Comparison of Prone Position and Standard Electrocardiogram in COVID-19 Patients

Study Overview
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Brief Summary
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Prolonged prone position ventilation reduces the 30-day mortality in acute respiratory distress syndrome (ARDS) and in COVID-19 infection. A large number of patients with COVID-19 suffered from new-onset cardiac disease, therefore, ECG is crucial. However, there is limited data on the effects of prone position on the ECG in COVID-19 patients.

Detailed Description
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Prolonged prone position ventilation reduces the 30-day mortality in acute respiratory distress syndrome (ARDS) and in COVID-19 infection. The evidence showed that a large number of patients with COVID-19 suffered from new-onset cardiac disease due to inflammatory processes or cytokine storm, therefore, ECG is crucial for making the diagnosis including arrhythmias and myocardial infarction. However, there is limited data on the effects of prone position on the ECG in COVID-19 patients. Therefore, we aimed to identify differences of electrical parameters between prone position and standard ECG including the difference in amplitude and duration of P, QRS, PR interval, QT interval, ST-segment between both positions (supine and prone). Furthermore, we aimed to compare clinical diagnosis from EKG between prone position and standard ECG by the cardiologists.

Official Title
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Comparison of Prone Position and Standard Electrocardiogram in COVID-19 Patients: A Prospective Study in Specialized COVID-19

Conditions
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COVID-19 Acute Respiratory Distress Syndrome, Cardiovascular Diseases, Arrhythmias, Cardiac

Intervention / Treatment
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* Diagnostic Test: electrocardiogram


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: COVID-19 patients who were admitted to the COVID-19 specialized ward Age 18 -80 years old Suffered from pulmonary infiltration Exclusion Criteria: Intubated patients Cardiac arrest patients whether at presentation or during the study period ECG cannot be performed due to anatomical defects or superficial skin problems

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: electrocardiogram|Prone position electrocardiogram|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The change of P wave amplitude | The relative changes in P-wave amplitudes with different body positions were evaluated by dividing the 12-lead ECG into subregions (I, aVL: lateral limb leads; II, III, and aVF: inferior leads; V1 to V3: anterior precordial leads; V4 to V6: lateral precordial leads). | The first day of admission | 
| The change of QRS-complex amplitude | The relative changes in QRS-complex amplitudes with different body positions were evaluated by dividing the 12-lead ECG into subregions (I, aVL: lateral limb leads; II, III, and aVF: inferior leads; V1 to V3: anterior precordial leads; V4 to V6: lateral precordial leads). | The first day of admission | 
| The change of T wave amplitude | The relative changes in T wave amplitudes with different body positions were evaluated by dividing the 12-lead ECG into subregions (I, aVL: lateral limb leads; II, III, and aVF: inferior leads; V1 to V3: anterior precordial leads; V4 to V6: lateral precordial leads). | The first day of admission | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnosis | The EKG diagnosis from prone position and standard supine position which perform in the same time, in the same patient, by a cardiologist will be compared. | The first day of admission. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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COVID-19, electrocardiogram, ARDS, Prone position