Effect of systemic inflammatory response syndrome on ventricular repolarization parameters in COVID-19 patients

Authors : Önder Bilge, Halil Akın, Ercan Taştan, Murat Çap, Ferhat Işık, Metin Okşul, Şafak Kaya, Burhan Aslan, Emrah Erdoğan, Mehmet Zülkif Karahan
Pages : 516-522
Doi:10.18663/tjcl.1721505
View : 22 | Download : 41
Publication Date : 2025-09-30
Article Type : Research Paper
Abstract :Aim: Malignant ventricular arrhythmia is a significant cause of mortality in COVID-19 patients. We aimed to investigate ventricular repolarization parameters that predict the risk of malignant ventricular arrhythmia in COVID-19 patients who developed systemic inflammatory response syndrome (SIRS). Material and Methods: Our study included 533 COVID-19 patients, divided into two groups: those who developed SIRS (n=197) and those without SIRS (n=336). ECG measurements were taken for QRS, QT, QTc, Tp-e intervals, Tp-e/QTc, Tp-e/QT, QT/QRS (Index of Cardiac Electrophysiological Balance, İCEB) and QTc/QRS (ICEBc), and these values were compared between groups. Results: The mean age of the study population was 62 years, and 49% (261) were female. The ICEBc was 5.1 for the SIRS group and 4.98 for the non-SIRS group (p=0.004). The QTc interval was 450 ms in the SIRS group and 427 ms in the non-SIRS group (p=0.001), indicating a substantially higher QTc interval in the SIRS group. Multivariable linear regression analysis revealed a significant correlation between ICEBc and SIRS, age, gender, and C-reactive protein (CRP). ROC analysis showed that ICEBc was a more significant predictor of in-hospital mortality than QTc (ICEBc: 64.5% sensitivity, 50.4% specificity; QTc: 56.4% sensitivity, 53.9% specificity). Conclusion: ICEBc and QTc were significantly higher in COVID-19 patients with SIRS compared to those without SIRS. ICEBc, known to be related to malignant arrhythmias on ECG in SIRS patients, may aid in predicting and preventing arrhythmic events. Additionally, ICEBc was found to be a better predictor of in-hospital mortality than QTc.
Keywords : ICEB, SIRS, COVID-19, ventriküler aritmiü

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