ArticleHeart rhythm2020
Behavior of the PR interval with increasing heart rate in patients with COVID-19.
Article in Heart rhythm, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Arrhythmias and electrocardiographic findings in Coronavirus disease 2019: A systematic review and meta-analysis.Pacing and clinical electrophysiology : PACE · 2021Pooled it
- QTc prolongation in COVID-19 patients treated with hydroxychloroquine, chloroquine, azithromycin, or lopinavir/ritonavir: A systematic review and meta-analysis.Pharmacoepidemiology and drug safety · 2021Pooled it
- Increased interleukin-6 levels are associated with atrioventricular conduction delay in severe COVID-19 patients.Journal of arrhythmia · 2024Article
- Clinical Characteristics and Comparative Proteomics Analysis of COVID-19-Related Atrioventricular Block.Reviews in cardiovascular medicine · 2024Article
- Complete Heart Block: A Case Report and Review of a Rare Manifestation of COVID-19.ARYA atherosclerosis · 2022Article
- Incidence of Atrioventricular Blocks and its Association with In-Hospital Mortality and Morbidity in Patients with Coronavirus Disease 2019.Journal of cardiology · 2022Article
- ECG-BiCoNet: An ECG-based pipeline for COVID-19 diagnosis using Bi-Layers of deep features integration.Computers in biology and medicine · 2022Article
- The mechanism underlying extrapulmonary complications of the coronavirus disease 2019 and its therapeutic implication.Signal transduction and targeted therapy · 2022Review
- Phenotypic heterogeneity of COVID-19 pneumonia: clinical and pathophysiological relevance of the vascular phenotype.ESC heart failure · 2022Review
- Unravelling Atrioventricular Block Risk in Inflammatory Diseases: Systemic Inflammation Acutely Delays Atrioventricular Conduction via a Cytokine-Mediated Inhibition of Connexin43 Expression.Journal of the American Heart Association · 2021Article
- Deep Learning Methods for Remote Heart Rate Measurement: A Review and Future Research Agenda.Sensors (Basel, Switzerland) · 2021Review
- Complete heart block in patients infected with SARS-CoV-2: A case series from a developing country.Annals of medicine and surgery (2012) · 2021Article
- Describing heart rate variability in patients with chronic atrial fibrillation during hospitalization for COVID-19.Journal of arrhythmia · 2021Article
- The Combination of Chest Computed Tomography and Standard Electrocardiogram Provides Prognostic Information and Pathophysiological Insights in COVID-19 Pneumonia.Journal of clinical medicine · 2021Article
- Electrocardiographic Changes in Children with Multisystem Inflammation Associated with COVID-19: Associated with Coronavirus Disease 2019.The Journal of pediatrics · 2021Article
- Classification of COVID-19 electrocardiograms by using hexaxial feature mapping and deep learning.BMC medical informatics and decision making · 2021Article
- Machine Learning Approach to Predicting COVID-19 Disease Severity Based on Clinical Blood Test Data: Statistical Analysis and Model Development.JMIR medical informatics · 2021Article
- A case of complete heart block in a COVID-19 infected patient.Journal of cardiology cases · 2021Article
- Electrocardiography in Early Diagnosis of Cardiovascular Complications of COVID-19; a Systematic Literature Review.Archives of academic emergency medicine · 2021Review
- Editorial commentary: Cardiac arrhythmias in the era of COVID-19 pandemic.Trends in cardiovascular medicine · 2020Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMyriad manifestations of cardiovascular involvement have been described in patients with coronavirus disease 2019 (COVID-19), but there have been no reports of COVID-19 affecting the cardiac conduction system. The PR interval on the electrocardiogram (ECG) normally shortens with increasing heart rate (HR). The case of a patient with COVID-19 manifesting Mobitz type 1 atrioventricular (AV) block that normalized as the patient's condition improved prompted us to investigate PR interval behavior in patients with COVID-19.
objectiveThe purpose of this study was to characterize PR interval behavior in hospitalized patients with COVID-19 and to correlate that behavior with clinical outcomes.
methodsThis study was a cross-sectional cohort analysis of confirmed COVID-19 cases (March 26, 2020, to April 25, 2020). We reviewed pre-COVID-19 and COVID-19 ECGs to characterize AV conduction by calculating the PR interval to HR (PR:HR) slope. Clinical endpoints were death or need for endotracheal intubation.
resultsECGs from 75 patients (246 pre-COVID-19 ECGs and 246 COVID-19 ECGs) were analyzed for PR:HR slope. Of these patients, 38 (50.7%) showed the expected PR interval shortening with increasing HR (negative PR:HR slope), whereas 37 (49.3%) showed either no change (8 with PR:HR slope = 0) or paradoxical PR interval prolongation (29 with positive PR:HR slope) with increasing HR. Patients without PR interval shortening were more likely to die (11/37 [29.7%] vs 3/38 [7.9%]; P = .019) or require endotracheal intubation (16/37 [43.2%] vs 8/38 [21.1%]; P = .05) compared to patients with PR interval shortening.
conclusionHalf of patients with COVID-19 showed abnormal PR interval behavior (paradoxical prolongation or lack of shortening) with increasing HR. This finding was associated with increased risk of death and need for endotracheal intubation.
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