Background: Coronavirus disease 2019 (COVID-19) was recognized as an outbreak in December 2019. While the main symptoms and severe complications of COVID-19 involve the respiratory system, this disease can also result in cardiac complications including cardiac dysrhythmias. In the previous studies, several electrocardiographic patterns were associated with poor outcomes. However, there is still sparse data on electrocardiographic abnormalities and their prognostic outcomes in Thailand.

Objective: To describe the prevalence of electrocardiographic abnormalities of hospitalized COVID-19 infected patients in King Chulalongkorn Memorial Hospital and electrocardiographic patterns associated with in-hospital mortality.

Materials and Methods: The present study was a retrospective, single-center, observational study. The medical records of hospitalized symptomatic patients diagnosed with COVID-19 infection confirmed by RT-PCR between January 2020 and December 2021 were reviewed. Data from each electrocardiogram and in-hospital mortality of patients were collected. Patients without electrocardiograms and patients who had pacemakers were excluded. The primary outcome was the prevalence of electrocardiographic abnormalities. The secondary outcome was the abnormal electrocardiographic patterns associated with in-hospital mortality.

Results: There were 180 patients included in the present study with a mean age of 61.01±16.17 years, and 56% were male. From the present study, 154 patients (85.6%) had at least one abnormal electrocardiographic finding during admission. The most common abnormal electrocardiographic patterns were prolonged QT interval at 36.8%, tachycardia at 29.1%, ST depression at 23.4%, and pathologic Q wave at 19.5%. Thiry-three patients (18.3%) died during hospitalization, and electrocardiographic patterns associated with in-hospital mortality were tachycardia (OR 7.86, 95% CI 2.75 to 22.44, p<0.001), premature atrial complexes (OR 5.06, 95% CI 1.29 to 19.78, p=0.02), prolonged QTc interval (OR 4.71, 95% CI 1.6 to 13.9, p=0.005), and ST depression (OR 2.96, 95% CI 1.04 to 8.4, p=0.042). All deaths had at least one electrographic abnormality.

Conclusion: The prevalence of electrocardiographic abnormalities of hospitalized COVID-19 infected patients in King Chulalongkorn Memorial Hospital who had underwent 12-lead electrocardiogram was 85.6%. In addition, some electrocardiographic patterns were associated with in-hospital mortality.

Received 6 March 2024 | Revised 13 May 2024 | Accepted 14 May 2024

DOI: 10.35755/jmedassocthai.2024.8.14018