Alterações eletrocardiográficas nos pacientes portadores da COVID-19
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Apr 15, 2023
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Resumo
Objetivo: Reconhecer as alterações no eletrocardiograma nos pacientes portadores da COVID-19. Métodos: Trata-se de uma revisão integrativa de literatura em que foi realizado uma busca por trabalhos nas plataformas PubMed, Medline e DOAJ e um total de 25 artigos foram incluídos no trabalho científico após a aplicação dos critérios de inclusão e exclusão. Resultados: Por meio dos estudos realizados foram observados que as principais alterações nos ECG dos enfermos foi a alteração do segmento ST, alargamento do complexo QRS, inversão da onda T, e alargamento do intervalo QTc, essas alterações estão relacionadas com o alto risco de arritmias. Além disso, o processo fisiopatológico está associado com o uso de medicamentos administrados, inflamação do próprio vírus e da resposta exacerbada do organismo na liberação de citocinas. Considerações finais: Em consideração, essas variações eletrocardiográficas são decorrentes da terapia medicamentosa instaurada, excesso de citocinas e inflamação direta do vírus, essas alterações implicam diretamente no prognóstico de cada paciente.
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Como Citar
VieiraE. A., & VilagraS. M. B. W. (2023). Alterações eletrocardiográficas nos pacientes portadores da COVID-19. Revista Eletrônica Acervo Médico, 23(4), e12263. https://doi.org/10.25248/reamed.e12263.2023
Seção
Revisão Bibliográfica
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Referências
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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.
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.