The Anatolian Journal of Cardiology
Original Investigation

Fragmented QRS is a marker of mortality in patients with severe COVID-19: A retrospective observational study

1.

Department of Cardiology, Manisa City Hospital; Manisa-Turkey

2.

Department of Cardiology, Merkez Efendi State Hospital; Manisa-Turkey

3.

Department of Cardiology, Faculty of Medicine, Sıtkı Koçman University; Muğla-Turkey

4.

Department of Cardiology, Faculty of Medicine, Celal Bayar University; Manisa-Turkey

Anatol J Cardiol 2021; 25: 811-820
DOI: 10.5152/AnatolJCardiol.2021.62
Read: 173 Downloads: 82 Published: 01 November 2021

Objective: In this study, we aimed to investigate the association of fragmented QRS (f-QRS) with in-hospital death in patients with severe novel coronavirus disease 2019 (COVID-19).

Methods: This was a retrospective and observational study. A total of 201 consecutive patients with severe COVID-19 were enrolled. Demographic data, laboratory parameters, medications, electrocardiographic (ECG) findings, and clinical outcomes were recorded. Patients with and without f-QRS were compared, and predictors of all-cause in-hospital mortality were analyzed.

Results: A total of 135 patients without f-QRS (mean age of 64 years, 43% women) and 66 patients with f-QRS (mean age of 66 years, 39% women) were included. C-reactive protein (CRP), D-dimer, troponin I, ferritin levels, and CRP to albumin ratio were significantly higher in patients with f-QRS. The need for invasive mechanical ventilation (63.6% vs. 41.5%, p=0.003) and all-cause in-hospital mortality [54.5% vs. 28.9%, log rank p=0.001, relative risk 1.88, 95% confidence interval (CI) 1.16–4.78] were significantly higher in patients with f-QRS. A number value of f-QRS leads ≥2 yields sensitivity and specificity (85.3% and 86.7%, respectively) for predicting in-hospital all-cause mortality. Multivariable analysis showed that f-QRS (odds ratio: 1.041, 95% Cl: 1.021–1.192, p=0.040) were independently associated with in-hospital death.

Conclusion: This study revealed that the presence of f-QRS in ECG is associated with higher in-hospital all-cause mortality in patients with severe COVID-19. f-QRS is an easily applicable simple indicator to predict the risk of death in these patients.

Cite this article as: Özdemir İH, Özlek B, Özen MB, Gündüz R, Çetin N, Özlek E, et al. Fragmented QRS is a marker of mortality in patients with severe COVID-19: A retrospective observational study. Anatol J Cardiol 2021; 25: 811-20.

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ISSN 2149-2263 EISSN 2149-2271