Nikoo MH, Sadeghi A, Estedlal A, Fereidooni R, Dehdari Ebrahimi N, Maktabi A, Kamgar M, Mehran F, Mehdibeygi O, Esfandiari H, Taherinezhad Tayebi M, Heydari ST. Conduction system disorders and electrocardiographic findings in COVID-19 deceased patients in 2021, Shiraz, Iran. World J Cardiol 2022; 14(12): 617-625 [PMID: 36605421 DOI: 10.4330/wjc.v14.i12.617]
Corresponding Author of This Article
Seyed Taghi Heydari, PhD, Associate Professor, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz , Iran. heydari.st@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mohammad Hossein Nikoo, Haleh Esfandiari, Mohammadamir Taherinezhad Tayebi, Non-communicable Diseases Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
Alireza Sadeghi, Niloofar Dehdari Ebrahimi, Amirhossein Maktabi, Mahtab Kamgar, Fatemeh Mehran, Omid Mehdibeygi, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
Alireza Estedlal, Reza Fereidooni, Seyed Taghi Heydari, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Author contributions: Nikoo MH contributed to conceptualization, design, data curation, final edit and review, and project administration; Sadeghi A, Estedlal A, and Fereidooni R contributed to writing of the primary draft, final editing and review; Ebrahimi N, Maktabi A, Kamgar M, Mehran F, Mehdibeygi O, Esfandiari H, and Taherinezhad Tayebi M contributed to data collection; Heydari ST contributed to formal analysis and design; all the authors verify the data and are accountable for all aspects of the work.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Shiraz University of Medical Sciences (Approval No. IR.SUMS.MED.REC.1400.270).
Informed consent statement: The informed consent was waived from the patinets.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: Data are available for academic researchers via the research deputy of Shiraz Medical School (med_thesis@sums.ac.ir) upon reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Seyed Taghi Heydari, PhD, Associate Professor, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz , Iran. heydari.st@gmail.com
Received: September 5, 2022 Peer-review started: September 5, 2022 First decision: October 13, 2022 Revised: October 21, 2022 Accepted: October 31, 2022 Article in press: October 31, 2022 Published online: December 26, 2022 Processing time: 105 Days and 1.5 Hours
Abstract
BACKGROUND
Cardiac conduction disorders and electrocardiographic (ECG) changes may occur as a manifestation of coronavirus disease 2019 (COVID-19), especially in severe cases.
AIM
To describe conduction system disorders and their association with other electrocardiographic parameters in patients who died of COVID-19.
METHODS
In this cross-sectional study, electrocardiographic and clinical data of 432 patients who expired from COVID-19 between August 1st, 2021, and December 1st, 2021, in a tertiary hospital were reviewed.
RESULTS
Among 432 patients who died from COVID-19, atrioventricular block (AVB) was found in 40 (9.3%). Among these 40 patients, 28 (6.5%) suffered from 1st degree AVB, and 12 (2.8%) suffered from complete heart block (CHB). Changes in ST-T wave, compatible with myocardial infarction or localized myocarditis, appeared in 189 (59.0%). Findings compatible with myocardial injury, such as fragmented QRS and prolonged QTc, were found in 91 patients (21.1%) and 28 patients (6.5%), respectively. In patients who died of COVID-19, conduction disorder was unrelated to any underlying medical condition. Fragmented QRS, axis deviation, and ST-T changes were significantly related to conduction system disorder in patients who died of COVID-19 (P value < 0.05).
CONCLUSION
Conduction system disorders are associated with several other ECG abnormalities, especially those indicative of myocardial ischemia or inflammation. Most patients (73.14%) who died of COVID-19 demonstrated at least one ECG abnormality parameter. Since a COVID-19 patient's ECG gives important information regarding their cardiac health, our findings can help develop a risk stratification method for at-risk COVID-19 patients in future studies.
Core Tip: No study has yet transpired to assess the correlation of conduction system disorders with other electrocardiographic findings in the setting of coronavirus disease 2019 (COVID-19). This paper can shed light on different conduction disorders seen in COVID-19.
