%0 Journal Article
%T T-wave inversion as a manifestation of COVID-19 infection: a case series.
%A Romero J
%A Alviz I
%A Parides M
%A Diaz JC
%A Briceno D
%A Gabr M
%A Gamero M
%A Patel K
%A Braunstein ED
%A Purkayastha S
%A Polanco D
%A Valencia CR
%A Della Rocca D
%A Velasco A
%A Yang R
%A Tarantino N
%A Zhang XD
%A Mohanty S
%A Bello J
%A Natale A
%A Jorde UP
%A Garcia M
%A Di Biase L
%J J Interv Card Electrophysiol
%V 59
%N 3
%D Dec 2020
%M 33128658
%F 1.759
%R 10.1007/s10840-020-00896-7
%X OBJECTIVE: Cardiac involvement with COVID-19 infection has become evident by elevated troponin, cardiac arrhythmias, ST segment elevation, myocarditis, fulminant heart failure, and sudden cardiac death. We aimed to describe the association of COVID-19 and T-wave inversion (TWI) in a large case series.
METHODS: We conducted an observational, retrospective study of confirmed COVID-19 cases with at least one electrocardiogram (ECG) in a large hospital in New York City (March 23, 2020-April 23, 2020). Patients with new TWI or pseudonormalization were further analyzed. Mortality and the need for invasive mechanical ventilation were the main outcomes.
RESULTS: A total of 3225 patients were screened; 195 (6%) were selected for further analysis: 181 with TWI and 14 with T-wave pseudonormalization. Mean age was 66 ± 7 years; 51% were male. TWI were more commonly noted in the lateral (71%), followed by anterior (64%), inferior (57%), and septal (26%) leads. A total of 44 patients (23%) had elevated troponin. A total of 50 patients died (26%). Mortality rates of 35%, and 52% were observed in patients with diffuse TWI, and elevated troponin, respectively. Mortality rate of 80% was observed in patients with both elevated troponin and diffuse TWI. Additionally, 30% of the entire cohort and 58% of patients with elevated troponin required invasive mechanical ventilation.
CONCLUSIONS: Our study demonstrates that new TWI is a relatively common finding in COVID-19 patients. Importantly, our findings suggest that new TWI or T-wave pseudonormalization, particularly with elevated troponin, was associated with higher rates of mechanical ventilation and in-hospital mortality.