Risk factors and electrocardiogram characteristics for mortality in critical inpatients with COVID-19.
BACKGROUND
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide.


HYPOTHESIS
The possible risk factors that lead to death in critical inpatients with coronavirus disease 2019 (COVID-19) are not yet fully understood.


METHODS
In this single-center, retrospective study, we enrolled 113 critical patients with COVID-19 from Renmin Hospital of Wuhan University between February 1, 2020 and March 15, 2020. Patients who survived or died were compared.


RESULTS
A total of 113 critical patients with COVID-19 were recruited; 50 (44.3%) died, and 63 (55.7%) recovered. The proportion of patients with ventricular arrhythmia was higher in the death group than in the recovery group (P = .021) and was higher among patients with myocardial damage than patients without myocardial damage (P = .013). Multivariate analysis confirmed independent predictors of mortality from COVID-19: age > 70 years (HR 1.84, 95% CI 1.03-3.28), initial neutrophil count over 6.5 × 109 /L (HR 3.43, 95% CI 1.84-6.40), C-reactive protein greater than 100 mg/L (HR 1.93, 95% CI 1.04-3.59), and lactate dehydrogenase over 300 U/L (HR 2.90, 95% CI 1.26-6.67). Immunoglobulin treatment (HR 0.39, 95% CI 0.21-0.73) can reduce the risk of death. Sinus tachycardia (HR 2.94, 95% CI 1.16-7.46) and ventricular arrhythmia (HR 2.79, 95% CI 1.11-7.04) were independent ECG risk factors for mortality from COVID-19.


CONCLUSIONS
Old age (>70 years), neutrophilia, C-reactive protein greater than 100 mg/L and lactate dehydrogenase over 300 U/L are high-risk factors for mortality in critical patients with COVID-19. Sinus tachycardia and ventricular arrhythmia are independent ECG risk factors for mortality from COVID-19.
['Li|Lingzhi|L|', 'Zhang|Shudi|S|', 'He|Bing|B|', 'Chen|Xiaobei|X|', 'Wang|Shihong|S|', 'Zhao|Qingyan|Q|https://orcid.org/0000-0002-9610-2452']
D000328:Adult D000368:Aged D002097:C-Reactive Protein D000086382:COVID-19 D016638:Critical Illness D004562:Electrocardiography D005260:Female D006801:Humans D007297:Inpatients D007958:Leukocyte Count D008297:Male D008875:Middle Aged D009504:Neutrophils D012189:Retrospective Studies D012307:Risk Factors D012720:Severity of Illness Index
risk factors mortality COVID-19 arrhythmia critical type