats:italic>p<\/jats:italic> = 0.02), as well as a new S1Q3 pattern (OR = 13.23, 95% CI: 1.49\u2013286.56, <jats:italic>p<\/jats:italic> = 0.03) and new supraventricular arrhythmia (OR = 3.8, 95% CI: 1.11\u201313.35, <jats:italic>p<\/jats:italic> = 0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The presence of abnormal ECG during COVID-19 is frequent. Physicians should be aware of the usefulness of ECG for risk stratification during COVID-19.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.993479","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T05:59:30Z","timestamp":1664949570000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Electrocardiogram abnormalities and prognosis in COVID-19"],"prefix":"10.3389","volume":"9","author":[{"given":"Gabriel","family":"Chevrot","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Hauguel-Moreau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"P\u00e9pin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Vieillard-Baron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Sophie","family":"Lot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mounir","family":"Ouadahi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9l\u00e8ne","family":"Hergault","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"A\u00efdan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9gol\u00e8ne","family":"Greffe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrien","family":"Costantini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Dubourg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9bastien","family":"Beaune","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Mansencal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1800","DOI":"10.3389\/fmicb.2020.01800","article-title":"Geographic and genomic distribution of SARS-CoV-2 mutations","volume":"11","author":"Mercatelli","year":"2020","journal-title":"Front Microbiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"R849","DOI":"10.1016\/j.cub.2020.06.031","article-title":"On the evolutionary epidemiology of SARS-CoV-2","volume":"30","author":"Day","year":"2020","journal-title":"Curr Biol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"11850","DOI":"10.1021\/acs.jpclett.1c03380","article-title":"Mechanisms of SARS-CoV-2 evolution revealing vaccine-resistant mutations in Europe and America","volume":"12","author":"Wang","year":"2021","journal-title":"J Phys Chem Lett"},{"key":"B4","article-title":"Emerging variants of SARS-CoV-2 and novel therapeutics against coronavirus (COVID-19)","author":"Aleem","year":"2022","journal-title":"StatPearls"},{"key":"B5","article-title":"Features, evaluation, and treatment of coronavirus (COVID-19)","author":"Cascella","year":"2022","journal-title":"StatPearls"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.1016\/j.jiph.2020.07.014","article-title":"COVID-19 and comorbidities: deleterious impact on infected patients","volume":"13","author":"Ejaz","year":"2020","journal-title":"J Infect Public Health."},{"key":"B7","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.carrev.2020.08.028","article-title":"Systematic review of COVID-19 related myocarditis: insights on management and outcome","volume":"23","author":"Sawalha","year":"2021","journal-title":"Cardiovasc Revasc Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1056\/NEJMoa1702090","article-title":"Acute myocardial infarction after laboratory-confirmed influenza infection","volume":"378","author":"Kwong","year":"2018","journal-title":"N Engl J Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1093\/cvr\/cvaa078","article-title":"The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2","volume":"116","author":"Chen","year":"2020","journal-title":"Cardiovasc Res."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2001365","DOI":"10.1183\/13993003.01365-2020","article-title":"Pulmonary embolism in patients with COVID-19 pneumonia","volume":"56","author":"Bompard","year":"2020","journal-title":"Eur Respir J"},{"key":"B11","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1161\/CIRCULATIONAHA.120.047430","article-title":"Pulmonary embolism in patients with COVID-19: awareness of an increased prevalence","volume":"142","author":"Poissy","year":"2020","journal-title":"Circulation."},{"key":"B12","doi-asserted-by":"publisher","first-page":"E335","DOI":"10.1148\/radiol.2020201955","article-title":"Acute pulmonary embolism and COVID-19","volume":"297","author":"Poyiadji","year":"2020","journal-title":"Radiology."},{"key":"B13","doi-asserted-by":"publisher","first-page":"E70","DOI":"10.1148\/radiol.2020203557","article-title":"Pulmonary embolism and deep vein thrombosis in COVID-19: a systematic review and meta-analysis","volume":"298","author":"Suh","year":"2021","journal-title":"Radiology."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1504","DOI":"10.1016\/j.ajem.2020.04.048","article-title":"Cardiovascular complications in COVID-19","volume":"38","author":"Long","year":"2020","journal-title":"Am J Emerg Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"E678","DOI":"10.3390\/medicina56120678","article-title":"Update on COVID-19 myocarditis","volume":"56","author":"Agdamag","year":"2020","journal-title":"Medicina"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1016\/j.hrthm.2020.05.001","article-title":"Recognizing COVID-19-related myocarditis: the possible pathophysiology and proposed guideline for diagnosis and management","volume":"17","author":"Siripanthong","year":"2020","journal-title":"Heart Rhythm."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2372","DOI":"10.1016\/j.jacc.2020.03.021","article-title":"Catheterization laboratory considerations during the coronavirus (COVID-19) pandemic: from the ACC's interventional council and SCAI","volume":"75","author":"Welt","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"2352","DOI":"10.1016\/j.jacc.2020.03.031","article-title":"Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic","volume":"75","author":"Driggin","year":"2020","journal-title":"J Am Coll Cardiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/s11239-020-02201-9","article-title":"Impact of Coronavirus Disease 2019 outbreak on acute coronary syndrome admissions: four weeks to reverse the trend","volume":"51","author":"Hauguel-Moreau","year":"2021","journal-title":"J Thromb Thrombolysis"},{"key":"B20","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1016\/j.pcad.2020.05.013","article-title":"Special article - acute myocardial injury in patients hospitalized with COVID-19 infection: a review","volume":"63","author":"Bavishi","year":"2020","journal-title":"Prog Cardiovasc Dis"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1161\/CIRCULATIONAHA.120.051828","article-title":"Microthrombi as a major cause of cardiac injury in COVID-19: a pathologic study","volume":"143","author":"Pellegrini","year":"2021","journal-title":"Circulation"},{"key":"B22","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1097\/MCA.0000000000001107","article-title":"SARS-CoV-2 in coronary blood from thrombus aspiration in a patient with myocardial infarction","volume":"33","author":"Hauguel-Moreau","year":"2022","journal-title":"Coron Artery Dis"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1848","DOI":"10.1093\/europace\/euaa258","article-title":"Electrocardiographic features of 431 consecutive, critically ill COVID-19 patients: an insight into the mechanisms of cardiac involvement","volume":"22","author":"Bertini","year":"2020","journal-title":"Europace"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1007\/s11739-020-02578-8","article-title":"Clinical and electrocardiographic characteristics at admission of COVID-19\/SARS-CoV2 pneumonia infection","volume":"16","author":"Denegri","year":"2021","journal-title":"Intern Emerg Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.jelectrocard.2019.03.008","article-title":"Prognostic significance of electrocardiographic right ventricular hypertrophy in the general population","volume":"54","author":"Kowal","year":"2019","journal-title":"J Electrocardiol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1016\/j.cardfail.2020.06.005","article-title":"Electrocardiographic findings in coronavirus disease-19: insights on mortality and underlying myocardial processes","volume":"26","author":"McCullough","year":"2020","journal-title":"J Card Fail"},{"key":"B27","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.ajem.2020.12.060","article-title":"Electrocardiographic manifestations of COVID-19","volume":"41","author":"Long","year":"2021","journal-title":"Am J Emerg Med"},{"key":"B28","doi-asserted-by":"publisher","first-page":"706","DOI":"10.34172\/aim.2021.103","article-title":"Characteristic electrocardiography findings of COVID-19 patients","volume":"24","author":"Gur","year":"2021","journal-title":"Arch Iran Med"},{"key":"B29","unstructured":"RCore Team,. R: A Language Environment for Statistical Computing.\n          ViennaR Foundation for Statistical Computing2019"},{"key":"B30","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.jelectrocard.2020.12.005","article-title":"New onset atrial fibrilation and risk faktors in COVID-19","volume":"65","author":"Kelesoglu","year":"2021","journal-title":"J Electrocardiol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1007\/s11739-020-02493-y","article-title":"Cardiac involvement at presentation in patients hospitalized with COVID-19 and their outcome in a tertiary referral hospital in Northern Italy","volume":"15","author":"Ghio","year":"2020","journal-title":"Intern Emerg Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1016\/j.ijcard.2020.09.038","article-title":"Assessing QT interval in COVID-19 patients:safety of hydroxychloroquine-azithromycin combination regimen","volume":"324","author":"Bernardini","year":"2021","journal-title":"Int J Cardiol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/s12873-021-00539-8","article-title":"Electrocardiographic abnormalities in COVID-19 patients visiting the emergency department: a multicenter retrospective study","volume":"21","author":"De Carvalho","year":"2021","journal-title":"BMC Emerg Med"},{"key":"B34","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s11239-020-02292-4","article-title":"Occurrence of pulmonary embolism related to COVID-19","volume":"52","author":"Hauguel-Moreau","year":"2021","journal-title":"J Thromb Thrombolysis"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.993479\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T05:59:35Z","timestamp":1664949575000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.993479\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,5]]},"references-count":34,"alternative-id":["10.3389\/fcvm.2022.993479"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2022.993479","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,5]]},"article-number":"993479"}}