Hedieh Alimi - Associate Professor of Cardiology, Fellowship of Echocardiography, Vascular and endovascular surgery research center, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Maryam Emadzadeh - Associate Professor, Clinical Research Development Unit, Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Seyyed Mahdiyar Noughab - Resident of cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

BACKGROUND: Coronavirus disease ۲۰۱۹ (COVID-۱۹) may lead to myocardial damage and arrhythmia. Patients with ECG changes have shown an increased risk of mortality.OBJECTIVE: We aimed to study the changes in the electrocardiogram, which may be of great significance for risk stratification of COVID-۱۹-positive patients.METHODS: A retrospective study was conducted to compare electrocardiogram changes and disease severity markers in COVID-۱۹-positive patients admitted to a referral hospital between February ۲۰ and March ۲۰, ۲۰۲۰.RESULTS: Our study consisted of ۲۰۱ cases, including ۱۲۳ males and ۷۸ females. Ages ranged between ۱۶ and ۹۷ years old. Fifty-two (۲۵.۹%) cases had a history of ICU admission. Multivariate logistic regression analysis showed that a low O۲ saturation level (OR = ۰.۹۲۰, ۹۵% CI ۰.۸۶۸–۰.۹۷۶, p=۰.۰۰۵), several lab tests, ECG changes (OR = ۴۶.۸۴, ۹۵% CI ۳.۸۷۶– ۵۶۶.۲۸۷, p = .۰۰۲) and Age (OR = ۱.۰۳, ۹۵% CI ۱.۰۰۰– ۱.۰۶۵, p = .۰۴۸) were the independent risk factors for predicting mortality rate. In addition, we utilized multivariate logistic regression analysis, demonstrating that LBBB (OR = ۴.۶۰۱, ۹۵%CI: ۱.۳۵۷–۱۵.۶۰۰, p=۰.۰۱۴) is the only ECG risk factor associated with morbidity in elderly patients with ECG changes.CONCLUSIONS: ECG changes are strong indicators of high mortality rates in elderly COVID-۱۹ patients. ECG interpretations should therefore be used for risk stratification and predicting the need for ICU admission.

COVID-۱۹, Pneumonia, complete heart block