Background
Different patterns of cardiac involvement have been described in patients with COVID-19 infection, including myocarditis, ST-elevations, T-wave inversions (TWI), elevated troponins, and sudden cardiac death.
Objective
We aimed to compare outcomes of patients admitted with COVID-19 and presenting with TWI to patients without this ECG finding.
Methods
A propensity score-matched analysis using a retrospective database of patients admitted with COVID-19 at an urban medical center from March 2020 to June 2020 was performed to assess outcomes in patients with new TWI compared to controls without new TWI. Patients were matched based on baseline comorbidities.
Results
2681 patients with COVID-19 infection were included in our analysis, 164 with new TWI and 2517 with no TWI. A 1:1 PSM matching was performed and yielded 159 patients in each group. TWIs were associated with a higher incidence of intubation and mechanical ventilation (31.1% vs 20.1%, HR 1.676, p=0.001). Moreover, patients with TWI were more likely to require vasopressors (27.4% vs 18.2%, p=0.003), and the average length of hospital stay was noted to be longer in patients with TWI (8.5 days vs 5 days in patients without TWI). However, there was no difference in mortality in the presence of TWI (HR=1.102, p=0.64).
Conclusion
Our study demonstrates that new TWIs were associated with higher rates of mechanical ventilation and vasopressor utilization in patients with COVID-19 infection. However, this finding is not associated with significantly increased mortality compared to controls without this new ECG finding. Further studies are needed to complement these findings.
