English Polski
Vol 17, No 1 (2022)
Review paper
Published online: 2022-02-28

open access

Page views 2190
Article views/downloads 221
Get Citation

Connect on Social Media

Connect on Social Media

Electrocardiographic changes in patients with COVID-19

Patryk Siedlecki1, Małgorzata Kurpesa1
Folia Cardiologica 2022;17(1):35-39.


Electrocardiography is one of the basic diagnostic tests performed in hospitalized coronavirus disease 2019 (COVID-19) patients. Due to its wide availability and low cost, it is useful in the initial evaluation of COVID-19 patients with a history of cardiovascular disease, and patients with suspected cardiovascular complications in the course of the infection. Electrocardiographic findings seen in COVID-19 patients may include P wave and atrioventricular conduction abnormalities, QRS complex alterations including their fragmentation, evidence of right ventricular overload, ST-T changes, and QTc interval prolongation. The most common cardiac arrhythmias are supraventricular arrhythmias, particularly atrial fibrillation.

Article available in PDF format

View PDF Download PDF file


  1. Medycyna Praktyczna [Internet]. Interna. Dodatkowe materiały. COVID-19 (choroba spowodowana przez SARS-CoV-2). 07.04.2021. https://www.mp.pl/interna/chapter/B01.XI.C.18.1 (7.06.2021).
  2. Long B, Brady WJ, Bridwell RE, et al. Electrocardiographic manifestations of COVID-19. Am J Emerg Med. 2021; 41: 96–103.
  3. Madjid M, Safavi-Naeini P, Solomon SD, et al. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol. 2020; 5(7): 831–840.
  4. Yenerçağ M, Arslan U, Şeker OO, et al. Evaluation of P-wave dispersion in patients with newly diagnosed coronavirus disease 2019. J Cardiovasc Med (Hagerstown). 2021; 22(3): 197–203.
  5. Amaratunga EA, Corwin DS, Moran L, et al. Bradycardia in patients with COVID-19: a calm before the storm? Cureus. 2020; 12(6): e8599.
  6. Babapoor-Farrokhran S, Batnyam U, Wiener PC, et al. Atrioventricular and sinus node dysfunction in stable COVID-19 patients. SN Compr Clin Med. 2020 [Epub ahead of print]: 1–4.
  7. Bertini M, Ferrari R, Guardigli G, et al. Electrocardiographic features of 431 consecutive, critically ill COVID-19 patients: an insight into the mechanisms of cardiac involvement. Europace. 2020; 22(12): 1848–1854.
  8. Abrams MP, Wan EY, Waase MP, et al. Clinical and cardiac characteristics of COVID-19 mortalities in a diverse New York City Cohort. J Cardiovasc Electrophysiol. 2020; 31(12): 3086–3096.
  9. Yildirim A, Karaca IO, Yilmaz FK, et al. Fragmented QRS on surface electrocardiography as a predictor of cardiac mortality in patients with SARS-CoV-2 infection. J Electrocardiol. 2021; 66: 108–112.
  10. Li Y, Liu T, Tse G, et al. Electrocardiograhic characteristics in patients with coronavirus infection: a single-center observational study. Ann Noninvasive Electrocardiol. 2020; 25(6): e12805.
  11. Angeli F, Spanevello A, De Ponti R, et al. Electrocardiographic features of patients with COVID-19 pneumonia. Eur J Intern Med. 2020; 78: 101–106.
  12. Wang Y, Chen L, Wang J, et al. Electrocardiogram analysis of patients with different types of COVID-19. Ann Noninvasive Electrocardiol. 2020; 25(6): e12806.
  13. World Health Organization. COVID-19 clinical management: living guidance 25 January 2021.
  14. Chen L, Feng Yi, Tang J, et al. Surface electrocardiographic characteristics in coronavirus disease 2019: repolarization abnormalities associated with cardiac involvement. ESC Heart Fail. 2020; 7(6): 4408–4415.
  15. Öztürk F, Karaduman M, Çoldur R, et al. Interpretation of arrhythmogenic effects of COVID-19 disease through ECG. Aging Male. 2020; 23(5): 1362–1365.
  16. van den Broek MPH, Möhlmann JE, Abeln BGS, et al. Chloroquine-induced QTc prolongation in COVID-19 patients. Neth Heart J. 2020; 28(7-8): 406–409.
  17. Carafoli E. Chloroquine and hydroxychloroquine in the prophylaxis and therapy of COVID-19 infection. Biochem Biophys Res Commun. 2021; 538: 156–162.
  18. Shah RR. Chloroquine and hydroxychloroquine for COVID-19: perspectives on their failure in repurposing. J Clin Pharm Ther. 2021; 46(1): 17–27.
  19. Bhatla A, Mayer MM, Adusumalli S, et al. COVID-19 and cardiac arrhythmias. Heart Rhythm. 2020; 17(9): 1439–1444.
  20. Coromilas EJ, Kochav S, Goldenthal I, et al. Worldwide survey of COVID-19-associated arrhythmias. Circ Arrhythm Electrophysiol. 2021; 14(3): e009458.
  21. Gopinathannair R, Merchant FM, Lakkireddy DR, et al. COVID-19 and cardiac arrhythmias: a global perspective on arrhythmia characteristics and management strategies. J Interv Card Electrophysiol. 2020; 59(2): 329–336.
  22. Kho J, Ioannou A, Van den Abbeele K, et al. Pulmonary embolism in COVID-19: Clinical characteristics and cardiac implications. Am J Emerg Med. 2020; 38(10): 2142–2146.
  23. Middeldorp S, Coppens M, van Haaps TF, et al. Incidence of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost. 2020; 18(8): 1995–2002.
  24. Avila J, Long B, Holladay D, et al. Thrombotic complications of COVID-19. Am J Emerg Med. 2021; 39: 213–218.