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Delayed cardiac repolarization as a predictor of in-hospital mortality in patients with COVID-19

HeartFishbein J, Coleman KM, Bhullar A, et al. | February 14, 2022

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During the first wave of the pandemic, there was a rapid influx of COVID-19 admissions highlighting the necessity for an efficient and streamlined risk stratification tool to aid in triaging. Researchers herein sought for a clinical prediction tool for patients presenting to the hospital with COVID-19 infection.

  • In this retrospective cohort study, researchers assessed patients admitted in one of 13 Northwell Health Hospitals, located in the wider New York Metropolitan area between 1 March 2020 and 27 April 2020.

  • Among 7,098 patients, all-cause, in-hospital mortality of 27.1% was recorded. Following are the independent predictors of mortality: demographic characteristics (male gender, race and increased age), presenting vitals (oxygen saturation < 92% and heart rate > 120 bpm), metabolic panel values (serum lactate > 2.0 mmol/L, sodium > 145, mmol/L, blood urea nitrogen > 40 mmol/L, aspartate aminotransferase > 40 U/L, Creatinine > 1.3 mg/dL and glycose > 100 mg/L) and comorbidities (congestive heart failure, chronic obstructive pulmonary disease and coronary artery disease).

  • In addition to those, there appeared an independent correlation of delayed cardiac repolarization (QT corrected for heart rate (QTc) >500 ms) with mortality.

  • Incorporation of previously mentioned parameters was done into a risk score that precisely predicted in-hospital mortality.

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