Potential of electrocardiogram contour analysis in predicting severe coronavirus disease 2019
https://doi.org/10.15829/17288800-2025-4376
EDN: TYAGQW
Abstract
Aim. To study the prognostic value of electrocardiogram (ECG) contour analysis parameters in patients with novel coronavirus infection (COronaVIrus Disease 2019, COVID-19).
Material and methods. A total of 110 people diagnosed with corona-virus disease 2019 (COVID-19) were included in the study. Paraclinical research data were studied as possible predictors of COVID-19 severity. Particular attention was paid to the characteristics of the P wave, QRS complex, and T wave areas in various ECG leads assessed upon admission of patients to the hospital. Statistical analysis was performed using Statistica 12, StatTech v. 4.7.1. Differences were considered significant at p<0,05.
Results. A prognostic model was developed to determine the probability of severe COVID-19. The following parameters were included in the model: QRS complex area in lead III, QRS complex area in lead AVF and the level of C-reactive protein upon admission to the hospital. The sensitivity and specificity of the resulting prognostic model were 71,4 and 94,7%, respectively.
Conclusion. To assess the ECG changes, a new technology should be used — contour analysis along with qualitative, semi-quantitative and quantitative methods for assessing the parameters.
About the Authors
E. O. Ryadnova
S.M. Kirov Military Medical Academy
Russian Federation
Russian Federation
Saint Petersburg
V. P. Kitsyshin
S.M. Kirov Military Medical Academy
Russian Federation
Russian Federation
Saint Petersburg
References
1. Townsend JP, Hassler HB, Lamb AD, et al. Seasonality of endemic COVID-19. mBio 2023;14:e0142623. doi:10.1128/mbio.01426-23.
2. Marchenko MD, Bezchastnova GS, Novikova YR. Assessment of the epidemiological situation and incidence of COVID-19 for the spring quarter of 2024 using the example of the regional perinatal center of the city of Vladivostok. Symbol of Science. 2025;103-7. (In Russ.)
3. Kutelev GG, Mirzoev NT, Ivanov VV, et al. Clinical case of the Novel Coronavirus Infection with the development of cardiovascular complications against the background of comorbid pathology. DoctorRu. 2022;21(6):25-8. (In Russ.) doi:10.31550/1727-2378-2022-21-6-25-28.
4. Mirzoev NT, Kutelev GG, Ivanov VV, et al. Changes of the electrical axis of the heart and dyslipidemia as possible markers of cardiovascular damage in patients after COVID-19. DoctorRu. 2023;22(2):15-20. (In Russ.) doi:10.31550/17272378-2023-22-2-15-20.
5. Ryabykina GV. ECG Changes in COVID-19 Infection. Kardiologiia. 2020;60(8):16-22. (In Russ.) doi:10.18087/cardio.2020.8.n1192.
6. Sugraliyev AB. Cardiac Involvement in COVID-19. Kardiologiia. 2021;61(4):15-23. (In Russ.) doi:10.18087/cardio.2021.4.n1408.
7. Podzolkov VI, Ishina TI, Medvedev ID, et al. Pulmonary hypertension and right ventricular dysfunction as predictors of severe coronavirus infection. Russian Journal of Cardiology. 2023;28(7): 5481. (In Russ.)
8. Haarmark C, Graff C, Andersen MP, et al. Reference values of electrocardiogram repolarization variables in a healthy population. J Electrocardiol. 2010;43:31-9. doi:10.1016/j.jelectrocard.2009.08.001.
9. Druzhilov MA, Kuznetsova TY. Epicardial adiposity as a predictor of COVID-19 severity in overweight and obese patients. Russian Journal of Cardiology. 2022;27(3):4850. (In Russ.) doi:10.15829/1560-4071-2022-4850.
10. Elias P, Poterucha TJ, Jain SS, et al. The Prognostic Value of Electrocardiogram at Presentation to Emergency Department in Patients With COVID-19. Mayo Clin Proc. 2020;95:2099-109. doi:10.1016/j.mayocp.2020.07.028.
11. 11. Sivri F, Özdemir B, Çelik MM, et al. Prognostic Value of T-wave Positivity in Lead aVR in COVID-19 Pneumonia. Rev Assoc Medica Bras. 1992 2022;68:882-7. doi:10.1590/1806-9282.20211096.
12. 12. Romero J, Gabr M, Diaz JC, et al. Electrocardiographic Featu res of Patients with COVID-19: An Updated Review. Card Electrophysiol Clin. 2022;14:63-70. doi:10.1016/j.ccep.2021.10.006.
13. 13. Long B, Brady WJ, Bridwell RE, et al. Electrocardiographic manifestations of COVID-19. Am J Emerg Med 2021;41:96-103. doi:10.1016/j.ajem.2020.12.060.
14. 14. Bratilova ES, Kachnov VA, Tyrenko VV. Electrocardiographic sings of cardiovascular system dysfunction in the context of various courses of COVID-19 in young and middle ages individuals. Herald of the Nortwestern state medical university n.a. I. I. Mechnikov 2024;16(1):41-50. (In Russ.) doi:10.17816/mechnikov625789.
15. Barman HA, Atici A, Alici G, et al. The effect of the severity COVID-19 infection on electrocardiography. Am J Emerg Med. 2021;46:317-22. doi:10.1016/j.ajem.2020.10.005.
16. Berns SA, Leontyeva MS, Tavlueva EV, et al. Features of the Course of Arterial Hypertension in the Era of the COVID-19 Pandemic: Common Pathogenetic Links Between Hypertension and SARSCoV-2. Kardiologiia. 2024;64(4):72-8. (In Russ.) doi:10.18087/cardio.2024.4.n2525.
17. Alareedh M, Nafakhi H, Shaghee F, et al. Electrocardiographic markers of increased risk of sudden cardiac death in patients with COVID-19 pneumonia. Ann Noninvasive Electrocardiol J Int Soc Holter Noninvasive Electrocardiol Inc. 2021;26:e12824. doi:10.1111/anec.12824.
18. Koc S, Bozkaya VO, Yikilgan AB. Electrocardiographic QRS axis shift, rotation and COVİD-19. Niger J Clin Pract. 2022;25:415-24. doi:10.4103/njcp.njcp_9_21.
Supplementary files
What is already known about the subject?
- Since the beginning of coronavirus disease 2019 (COVID-19) pandemic, the incidence of repolarization disorders in individuals >20 years of age has increased from 8,2% to 71%.
- Changes in ECG parameters in individuals with severe COVID-19 are more common than in patients with mild cases.
What might this study add?
- Contour analysis parameters vary significantly depending on the severity of COVID-19.
- QRS complex areas in leads III and aVF and C-reactive protein levels can be included in a model for predicting COVID-19 severity.
Review
For citations:
Ryadnova E.O., Kitsyshin V.P. Potential of electrocardiogram contour analysis in predicting severe coronavirus disease 2019. Cardiovascular Therapy and Prevention. 2025;24(7):4376. (In Russ.) https://doi.org/10.15829/17288800-2025-4376. EDN: TYAGQW
Views:
145
Email this article 
