新型冠状病毒肺炎患者的心电图对比分析

The analysis of electrocardiogram changes between admission and discharge in hospitalized inpatients with COVID-19

目的了解新型冠状病毒肺炎(COVID-19)住院患者入出院体表心电图变化情况。方法回顾性分析2020年1月20日至3月1日于武汉大学中南医院收治的147例COVID-19患者的体表心电图,观察入院心电图及相对应出院心电图的变化。结果共有COVID-19患者147例,其中轻型/普通型123例,重型/危重型24例。患者入院体表心电图异常率达60.5%,心律失常(40.8%)和ST-T改变(25.9%)是最常见的异常表现。心电图异常者出院时心电图好转率为20.2%,且轻型/普通型患者出院体表心电图好转率高于重型/危重型患者(22.5%vs. 11.1%,p=0.28),但无统计学差异。患者出院时新出现异常心电图的发生率为27.2%,重型/危重型患者新出现异常心电图的发生率显著高于轻型/普通型患者(54.2%vs. 22.0%,p<0.01)。结论新型冠状病毒肺炎患者入院体表心电图异常率较高,各型心律失常及ST-T改变是最常见的入院体表心电图异常表现。其中重型/危重型患者出院时新发心电图异常发生率较高,提示临床医生应密切关注重型/危重型患者心电图变化,预防不良心脏事件的发生。

Objective To evaluate the changes of surface electrocardiogram in hospitalized patients diagnosed with coronavirus disease 2019(COVID-19). Methods One hundred and forty-seven COVID-19 patients hospitalized in Zhongnan Hospital of Wuhan University from January 20, 2020 to March 1, 2020 were included. Surface electrocardiogram(ECG) were performed at admission and discharge and the changes of ECG were analyzed. Results There were 147 COVID-19 patients(24 in critical/severe group and 123 in mild/common group) finally included in this study. The incidence of abnormal ECG on admission was 60.5%, arrhythmias and ST-T change were the most frequent manifestations. The ECG improvement was seen in 20.2% of patients with 22.5% in the mild/common group than 11.1% in the critical/severe group(p=0.28). Moreover, the incidence of newly abnormal ECG was seen in 27.2%of patients with 54.2% in the critical/severe group and 22.0% in the mild/common group(p<0.01). Conclusions A high incidence of abnormal ECG is seen in hospitalized COVID-19 patients on admission and arrhythmias and ST-T change are the most frequent manifestations. The incidence of newly abnormal ECG in the critical/severe COVID-19 patients is relatively high, indicating close attention should be paid to the changes of ECG in the critical/severe COVID-19 patients to prevent adverse cardiac events.