ISSN 2149-2263 | E-ISSN 2149-2271
Volume : 25 Issue : 11 Year : 2021
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The Anatolian Journal of Cardiology Fragmented QRS is a marker of mortality in patients with severe COVID-19: A retrospective observational study [Anatol J Cardiol]
Anatol J Cardiol. 2021; 25(11): 811-820 | DOI: 10.5152/AnatolJCardiol.2021.62

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

İbrahim Halil Özdemir1, Bülent Özlek2, Mehmet Burak Özen1, Ramazan Gündüz1, Nurullah Çetin3, Eda Özlek2, Bekir Sedat Yıldız3, Hakan Tıkız3
1Department of Cardiology, Manisa City Hospital; Manisa-Turkey;Department of Cardiology, Merkez Efendi State Hospital; Manisa-Turkey
2Department of Cardiology, Faculty of Medicine, Sıtkı Koçman University; Muğla-Turkey
3Department of Cardiology, Faculty of Medicine, Celal Bayar University; Manisa-Turkey

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.

Keywords: coronavirus disease 2019, electrocardiography, fragmented QRS, mortality

İbrahim Halil Özdemir, Bülent Özlek, Mehmet Burak Özen, Ramazan Gündüz, Nurullah Çetin, Eda Özlek, Bekir Sedat Yıldız, Hakan Tıkız. Fragmented QRS is a marker of mortality in patients with severe COVID-19: A retrospective observational study. Anatol J Cardiol. 2021; 25(11): 811-820

Corresponding Author: İbrahim Halil Özdemir, Türkiye
Manuscript Language: English