The effect of the basal frontal QRS-T angle on disease severity and mortality in Covid-19 patients

Year 2023, Volume: 40 Issue: 3, 478 - 484, 30.09.2023

Gülçin Patmano , Bedri Caner Kaya , Mehmet Tercan , Tuğba Bingöl Tanrıverdi , Firdevs Tugba Bozkurt

Abstract

This study aimed to determine the relationship between the frontal QRS-T angle, the severity of the disease, and mortality, calculated with the ECG data taken during admission to the hospital. In this retrospective study, patients hospitalized in intensive care units and regular services with Covid-19 disease at Health Sciences University Mehmet Akif Inan Training and Research Hospital between April-September 2020 were included. Patients who were not given Covid-19 medication except for five days of Hydroxychloroquine (HC) and Azithromycin (AZ) with no cardiac disease history and daily taken ECGs were included in the study. A total of 135 patients were included in this study. While 45.9% of the patients received only HC treatment, 54.1% also received additional AZ treatment. It was observed that the frontal QRS-T angle was significantly longer in intensive care patients and intubated patients (p =<0.001). ROC curve analysis demonstrated that the best cut-off value for predicting mortality was 101.5o. The in-hospital mortality rate was significantly higher in patients with widened frontal QRS-T angle (p = 0.008). QRS widening, QTc prolongation, and QRS-T angle widening were substantially more frequent in intensive care patients (p=0.001,p<0.001, and p<0.001, respectively). Significantly QTc prolongation was observed more frequently in patients hospitalized in intensive care and followed up intubated (p<0.001 and p=0.003, respectively). The most common QTc prolongation time was on the 4th day of treatment in both groups (43.8% and 46.8%). Multivariate logistic regression analysis showed that frontal QRS-T angle ≥ 101.5o (OR: 7.08, 95%CI: 1.17-42.75, P = 0.033) was an independent predictor of mortality. The prolonged frontal QRS-T angle in Covid-19 patients increases the severity of the disease and mortality rates. The frontal QRS-T angle can be used to determine the prognosis of Covid-19 patients due to its advantages, such as easy evaluation and no extra costs.

Keywords

Covid-19 disease, QTc prolongation, mortality, frontal QRS-T angle

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