Electrocardiographic changes in patients with COVID-19
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Published
Apr 15, 2023
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Abstract
Objective: To recognize changes in the electrocardiogram in patients with COVID-19. Methods: This is an integrative literature review in which a search was carried out on PubMed, Medline and DOAJ platforms and a total of 25 articles were included in the scientific work after applying the inclusion and exclusion criteria. Results: Through the studies carried out, it was observed that the main changes in the ECG of the patients were the alteration of the ST segment, widening of the QRS complex, inversion of the T wave, and widening of the QTc interval, these changes are related to the high risk of arrhythmias. In addition, the pathophysiological process is associated with the use of administered drugs, inflammation of the virus itself and the exacerbated response of the organism in the release of cytokines. Final considerations: In consideration, these electrocardiographic variations are due to the established drug therapy, excess cytokines and direct inflammation of the virus, these changes directly imply the prognosis of each patient.
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How to Cite
VieiraE. A., & VilagraS. M. B. W. (2023). Electrocardiographic changes in patients with COVID-19. Revista Eletrônica Acervo Médico, 23(4), e12263. https://doi.org/10.25248/reamed.e12263.2023
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Revisão Bibliográfica
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References
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32. WATSON JA, et al. Concentration-dependent mortality of chloroquine in overdose. Elife, 2020; 8: e58631.
33. WU TC, et al. QT Interval Control to Prevent Torsades de Pointes during Use of Hydroxychloroquine and/or Azithromycin in Patients with COVID-19. Arq Bras Cardiol, 2020; 114(6): 1061-1066.
34. XU H, et al. High expression of ACE2 receptor of 2019-nCov on the epithelial cells of oral mucosa. Int J Oral Sci, 2020; 12: 8.
35. YAO X, et al. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis, 2020; 71(15): 732-739.
36. ZEITLNGER M, et al. Phamacoknetics-pharmacodynamics of antiviral agents used to treat SARS-CoV-2 and their potential interaction with drugs and other supportive measures: a comprehensive review by the PK/PD f anti-infectives study Group of the European Society of antimicrobial agents, 2020; 59(10): 1195-1216.
2. BARMAN HA, et al. The effect of the severity COVID-19 infection on electrocardiography. Am J Emerg Med, 2020; S0735-6757(20): 30889-5.
3. BECKER ML, et al. QTc Prolongation in COVID-19 Patients Using Chloroquine. Cardiovasc Toxicol, 2021; 21(4): 314-321.
4. BERGAMASCHI L, et al. The value of ECG changes in risk stratification of COVID-19 patients. Ann Noninvasive Electrocardiol, 2021; 26(3): e12815.
5. BOUROUIBA L. Turbulent gas clouds and respiratory pathogen emissions: potential implications for reducing transmission of COVID-19. JAMA, 2020; 323(18): 1837-1838.
6. ÇAP M, et al. The effect of favipiravir on QTc interval in patients hospitalized with coronavirus disease 2019. J Electrocardiol, 2020; 63: 115-119.
7. CUI J, et al. Origin and evoltion of pathogenic coronaviruses Nat RevMicrobiol, 2019; 17(3): 181-92.
8. ECHARTE MJ, et al. Effect of hydroxychloroquine, azithromycin and lopinavir/ritonavir on the QT corrected interval in patients with COVID-19. J Electrocardiol, 2021; 64: 30-35.
9. GONZÁLEZ NT, et al. QT interval measurement with portable device during COVID-19 outbreak. Int J Cardiol Heart Vasc, 2020; 30: 100644.
10. HE J, et al. Characteristic Electrocardiographic Manifestations in Patients with COVID-19. Can J Cardiol, 2020; 36(6): 966.e1-966.e4.
11. INCIARD RM, et al. Cardiac involvement in a patient with coronavirus disease 2019 (COVID-19). JAMA Cardiol, 2020; 5(7): 819-824.
12. ISLAM KU e IQBAL J. An Update on Molecular Diagnostics for COVID-19. Front Cell Infect Microbiol, 2020;10:560616.
13. KARIYANNA PT, et al. A Systematic Review of COVID-19 and Myocarditis. Am J Med Case Rep, 2020; 8 (9): 299-305.
14. KOC M, et al. Disease Severity affects ventricular repolarization parameters in patients with COVID-19. ABC Cardiol, 2020; 115(5): 907-913.
15. LANZA GA, et al. Electrocardiographic findings at presentation and clinical outcome in patients with SARS-CoV-2 infection. Europace, 2021; 23(1): 123-129.
16. LIAQAT A, et al. Evaluation of myocardial injury patterns and ST segment changes in critical and non-critical patients with coronavirus-19 disease. Sci Rep, 2021; 11(1): 4828.
17. LONG B, et al. Cardiovascular complications in COVID-19. Am J Emerg Med, 2020; 38(7): 1504-1507.
18. MATTEUCCI A, et al. Electrocardiographic modifications and cardiac involvement in COVID-19 patients: results from an Italian cohort. J Cardiovasc Med (Hagerstown), 2021; 22(3): 190-196.
19. MOEY MYY, et al. Electrocardiographic Changes and Arrhythmias in Hospitalized Patients With COVID-19. Circ Arrhythm Electrophysiol, 2020; 13(10): e009023.
20. O'CONNELL TF, et al. Hydroxychloroquine/Azithromycin Therapy and QT Prolongation in Hospitalized Patients with COVID-19. JACC Clin Electrophysiol, 2021; 7(1): 16-25.
21. PAVRI BB, et al. Behavior of the PR interval with increasing heart rate in patients with COVID-19. Heart Rhythm, 2020; 17(9): 1434-1438.
22. POTERUCHA TJ, et al. Admission Cardiac Diagnostic Testing with Electrocardiography and Troponin Measurement Prognosticates Increased 30-Day Mortality in COVID-19. J Am Heart Assoc, 2021; 10(1): e018476.
23. RAMIREDDY A, et al. Experience With Hydroxychloroquine and Azithromycin in the Coronavirus Disease 2019 Pandemic: Implications for QT Interval Monitoring. J Am Heart Assoc, 2020; 9(12): e017144.
24. REGAN W, et al. Electrocardiographic Changes in Children with Multisystem Inflammation Associated with COVID-19: Associated with Coronavirus Disease 2019. J Pediatr, 2021: S0022-3476(20): 31542-0.
25. RYABYKINA G. Alterações do eletrocardiograma na infecção por COVID-19. Cardiologia, 2020; 60:16-22.
26. SAMUEL S, et al. Incidence of arrhythmias and electrocardiographic abnormalities in symptomatic pediatric patients with PCR-positive SARS-CoV-2 infection, including drug-induced changes in the corrected QT interval. Heart Rhythm, 2020; 17(11): 1960-1966.
27. SECCO GG, et al. Invasive strategy for COVID patients presenting with acute coronary syndrome: The first multicenter Italian experience. Catheter Cardiovasc Interv, 2021; 97(2): 195-198.
28. UĞURLU IB, et al. Effect of triple antimicrobial therapy on electrocardiography parameters in patients with mild-to-moderate coronavirus disease 2019. Anatol J Cardiol,2021; 25(3): 184-190.
29. VITA A, et al. Electrocardiographic Findings and Clinical Outcome in Patients with COVID-19 or Other Acute Infectious Respiratory Diseases. J Clin Med, 2020; 9(11): 3647.
30. WANG W e J WEI. Update understanding of the outbreak of 2019 novel coronavirus (2019 nCov) in Wuhan, China. J Med Virol, 2020; 92(4): 441-447.
31. WANG Y, et al. Electrocardiogram analysis of patients with different types of COVID-19. Ann Noninvasive Electrocardiol, 2020; 25(6): 12806.
32. WATSON JA, et al. Concentration-dependent mortality of chloroquine in overdose. Elife, 2020; 8: e58631.
33. WU TC, et al. QT Interval Control to Prevent Torsades de Pointes during Use of Hydroxychloroquine and/or Azithromycin in Patients with COVID-19. Arq Bras Cardiol, 2020; 114(6): 1061-1066.
34. XU H, et al. High expression of ACE2 receptor of 2019-nCov on the epithelial cells of oral mucosa. Int J Oral Sci, 2020; 12: 8.
35. YAO X, et al. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis, 2020; 71(15): 732-739.
36. ZEITLNGER M, et al. Phamacoknetics-pharmacodynamics of antiviral agents used to treat SARS-CoV-2 and their potential interaction with drugs and other supportive measures: a comprehensive review by the PK/PD f anti-infectives study Group of the European Society of antimicrobial agents, 2020; 59(10): 1195-1216.