Key result
Partial interatrial block predicts ~165% higher in-hospital COVID-19 mortality, while advanced block predicts thrombotic events.
Why the study?
Abnormal electrocardiographic findings are associated with increased mortality in COVID-19 patients, but no studies had evaluated the prognostic impact of interatrial block in this population.
Does the presence of interatrial block on admission ECG predict ARDS requiring intubation, in-hospital mortality, and thromboembolic events in hospitalized COVID-19 patients?
Cohort (n=300)
Yes
Does the presence of interatrial block on admission ECG predict ARDS requiring intubation, in-hospital mortality, and thromboembolic events in hospitalized COVID-19 patients?
Hazard Ratio: 2.65
p-value: p=0.02
Interatrial block on admission ECG is a useful early predictor of increased risk for incident thrombotic events, ARDS requiring intubation, and in-hospital mortality in COVID-19 patients.
May aid early risk stratification on admission ECG in COVID-19; hypothesis-generating pending prospective validation.
INTRODUCTION: Some abnormal electrocardiographic findings were independently associated with increased mortality in patients admitted for COVID-19; however, no studies have focussed on the prognosis impact of the interatrial block (IAB) in this clinical setting. The aim of our study was to assess the prevalence and clinical implications of IAB, both partial and advanced, in hospitalized COVID-19 patients. MATERIALS: We retrospectively evaluated 300 consecutive COVID-19 patients (63.22 ± 15.16 years; 70% males) admitted to eight Italian Hospitals from February 2020 to April 2020 who underwent twelve lead electrocardiographic recording at admission. The study population has been dichotomized into two groups according to the evidence of IAB at admission, both partial and advanced. The differences in terms of ARDS in need of intubation, in-hospital mortality and thromboembolic events (a composite of myocardial infarction, stroke and transient ischaemic attack) have been evaluated. RESULTS: The presence of IAB was noticed in 64 patients (21%). In the adjusted logistic regression model, the partial interatrial block was found to be an independent predictor of ARDS in need of intubation (HR: 1.92; p: .04) and in-hospital mortality (HR: 2.65; p: .02); moreover, the advanced interatrial block was an independent predictor of thrombotic events (HR: 7.14; p < .001). CONCLUSIONS: Among COVID-19 patients hospitalized in medical wards, the presence of interatrial block is more frequent than in the general population and it might be useful as an early predictor for increased risk of incident thrombotic events, ARDS in need of intubation and in-hospital mortality.
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Russo et al. (2022) conducted a cohort in COVID-19 (n=300). Interatrial block vs. No interatrial block was evaluated on in-hospital mortality (HR 2.65, p=0.02). Partial interatrial block independently predicted in-hospital mortality (HR 2.65; P=0.02) in hospitalized COVID-19 patients, while advanced block predicted thrombotic events (HR 7.14; P<0.001).
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