According to a new study from Mount Sinai, specific dynamic changes in the electrocardiogram (EKG) of hospitalized patients with COVID-19 or influenza help predict the time frame of deterioration in health and death. The study, published online September 24 in the American Journal of Cardiology, shows that the reduced waveforms in these tests can be used to help better identify high-risk patients and provide them with more active monitoring and treatment.
"Our research shows that during the course of the COVID-19 disease, the weakening of the waveform on the ECG can become an important tool for medical staff caring for these patients, enabling them to capture rapid clinical changes during hospitalization and intervene more quickly. As the number of COVID-19 cases and hospitalizations continues to rise, ECG may help hospitals use ECG to take care of these patients before their condition deteriorates sharply," said senior author Joshua Lampert, MD, a researcher in cardiac electrophysiology at Mount Sinai Hospital. "This is particularly useful in overwhelmed systems because there is no need to wait for blood tests to resume, and most healthcare professionals can perform this test. In addition, the ECG can be performed while other bedside patients are in care, eliminating the need for another healthcare provider. The potential risk of personnel exposure to COVID-19."
An electrocardiogram is a non-invasive test that records the electrical activity of the heart. It is widely used to diagnose cardiovascular disease and arrhythmia, or arrhythmia. Small patches called electrodes are placed on the arms, legs, and chest, and are connected by wires to a machine that converts electrical signals from the heart into waves.
Researchers retrospectively analyzed the electrocardiograms of 140 COVID-19 patients hospitalized in the Mount Sinai Health System in New York City from March 7 to April 12, 2020, and compared them with laboratory-confirmed influenza A Or flu patients’ 281 ECGs were compared. B was admitted to Mount Sinai Hospital from January 2, 2017 to January 5, 2020.
The researchers looked at three ECG time points for each patient: the baseline scan (which can be found in the records of Mount Sinai) taken within one year before the COVID-19 or flu hospitalization, the scans taken at admission, and the scans taken during this period Follow-up ECG examination. Hospitalized.
They manually measured the height of QRS waveforms on all electrocardiograms—a measure of the electrical activity of the ventricles and the main chambers of the heart; this change in electrical activity may be a sign of ventricular failure. The researchers analyzed the follow-up ECG after admission and analyzed the changes in the waveform according to a set of standards they developed called LoQRS Amplitude (LoQRS) to identify the contraction of the electrical signal on the ECG. LoQRS is defined as the QRS amplitude measured from the arms and legs is less than 5 mm or less than 10 mm when measured on the chest wall, and the waveform height at any position is relatively reduced by at least 50%.
The 52 COVID-19 patients in the study failed to survive, and analysis showed that 74% of them had LoQRS. Their ECG QRS waveform became smaller about 5.3 days after admission, and they died about two days after the first abnormal ECG was found.
Of the 281 flu patients studied, 11% had LoQRS found. Seventeen influenza patients died, and LoQRS was present in 39% of cases. Influenza patients meet the LoQRS standard with a median time of 55 days after admission, and the median time to death is 6 days from the discovery of LoQRS. Overall, these results indicate that compared with COVID-19 patients, influenza patients have a weaker course of disease.
“In caring for COVID-19 patients, our research results indicate that not only can healthcare providers check the ECG when the patient first arrives at the hospital, but also perform ECG follow-up during the hospital stay to assess for LoQRS, especially if the patient does not Achieve profound clinical progress. If LoQRS is present, the team may consider upgrading medications or transferring patients to a highly monitored environment, such as an intensive care unit (ICU), to deal with the decline in health," Dr. Lampert added.
About Mount Sinai Health System
The Mount Sinai Medical System is the largest academic medical system in New York City, including eight hospitals, a leading medical school, and a large network of outpatient clinics throughout the New York area. Mount Sinai promotes the development of medicine and health through unparalleled education and translational research and discovery to provide the safest, highest quality, most accessible and fair care, and the most valuable care in any health system in the country. The health system includes approximately 7,300 junior and specialist physicians; 13 joint-venture outpatient surgery centers; more than 415 outpatient treatments in five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health center. Mount Sinai Hospital ranks among the top 20 hospitals in the United States on the "Honor Roll" of U.S. News and World Report, and ranks first in the country: No. 1 in Geriatrics, Cardiology/Cardiac Surgery, Diabetes/Endocrinology, Stomach Top 20 in Enterology/Gastrointestinal Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Pulmonary Surgery, Rehabilitation and Urology. The Ophthalmology Department of Mount Sinai New York Eye and Ear Hospital ranked 12th. In the "Best Children's Hospital" by U.S. News and World Report, the Kravis Children's Hospital of Mount Sinai ranks among the best in four countries out of ten pediatric specialties. Icahn School of Medicine is one of the three medical schools that have won awards through multiple indicators: ranked in the top 20 in the "Best Medical Schools" by U.S. News and World Report, and tied with U.S. News and World Report's "Honour Roll" hospitals , Supported by the 14th National Institutes of Health in the country. Newsweek’s "Best Smart Hospital in the World" ranked Mount Sinai Hospital as the number one in New York and the top five in the world, and Mount Sinai Morningside Hospital in the top 20 in the world.
For more information, please visit https://www.mountsinai.org or find Mount Sinai on Facebook, Twitter and YouTube.
If you are a member of the media and before the deadline, please call the press office or call the press officer on call.
If you are a member of the media and before the deadline, please call the press office or call the press officer on call.