Preprint Communication Version 1 Preserved in Portico This version is not peer-reviewed

Noninvasive Ambulatory Electrocardiographic Markers from Patients with COVID-19 Pneumonia: A Report of Three Cases

Motohiro Kimata
ORCID logo ,
Kenichi Hashimoto
* ORCID logo ,
Naomi Harada
,
Yusuke Kawamura
,
Yoshifumi Kimizuka
,
Yuji Fujikura
,
Mayuko Kaneko
,
Nobuaki Kiriu
,
Yasumasa Sekine
,
Natsumi Iwabuchi
,
Tetsuro Kiyozumi
,
Akihiko Kawana
,
Susumu Matukuma
,
Yuji Tanaka
Version 1 : Received: 13 March 2024 / Approved: 13 March 2024 / Online: 13 March 2024 (07:31:31 CET)

A peer-reviewed article of this Preprint also exists.

Kimata, M.; Hashimoto, K.; Harada, N.; Kawamura, Y.; Kimizuka, Y.; Fujikura, Y.; Kaneko, M.; Kiriu, N.; Sekine, Y.; Iwabuchi, N.; Kiyozumi, T.; Kawana, A.; Matsukuma, S.; Tanaka, Y. Noninvasive Ambulatory Electrocardiographic Markers from Patients with COVID-19 Pneumonia: A Report of Three Cases. Medicina 2024, 60, 655. Kimata, M.; Hashimoto, K.; Harada, N.; Kawamura, Y.; Kimizuka, Y.; Fujikura, Y.; Kaneko, M.; Kiriu, N.; Sekine, Y.; Iwabuchi, N.; Kiyozumi, T.; Kawana, A.; Matsukuma, S.; Tanaka, Y. Noninvasive Ambulatory Electrocardiographic Markers from Patients with COVID-19 Pneumonia: A Report of Three Cases. Medicina 2024, 60, 655.

Abstract

Coronavirus disease 2019 (COVID-19) has affected medical practice. More than 7,000,000 patients died worldwide after being infected with COVID-19; however, no specific laboratory markers have yet been established to predict death related to this disease. In contrast, electrocardiographic changes owing to COVID-19 include QT prolongation and ST-T changes; however, there have been no studies on ambulatory electrocardiographic markers of COVID-19. We encountered three patients diagnosed as having COVID-19 who did not have a prior history of significant structural heart diseases. All had abnormalities in ambulatory echocardiogram parameters detected by high-resolution 24-h electrocardiogram monitoring: positive late potentials (LPs) and T-wave alternans (TWA), abnormal heart rate variability (HRV), and heart rate turbulence (HRT). Case 1 involved a 78-year-old woman with a history of chronic kidney disease, Case 2 a 76-year-old man with hypertension and diabetes, and Case 3 a 67-year-old man with renal cancer, lung cancer, and diabetes. None of them had a prior history of significant structural heart disease. Although no significant consistent increases in clinical markers were observed, all three patients died, mainly because of respiratory failure with mild heart failure. LP, TWA, HRV, and HRT were all positive in three cases with no significant structural cardiac disease at the initial phase of admission. There is a possibility that LP, TWA, HRV, and HRT have the potential to be risk stratifiers of COVID-19 pneumonia in the early phase of admission. Further accumulation of data regarding ambulatory electrocardiographic markers in patients with COVID-19 is needed.

Keywords

ambulatory electrocardiographic markers; coronavirus disease-19; COVID-19; global cardiac ischemia; Holter electrocardiograph; myocardial remodeling; SARS-CoV-2; sudden cardiac death

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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