Key result
Prolonged QTc on admission in COVID-19 survivors was not independently associated with the 1-year composite endpoint of death, hospital readmission, or new arrhythmia (HR 0.86).
Why the study?
Prolonged admission QTc interval and higher mortality have been reported in SARS-CoV-2 patients, but the long-term clinical impact of prolonged QTc is unknown.
Does a prolonged QTc interval on admission predict long-term adverse events in COVID-19 survivors?
Cohort (n=523)
No
Does a prolonged QTc interval on admission predict long-term adverse events in COVID-19 survivors?
Hazard Ratio: 0.86 (95% CI 0.231–3.203)
p-value: p=0.822
Prolonged QTc interval during acute COVID-19 hospitalization normalizes in most survivors and does not predict long-term adverse clinical outcomes at 1 year.
Prolonged QTc may flag elevated long-term risk in COVID-19 survivors; leaves open whether serial monitoring alters 1-year prognosis.
Background and objective: Prolonged QTc interval on admission and a higher risk of death in SARS-CoV-2 patients have been reported. The long-term clinical impact of prolonged QTc interval is unknown. This study examined the relationship in COVID-19 survivors of a prolonged QTc on admission with long-term adverse events, changes in QTc duration and its impact on 1-year prognosis, and factors associated with a prolonged QTc at follow-up. Methods: We conducted a single-center prospective cohort study of 523 SARS-CoV-2-positive patients who were alive on discharge. An electrocardiogram was taken on these patients within the first 48 h after diagnosis and before the administration of any medication with a known effect on QT interval and repeated in 421 patients 7 months after discharge. Mortality, hospital readmission, and new arrhythmia rates 1 year after discharge were reviewed. Results: = 0.212). In 84% of survivors with prolonged baseline QTc, it normalized at 7.9 ± 2.2 months. Of the survivors, 2.4% had prolonged QTc at follow-up, and this was independently associated with obesity, ischemic cardiomyopathy, chronic obstructive pulmonary disease, and cancer. Prolonged baseline QTc was not independently associated with the composite adverse event at 1 year. Conclusions: Prolonged QTc in the acute phase normalized in most COVID-19 survivors and had no clinical long-term impact. Prolonged QTc at follow-up was related to the presence of obesity and previously acquired chronic diseases and was not related to 1-year prognosis.
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Mojón-Álvarez et al. (2023) conducted a cohort in COVID-19 survivors (n=523). Prolonged QTc on admission (≥480 ms) vs. Normal QTc on admission (<480 ms) was evaluated on Composite of death, new episode of arrhythmia, or all-cause hospital readmission at 1 year (HR 0.86, 95% CI 0.231-3.203, p=0.822). Prolonged QTc on admission in COVID-19 survivors was not independently associated with the 1-year composite endpoint of death, hospital readmission, or new arrhythmia (HR 0.86).
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