Risk factors and electrocardiogram characteristics for mortality in critical inpatients with COVID‐19

Li, Lingzhi; Zhang, Shudi; He, Bing; Chen, Xiaobei; Wang, Shihong; Zhao, Qingyan

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 × 10(9)/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.