Analysis of the dynamics of electrocardiograms of patients who died from COVID-19 on admission, during treatment in a hospital and before death


DOI: https://dx.doi.org/10.18565/therapy.2024.3.26-40

Saifutdinov R.G., Saifutdinov R.R., Saifutdinova T.V., Galyautdinova A.A., Muginova L.K., Galiullina G.F., Gilmullina R.R., Kutlubaeva A.R., Mardanshina V.F., Minnebaeva A.A., Murakaev T.R., Mukhametsyanova A.F., Nasyrova G.F., Trefilova Yu.S., Khamatshina M.R.

1) Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia; 2) City Clinical Hospital No. 12, Kazan; 3) City Clinical Hospital No. 18, Kazan
Abstract. In addition to damage of respiratory system, infection caused by SARS-CoV-2 is  accompanied by changes in cardiovascular system with electrocardiographic (ECG) declinations.
The aim: to study the ECGs of deceased COVID-19 patients upon admission, during hospital treatment and before death.
Material and methods. From 01.06.2020 to 01.06.2021, 2641 patient with COVID-19 was examined and treated in the temporary COVID hospital in Kazan. 122 of these patients (4.6%) died. 117 patients who died (4.4%) underwent ECG testing. All ECGs were analyzed by three independent specialists in electrocardiography. Heart rate, position of cardiac electrical axis, rhythm (sinus, atrial, atrioventricular, atrial fibrillation and flutter, ventricular), extrasystoles (supraventricular and ventricular), blocks (atrial, atrioventricular, bundle branches), acute myocardial infarction (AMI) and previous myocardial infarction, ST segment and T wave abnormalities and ischemic disorders were assessed.
Results. Patients with COVID-19 died more often with sinus tachycardia. Predominance of sinus bradycardia in such patients was not detected. Before death, both female and male patients had a decrease in the number of supraventricular (about 2 times) and ventricular extrasystoles (more than 3 times), as well as 1st degree atrioventricular blocks. Complete blockade of the left bundle branch was not found in any patient upon admission; incomplete blockade was found in only 1 male patient (it persisted even before death). The number of cases of incomplete block of the right bundle branch before death decreased in both females and males; the number of patients with complete block of the right bundle branch remained virtually unchanged. The cases of blockade of the anterior superior branch of the left bundle branch before death in females decreased, while in male patients this number remained the same as on admission. The number of patients with myocardial ischemia in the pre-death period among females increased by more than 2.5 times, among men this figure remained almost unchanged. Changes in the T wave were observed more often. AMI was not diagnosed in any patient upon admission, while before death it was recorded somewhat more often in female patients than in male ones.
Conclusion. COVID-19 occurs with ECG abnormalities. Therefore, it is important that doctors know them well and make adequate decisions.
Keywords: electrocardiographic abnormalities in case of COVID-19, deceased patients, SARS-CoV-2, COVID-19
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About the Autors

Rafik G. Saifutdinov, MD, Dr. Sci.(Medicine), professor, head of the Department of hospital and outpatient therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
E-mail: rgsbancorp@mail.ru
ORCID: https://orcid.org/0000-0003-2839-100X
Rinat R. Saifutdinov, MD, PhD (Medicine), associate professor of the Department of hospital and polyclinic therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia, head of the Department of therapy, City Clinical Hospital No. 12, Kazan. Address: 420012, Kazan, 36 Butlerova St.
E-mail: r_saifutdinov@mail.ru
Tatyana V. Saifutdinova, MD, assistant at the Department of therapy, geriatrics and family medicine, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
E-mail: saifutdinova_t@mail.ru
Alsu A. Galyautdinova, MD., doctor of the Functional Department, City Clinical Hospital No. 12, Kazan. Address: 420036, Kazan, 7 Lechebnaya St.
Laysan K. Muginova, MD, doctor of the Functional Department, City Clinical Hospital No. 12, Kazan. Address: 420036, Kazan, 7 Lechebnaya St.
Gulnara F. Galiullina, MD, clinical resident of the Department of hospital and polyclinic therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
E-mail: english-worker@mail.ru
Rania R. Gilmullina, MD, clinical resident of the Department of hospital and polyclinic therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
E-mail: kalinino10@gmail.com
Anastasia R. Kutlubaeva, MD, clinical resident of the Department of hospital and polyclinic therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
E-mail: Nastyakutlubaeva@mail.ru
Veronika F. Mardanshina, MD, clinical resident of the Department of hospital and polyclinic therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
E-mail: 2010_semya@mail.ru
Adelya A. Minnebaeva, MD, clinical resident of the Department of hospital and polyclinic therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
Timur R. Murakaev, MD, clinical resident of the Department of hospital and polyclinic therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
E-mail: murakaevafarida@yandex.ru
Nailya A. Mukhametzyanova, MD, PhD (Medicine), head of the Functional Department, City Clinical Hospital No. 18, Kazan. Address: 420101, Kazan, 2 Kh. Mavlyutova St.
E-mail: Gb18ofdzav@mail.ru
Gulnara F. Nasyrova, MD, clinical resident of the Department of hospital and polyclinic therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
E-mail: khasanshina.gulnara@yandex.ru
Yulia S. Trefilova, MD, clinical resident of the Department of hospital and polyclinic therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
E-mail: uliyatrefilova@gmail.com
Milyausha R. Khamatshina, MD, clinical resident of the Department of hospital and polyclinic therapy, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova St.
E-mail: milyaushaa2500@mail.ru


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