Manifestaciones electrocardiográficas en pacientes con COVID 19 en un hospital de segundo nivel

• Autores: Jonathan Rene Ramírez Macias, Ana Georgina Bautista Cortés, Royer Dolores Martínez
• Localización: Revista Sanitaria de Investigación, ISSN-e 2660-7085, Vol. 5, Nº. 11, 2024
• Idioma: español
• DOI: 10.34896/RSI.2024.38.97.002
• Enlaces
  • Texto completo
• Resumen
  • español

    Antecedentes: La pandemia de COVID19, destacó por su florida sintomatología cardiaca, a nivel global las arritmias cardíacas se reportaron en casi el 17% de los pacientes con COVID19, siendo las más comunes: fibrilación auricular, flutter auricular, taquicardia supraventricular, taquicardia ventricular/fibrilación y bloqueo auriculoventricular.

    Objetivo: Determinar las manifestaciones electrocardiográficas en pacientes con COVID19 en un hospital de segundo nivel Material y Método: Estudio transversal, descriptivo, retrolectivo y analítico de marzo 2021 a diciembre 2022, de acuerdo con criterios de inclusión, se analizaron 223 expedientes, se recopilaron datos en relación con las variables: Tipo de arritmia: taquiarritmias, bradiarritmias, y otros cambios electrocardiográficos: onda P, segmento PR, QRS, punto J, QTc, segmento ST y onda T; comorbilidades, uso de proarrítmicos y severidad de COVID19. Las variables cualitativas se expresaron en frecuencias y porcentajes mediante figuras y tablas. La estadística inferencial se realizó mediante la prueba de x2.

    Resultados: De los 223 expedientes analizados se encontró 26 pacientes (11.65%) con bradiarritmias, 76 (34.08%) con taquiarritmias, y 121 (54.26%) con otras manifestaciones electrocardiográficas. La taquiarritmia más frecuente fue Fibrilación auricular 28 (12.55%). La edad más común fue 61-70 años 44 (19.73%), sexo predominante: hombres 120 (53.81%). Los proarrítmicos más comunes: antibióticos 160 (71.74%). Otros hallazgos encontrados fueron: Onda P 51 (22.86%), Intervalo PR 99 (44.39%), QRS 61 (27.35%), Punto J 24 (10.76%). Segmento ST 53 (23.76%), QTc 100 (44.84%), Onda T 44 (19.83%); La comorbilidad más frecuente fue hipertensión arterial 122 (54.70%).

    Conclusión: Se encontró a la Fibrilación auricular presente en 28 (12.55%) pacientes, sin embargo, la alteración electrocardiográfica más frecuentemente encontrada fue QTc largo en 92 pacientes (41.25%). El proarrítmico más común fueron los antibióticos, asociándose azitromicina y claritromicina a taquiarritmias con un valor de p= 0.61.

  • English

    Background: The COVID19 pandemic stood out for its florid cardiac symptoms. Globally, cardiac arrhythmias were reported in almost 17% of patients with COVID19, the most common being: atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia. fibrillation and atrioventricular block.

    Objective: Determine the electrocardiographic manifestations in patients with COVID19 in a second level hospital.

    Material and Methods: Cross-sectional, descriptive, retrolective and analytical study from March 2021 to December 2022, according to inclusion criteria, 223 files were analyzed, data was collected in relation to the variables: Type of arrhythmia: tachyarrhythmias, bradyarrhythmias, and others electrocardiographic changes: P wave, PR segment, QRS, J point, QTc, ST segment and T wave; comorbidities, use of proarrhythmics and severity of COVID19. Qualitative variables were expressed in frequencies and percentages using figures and tables. Inferential statistics were performed using the x2 test.

    Results: Of the 223 records analyzed, 26 patients (11.65%) were found with bradyarrhythmias, 76 (34.08%) with tachyarrhythmias, and 121 (54.26%) with other electrocardiographic manifestations. The most common tachyarrhythmia was atrial fibrillation 28 (12.55%). The most common age was 61-70 years 44 (19.73%), predominant sex: men 120 (53.81%). The most common proarrhythmics: antibiotics 160 (71.74%). Other findings found were: P wave 51 (22.86%), PR interval 99 (44.39%), QRS 61 (27.35%), J point 24 (10.76%). ST segment 53 (23.76%), QTc 100 (44.84%), T wave 44 (19.83%); The most frequent comorbidity was arterial hypertension 122 (54.70%).

    Conclusion: Atrial fibrillation was found present in 28 (12.55%) patients, however, the most frequently found electrocardiographic alteration was long QTc in 92 patients (41.25%). The most common proarrhythmic was antibiotics, with azithromycin and clarithromycin being associated with tachyarrhythmias with a value of p = 0.61.

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