Relationship of Right and Left Bundle Branch Blocks to Mortality in COVID-19 Patients Hospitalized in the Intensive Care Unit: a Descriptive-Analytical Retrospective Study.

Abstract

Background: COVID-19, in addition to affecting the respiratory system, exerts an impact on various extrapulmonary organs, including the cardiovascular system. This influence may lead to hospitalization in the intensive care unit (ICU) and even mortality. This study aimed to investigate the relationship of right and left bundle branch blocks (RBBB and LBBB) to mortality in COVID-19 patients admitted to the ICU.

Methods: This descriptive-analytical retrospective study examined 650 COVID-19 patients hospitalized in the ICU of Sina Hospital in Hamadan, Iran, during the fifth peak of the pandemic. Patients were initially categorized into two groups. Data were collected using a researcher-designed checklist that included demographic and clinical information, such as age, gender, smoking history, underlying medical conditions, initial electrocardiogram findings on admission (specifically the presence of RBBB or LBBB) and final outcomes (survival or mortality). Data analysis was conducted using SPSS software, at a significance level of 0.05.

Results: Among the 650 COVID-19 patients with a mean age of 60.55 ± 17.22 years, 24 subjects had RBBB and 20, LBBB. Among the 161 subjects who did not survive, 11 (6.8%) had RBBB and six (3.7%) LBBB. A significant association between RBBB and mortality in COVID-19 patients was found (P=0.049). Right bundle branch blocks were also significantly associated with underlying medical conditions (P=0.034) and smoking history (P=0.031).

Conclusion: Electrocardiography (ECG) is a valuable tool in predicting the severity of COVID-19 and patient mortality. The presence of RBBB is associated with higher mortality rates in COVID-19 patients. Therefore, ECG can serve as a valuable diagnostic tool both upon admission and during hospitalization.