Delayed cardiac repolarization as a predictor of in-hospital mortality in patients with COVID-19
Heart — Fishbein J, Coleman KM, Bhullar A, et al. | February 14, 2022
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.