R-Wave Peak Time as a New Predictor of Myocardial Injury in Patients Infected With Covid-19

Objectives: Myocardial injury is closely associated with the poor prognosis of patients infected with coronavirus disease 2019 (COVID-19). Early diagnosis of cardiovascular complications that develop during the process of COVID-19 is crucial. R-wave peak time (RWPT) is an electrocardiographic parameter in which myocardial involvement caused by various situations is shown. This study was designed to assess the predictive value of RWPT in patients infected with COVID-19 who developed a myocardial injury. Methodology: A total of 138 patients diagnosed with COVID-19 were enrolled in this prospective study. The patients were classified according to their troponin values ─ study group (SG, n= 52) with high troponin and control group (CG, n= 86) without elevated troponin. All data obtained from patients were compared. Results: QRS duration (101 ± 5 ms vs. 99 ± 6 ms, p= .013) and RWPT (43 ± 6 ms vs. 38 ± 5 ms, p<0.001) were significantly longer in SG than in the CG. In multivariate analysis, C-reactive protein (OR: 1.109, 95% CI: 1.058–1.163; p<0.001), ejection fraction (OR: .844, 95% CI: .765–.931; p=0.001), and RWPT (OR: 1.211, 95% CI: 1.096–1.339; p<0.001) were independent predictors of myocardial injury in COVID-19-infected individuals. The ROC analysis revealed a cut-off value of RWPT for myocardial injury of 40.5 ms, with a sensitivity of 63.5% and a specificity of 62.8% (AUC: 0.730, 95% CI: 0.641–0.819, p<0.001). Conclusion: RWPT is a significant predictor of myocardial injury and may benefit in better identifying patients with myocardial injury in COVID-19.