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QTc interval prolongation, inflammation, and mortality in patients with COVID-19.
J Interv Card Electrophysiol. 2021 Jul 22 [Online ahead of print]JI

Abstract

PURPOSE

Systemic inflammation has been associated with corrected QT (QTc) interval prolongation. The role of inflammation on QTc prolongation in COVID-19 patients was investigated.

METHODS

Patients with a laboratory-confirmed SARS-CoV-2 infection admitted to IRCCS San Raffaele Scientific Institute (Milan, Italy) between March 14, 2020, and March 30, 2020 were included. QTc-I was defined as the QTc interval by Bazett formula in the first ECG performed during the hospitalization, before any new drug treatment; QTc-II was the QTc in the ECG performed after the initiation of hydroxychloroquine drug treatment.

RESULTS

QTc-I was long in 45 patients (45%) and normal in 55 patients (55%). Patients with long QTc-I were older and more frequently males. C-Reactive protein (CRP) and white blood cell (WBC) count at hospitalization were higher in patients with long QTc-I and long QTc-II. QTc-I was significantly correlated with CRP levels at hospitalization. After a median follow-up of 83 days, 14 patients (14%) died. There were no deaths attributed to ventricular arrhythmias. Patients with long QTc-I and long QTc-II had a shorter survival, compared with normal QTc-I and QTc-II patients, respectively. In Cox multivariate analysis, independent predictors of mortality were age (HR = 1.1, CI 95% 1.04-1.18, p = 0.002) and CRP at ECG II (HR 1.1, CI 95% 1.0-1.1, p = 0.02).

CONCLUSIONS

QTc at hospitalization is a simple risk marker of mortality risk in COVID-19 patients and reflects the myocardial inflammatory status.

Authors+Show Affiliations

Arrhythmia Unit and Electrophysiology Laboratories, IRCCS San Raffaele Scientific Institute, Milan, Italy.Arrhythmia Unit and Electrophysiology Laboratories, IRCCS San Raffaele Scientific Institute, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.Arrhythmia Unit and Electrophysiology Laboratories, IRCCS San Raffaele Scientific Institute, Milan, Italy.Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. Cardiac Imaging Unit, Cardio-Thoracic Department, IRCCS San Raffaele Scientific Institute, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. Department of Hematology and Stem Cell Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy.IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.Arrhythmia Unit and Electrophysiology Laboratories, IRCCS San Raffaele Scientific Institute, Milan, Italy. pasqualevergara@hotmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34291390

Citation

Gulletta, Simone, et al. "QTc Interval Prolongation, Inflammation, and Mortality in Patients With COVID-19." Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing, 2021.
Gulletta S, Della Bella P, Pannone L, et al. QTc interval prolongation, inflammation, and mortality in patients with COVID-19. J Interv Card Electrophysiol. 2021.
Gulletta, S., Della Bella, P., Pannone, L., Falasconi, G., Cianfanelli, L., Altizio, S., Cinel, E., Da Prat, V., Napolano, A., D'Angelo, G., Brugliera, L., Agricola, E., Landoni, G., Tresoldi, M., Rovere, P. Q., Ciceri, F., Zangrillo, A., & Vergara, P. (2021). QTc interval prolongation, inflammation, and mortality in patients with COVID-19. Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing. https://doi.org/10.1007/s10840-021-01033-8
Gulletta S, et al. QTc Interval Prolongation, Inflammation, and Mortality in Patients With COVID-19. J Interv Card Electrophysiol. 2021 Jul 22; PubMed PMID: 34291390.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - QTc interval prolongation, inflammation, and mortality in patients with COVID-19. AU - Gulletta,Simone, AU - Della Bella,Paolo, AU - Pannone,Luigi, AU - Falasconi,Giulio, AU - Cianfanelli,Lorenzo, AU - Altizio,Savino, AU - Cinel,Elena, AU - Da Prat,Valentina, AU - Napolano,Antonio, AU - D'Angelo,Giuseppe, AU - Brugliera,Luigia, AU - Agricola,Eustachio, AU - Landoni,Giovanni, AU - Tresoldi,Moreno, AU - Rovere,Patrizia Querini, AU - Ciceri,Fabio, AU - Zangrillo,Alberto, AU - Vergara,Pasquale, Y1 - 2021/07/22/ PY - 2021/04/22/received PY - 2021/07/05/accepted PY - 2021/7/22/entrez PY - 2021/7/23/pubmed PY - 2021/7/23/medline KW - COVID-19 KW - Inflammation KW - QT interval KW - QTc KW - SARS-CoV-2 JF - Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing JO - J Interv Card Electrophysiol N2 - PURPOSE: Systemic inflammation has been associated with corrected QT (QTc) interval prolongation. The role of inflammation on QTc prolongation in COVID-19 patients was investigated. METHODS: Patients with a laboratory-confirmed SARS-CoV-2 infection admitted to IRCCS San Raffaele Scientific Institute (Milan, Italy) between March 14, 2020, and March 30, 2020 were included. QTc-I was defined as the QTc interval by Bazett formula in the first ECG performed during the hospitalization, before any new drug treatment; QTc-II was the QTc in the ECG performed after the initiation of hydroxychloroquine drug treatment. RESULTS: QTc-I was long in 45 patients (45%) and normal in 55 patients (55%). Patients with long QTc-I were older and more frequently males. C-Reactive protein (CRP) and white blood cell (WBC) count at hospitalization were higher in patients with long QTc-I and long QTc-II. QTc-I was significantly correlated with CRP levels at hospitalization. After a median follow-up of 83 days, 14 patients (14%) died. There were no deaths attributed to ventricular arrhythmias. Patients with long QTc-I and long QTc-II had a shorter survival, compared with normal QTc-I and QTc-II patients, respectively. In Cox multivariate analysis, independent predictors of mortality were age (HR = 1.1, CI 95% 1.04-1.18, p = 0.002) and CRP at ECG II (HR 1.1, CI 95% 1.0-1.1, p = 0.02). CONCLUSIONS: QTc at hospitalization is a simple risk marker of mortality risk in COVID-19 patients and reflects the myocardial inflammatory status. SN - 1572-8595 UR - https://www.unboundmedicine.com/medline/citation/34291390/QTc_interval_prolongation,_inflammation,_and_mortality_in_patients_with_COVID-19. L2 - https://doi.org/10.1007/s10840-021-01033-8 DB - PRIME DP - Unbound Medicine ER -
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