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Study: EKG may predict life-threatening illness in hospitalized COVID-19 patients

Study: EKG may predict life-threatening illness in hospitalized COVID-19 patients
Changes in EKG readings of hospitalized COVID-19 patients may be a predictor of life-threatening illness, according to a new study. File photo by Debbie Hill/UPI | License Photo

Sept. 24 (UPI) -- Changes in heart function observed on electrocardiograms of patients hospitalized with COVID-19 or influenza can help predict a time frame for worsening health, a study published Friday by the American Journal of Cardiology said.

Of the 52 COVID-19 patients in the study who died from the virus, 74% had evidence of a reduced electrical signal from the heart on an electrocardiogram, the data showed.

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Seven of the 17 patients who died from influenza in the study had similar results on EKGs, the researchers said.

The findings suggest that "shrinking waveforms" on EKGs, which indicate reduced electrical signals from the heart, could be used to help better identify high-risk patients and provide them more aggressive monitoring and treatment, they said.

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"With COVID-19 cases and hospitalizations continuing to rise, EKGs may be helpful for hospitals to use when caring for these patients before their condition gets dramatically worse," study co-author Dr. Joshua Lampert said in a press release.

"EKG can be done at the time of other bedside patient care, eliminating the potential exposure of another healthcare worker to COVID-19," said Lampert, a fellow in cardiac electrophysiology at Mount Sinai Hospital in New York City.

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Inflammation caused by COVID-19 can affect the heart in some people who develop serious illness, and a study published in July found that the virus can impact a person's heart rate for up to 30 days after the onset of symptoms.

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An EKG is a noninvasive test that records the electrical activity of the heart and typically is used to diagnose heart disease or irregular heartbeats, according to the researchers.

For this study, Lampert and his colleagues analyzed the EKG results for 140 patients hospitalized with COVID-19 across the Mount Sinai Health System in New York City between March 7 and April 12, 2020.

They compared the EKG findings of the COVID-19 patients to those of 281 people with seasonal influenza hospitalized between Jan. 2, 2017, and Jan. 5, 2020.

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Three EKG measurements were evaluated for each patient, with the first being recorded within one year before COVID-19 or influenza hospitalization -- and available in Mount Sinai's records for use as a baseline -- and the second and third conducted at hospital admission and during hospitalization.

The researchers manually measured waveform height, or the lines that record the electrical activity of the heart ventricles, for heart, on all the EKG, they said.

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Fifty-two COVID-19 patients in the study did not survive, and 38 of them had evidence of reduced heart electrical activity, the data showed.

The changes first were noted about five days into their hospital stays, on average, and they died about two days after the first abnormal EKG, the researchers said.

Of the 281 influenza patients, 17 died and seven of them showed signs of reduced heart electrical activity on an EKG, according to the researchers.

These changes were noted about 50 days into their hospital stays, on average, and they died about six days after these EKG results, the data showed.

"Our findings suggest it may be beneficial not only for healthcare providers to check an EKG when [a COVID-19] patient first arrives at the hospital, but also follow-up EKGs during their hospital stay," Lampert said.

If there is evidence of reduced electrical activity in the heart, "escalating medical therapy or transferring the patient to a highly monitored setting" might be warranted, he said.

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