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Diagnostic utility of electrocardiogram for screening of cardiac injury on cardiac magnetic resonance in post-hospitalised COVID-19 patients: a prospective multicenter study

Samat AHA 1 , Cassar MP 2 , Akhtar AM 2 , McCracken C 3 , Ashkir ZM 2 , Mills R 2 Show all authors , Moss AJ 4 , Finnigan LEM 3 , Lewandowski AJ 2 , Mahmod M 2 , Ogbole GI 5 , Tunnicliffe EM 2 , Lukaschuk E 3 , Piechnik SK 3 , Ferreira VM 2 , Nikolaidou C 2 , Rahman NM 6 , Ho LP 2 , Harris VC 4 , Singapuri A 4 , Manisty C 7 , O'Regan DP 8 , Weir-McCall JR 9 , Steeds RP 10 , Llm KP 11 , Cuthbertson DJ 12 , Kemp GJ 12 , Horsley A 13 , Miller CA 13 , O'Brien C 14 , Chiribiri A 14 , Francis ST 15 , Chalmers JD 16 , Plein S 17 , Poener AM 17 , Wild JM 18 , Treibel TA 19 , Marks M 20 , Toshner M 21 , Wain LV 22 , Evans RA 4 , Brightling CE 4 , Neubauer S 2 , McCann GP 4 , Raman B 23 , PHOSP-COVID Collaborative group

Affiliations 

  • 1 Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK; Department of Emergency Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • 2 Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK
  • 3 University of Oxford, Oxford, UK
  • 4 University Hospitals of Leicester NHS Trust & University of Leicester, Leicester, UK
  • 5 University of Oxford, Oxford, UK; Department of Radiology, University of Ibadan, Nigeria
  • 6 Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK; Oxford NIHR Biomedical Research Center, Oxford, UK; Oxford Chinese Academy of Medicine Institute, Oxford, UK
  • 7 Barts Health NHS Trust, London, UK
  • 8 MRC London Institute of Medical Sciences, Imperial College London, UK
  • 9 Royal Papworth Hospital, Cambridge, UK; Cambridge NIHR BRC and the NIHR Cambridge Clinical Research Facility, Cambridge, UK
  • 10 University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  • 11 Asthma UK and British Lung Foundation Partnership, UK
  • 12 University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
  • 13 Manchester University NHS Foundation Trust & University of Manchester, Manchester, UK
  • 14 King's College London, Guy's & St Thomas' NHS Foundation Trust, London, UK
  • 15 University of Nottingham, Nottingham, UK
  • 16 NHS Tayside & University of Dundee, Dundee, UK
  • 17 University of Leeds & Leeds Teaching Hospitals, Leeds, UK
  • 18 Sheffield Teaching Hospitals, University of Sheffield, Leicester, UK
  • 19 University College London NHS Foundation Trust, London, UK
  • 20 University College London NHS Foundation Trust, London, UK; London School of Hygiene & Tropical Medicine, London, UK
  • 21 Heart and Lung Research Institute, Dept of Medicine, Cambridge, UK; Cambridge NIHR BRC and the NIHR Cambridge Clinical Research Facility, Cambridge, UK
  • 22 Department of Population Health Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Center, Leicester, UK
  • 23 Oxford University Hospitals NHS Foundation Trust & University of Oxford, Oxford, UK. Electronic address: Betty.raman@cardiov.ox.ac.uk
Int J Cardiol, 2024 Nov 15;415:132415.
PMID: 39127146 DOI: 10.1016/j.ijcard.2024.132415

Abstract

BACKGROUND: The role of ECG in ruling out myocardial complications on cardiac magnetic resonance (CMR) is unclear. We examined the clinical utility of ECG in screening for cardiac abnormalities on CMR among post-hospitalised COVID-19 patients.

METHODS: Post-hospitalised patients (n = 212) and age, sex and comorbidity-matched controls (n = 38) underwent CMR and 12‑lead ECG in a prospective multicenter follow-up study. Participants were screened for routinely reported ECG abnormalities, including arrhythmia, conduction and R wave abnormalities and ST-T changes (excluding repolarisation intervals). Quantitative repolarisation analyses included corrected QT (QTc), corrected QT dispersion (QTc disp), corrected JT (JTc) and corrected T peak-end (cTPe) intervals.

RESULTS: At a median of 5.6 months, patients had a higher burden of ECG abnormalities (72.2% vs controls 42.1%, p = 0.001) and lower LVEF but a comparable cumulative burden of CMR abnormalities than controls. Patients with CMR abnormalities had more ECG abnormalities and longer repolarisation intervals than those with normal CMR and controls (82% vs 69% vs 42%, p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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