Fragmented QRS on surface electrocardiography as a predictor of cardiac mortality in patients with SARS-CoV-2 infection

Yildirim A., KARACA I. O., Yilmaz F. K., GÜNEŞ H. M., Cakal B.

Journal of Electrocardiology, vol.66, pp.108-112, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 66
  • Publication Date: 2021
  • Doi Number: 10.1016/j.jelectrocard.2021.03.001
  • Journal Name: Journal of Electrocardiology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.108-112
  • Keywords: COVID-19, SARS-CoV-2 infection, Electrocardiography, Fragmented QRS, Cardiac mortality
  • Istanbul Medipol University Affiliated: Yes


Aims: Although severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is mainly a respiratory system disease, recent studies reported that cardiac injury is associated with poor outcomes in this population. There are few studies which assessed standard electrocardiogram (ECG) as a prognostic tool during the course of SARS-CoV-2 infection. The aim of this study is to identify the relationship between of ECG parameters and prognosis of patients infected with SARS-CoV-2. Method and results: A total of 114 consecutive patients with a confirmed diagnosis of SARS-CoV-2 infection between March 2020 and May 2020 were included in the study. Standard 12‑lead surface ECG was reviewed for presence of fragmented QRS (fQRS), abnormal Q wave, T wave inversion, and duration of QRS. fQRS was observed in 36.8% (n = 42) of the patients who had SARS-CoV-2. Patient groups with and without fQRS did not differ in terms of age, gender, the presence of comorbid diseases and medical treatment. Hospitalization duration, intensive care unit(ICU) requirement, all-cause mortality, and cardiac mortality were found to be higher in patients with fQRS (all p values <0.05). There was a positive correlation between QRS duration and duration of hospital stay (p < 0.001, r = 0.421). QRS duration was also found to be associated with intensive care need, all-cause mortality, and cardiac mortality. Conclusion: Our data shows that QRS duration and the presence of fQRS on standard ECG can help to identify patients with worse clinical outcome admitted for SARS-CoV-2 infection.