PLoS ONE (Jan 2021)

J-waves in acute COVID-19: A novel disease characteristic and predictor of mortality?

  • Naufal Shamilevich Zagidullin,
  • Lukas J Motloch,
  • Timur Ilgamovich Musin,
  • Zilya Adibovna Bagmanova,
  • Irina Alexandrovna Lakman,
  • Anton Viktorovich Tyurin,
  • Ruslan Mansurovich Gumerov,
  • Dinar Enikeev,
  • Benzhi Cai,
  • Diana Firdavisovna Gareeva,
  • Paruir Artakovich Davtyan,
  • Damir Aidarovich Gareev,
  • Halima Malikovna Talipova,
  • Marat Rifkatovich Badykov,
  • Peter Jirak,
  • Kristen Kopp,
  • Uta C Hoppe,
  • Rudin Pistulli,
  • Valentin Nikolaevich Pavlov

DOI
https://doi.org/10.1371/journal.pone.0257982
Journal volume & issue
Vol. 16, no. 10
p. e0257982

Abstract

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BackgroundJ-waves represent a common finding in routine ECGs (5-6%) and are closely linked to ventricular tachycardias. While arrhythmias and non-specific ECG alterations are a frequent finding in COVID-19, an analysis of J-wave incidence in acute COVID-19 is lacking.MethodsA total of 386 patients consecutively, hospitalized due to acute COVID-19 pneumonia were included in this retrospective analysis. Admission ECGs were analyzed, screened for J-waves and correlated to clinical characteristics and 28-day mortality.ResultsJ-waves were present in 12.2% of patients. Factors associated with the presence of J-waves were old age, female sex, a history of stroke and/or heart failure, high CRP levels as well as a high BMI. Mortality rates were significantly higher in patients with J-waves in the admission ECG compared to the non-J-wave cohort (J-wave: 14.9% vs. non-J-wave 3.8%, p = 0.001). After adjusting for confounders using a multivariable cox regression model, the incidence of J-waves was an independent predictor of mortality at 28-days (OR 2.76 95% CI: 1.15-6.63; p = 0.023). J-waves disappeared or declined in 36.4% of COVID-19 survivors with available ECGs for 6-8 months follow-up.ConclusionJ-waves are frequently and often transiently found in the admission ECG of patients hospitalized with acute COVID-19. Furthermore, they seem to be an independent predictor of 28-day mortality.