Key result
COVID-19 infection linked to ~8 ms longer TpTe intervals indicating greater ECG repolarization heterogeneity.
Why the study?
COVID-19 is associated with increased risk of acute cardiac events, but its effect on repolarization heterogeneity is not yet established.
Does COVID-19 infection increase ECG markers of repolarization heterogeneity compared to non-COVID-19 controls?
Meta-Analysis (n=1,205)
Yes
Does COVID-19 infection increase ECG markers of repolarization heterogeneity compared to non-COVID-19 controls?
COVID-19 infection is associated with increased ECG markers of transmural repolarization heterogeneity, which may indicate an increased risk for arrhythmias.
Answers are grounded in this paper and cite their sources.
May warrant arrhythmia surveillance in COVID-19 patients; extends meta-analytic evidence on repolarization changes.
BACKGROUND: Coronavirus disease-2019 (COVID-19) has been associated with an increased risk of acute cardiac events. However, the effect of COVID-19 on repolarization heterogeneity is not yet established. In this study, we evaluated electrocardiogram (ECG) markers of repolarization heterogeneity in patients hospitalized with COVID-19. In addition, we performed a systematic review and meta-analysis of the published studies. METHODS: QT dispersion (QTd), the interval between T wave peak to T wave end (TpTe), TpTe/QT (with and without correction), QRS width, and the index of cardio-electrophysiological balance (iCEB) were calculated in 101 hospitalized COVID-19 patients and it was compared with 101 non-COVID-19 matched controls. A systematic review was performed in four databases and meta-analysis was conducted using Stata software. RESULTS: Tp-Te, TpTe/QT, QRS width, and iCEB were significantly increased in COVID-19 patients compared with controls (TpTe = 82.89 vs. 75.33 ms (ms), p-value = .005; TpTe/QT = 0.217 vs. 0.203 ms, p-value = .026). After a meta-analysis of 679 COVID-19 cases and 526 controls from 9 studies, TpTe interval, TpTe/QT, and TpTe/QTc ratios were significantly increased in COVID-19 patients. Meta-regression analysis moderated by age, gender, diabetes mellitus, hypertension, and smoking reduced the heterogeneity. QTd showed no significant correlation with COVID-19. CONCLUSION: COVID-19 adversely influences the ECG markers of transmural heterogeneity of repolarization. Studies evaluating the predictive value of these ECG markers are warranted to determine their clinical utility.
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Mahmoudi et al. (2022) conducted a meta-analysis in COVID-19 (n=1,205). COVID-19 infection vs. Non-COVID-19 matched controls was evaluated on TpTe interval (p=.005). COVID-19 infection significantly increased ECG markers of repolarization heterogeneity, including the TpTe interval (82.89 vs. 75.33 ms; p=0.005) compared with matched controls.
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