2026 年第 6 期 第 21 卷

新型冠状病毒感染对心血管门诊就诊人群心电图的影响

Effects of novel coronavirus infection on electrocardiogram in patients attending cardiovascular outpatient clinic

作者：殷荣荣1李刚2王熙1韩智红1任学军1

英文作者：Yin Rongrong1 Li Gang2 Wang Xi1 Han Zhihong1 Ren Xuejun1

单位：1首都医科大学附属北京安贞医院心脏起搏与CIED中心，北京100029；2首都医科大学附属北京安贞医院小儿心脏中心，北京100029

英文单位：1Cardiac Pacing and CIED Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Pediatric Cardiac Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：新型冠状病毒感染；心电图；心血管门诊

英文关键词：Novelcoronavirusinfection;Electrocardiogram;Cardiovascularoutpatientclinic

• 摘要：

• 目的 探索新型冠状病毒感染与心电图异常之间的关系，为新型冠状病毒相关心肌损伤的早期诊断和治疗提供依据。方法 采用回顾性平行对照研究设计，分别连续入选2021年12月7—14日就诊于首都医科大学附属北京安贞医院门诊，行心电图检查且未感染新型冠状病毒的患者(未感染组，1 801例)和2022年12月7—14日就诊于首都医科大学附属北京安贞医院门诊，行心电图检查且感染过新型冠状病毒的患者(感染组，631例)。比较2组患者心电图指标的差异，包括P波、QRS波等一般心电图指标、心电图诊断；并对是否存在心律失常进行亚组分析。结果 感染组和未感染组年龄、性别比较差异均无统计学意义（均P＞0.05）。感染组P波时限、PR间期、QRS时限、QT间期和QTc间期均较未感染组增宽(均P＜0.05)。感染组窦性心律占比较低［74.3%(469/631)比80.5%(1 449/1 801)］(P＜0.05)，而窦性心动过速和心房颤动占比较高［7.0%(44/631)比3.8%(69/1 801)、6.2%(39/631)比3.9%(70/1 801)］(均P＜0.05)。亚组分析显示窦性心律患者中，感染者的P波时限、PR间期、QRS时限和QTc间期明显长于未感染者(P＜0.05)；心律失常亚组患者中，感染者平均心率显著高于未感染者(P＜0.05)。结论 新型冠状病毒感染会对心电图造成显著但相对温和的异常，包括传导间期轻度延长，以及QTc间期略增宽和心房颤动等心律失常增加。

• Objective To explore the relationship between novel coronavirus infection (COVID-19) and electrocardiographic abnormalities, so as to provide evidence for the early diagnosis and treatment of COVID-19-related myocardial injury. Methods A retrospective parallel controlled study was conducted. A total of 1 801 outpatients who underwent electrocardiography without COVID-19 admitted to Beijing Anzhen Hospital, Capital Medical University from December 7 to December 14, 2021 were enrolled as the non-infected group, and 631 outpatients with confirmed COVID-19 receiving electrocardiographic examination from December 7 to December 14, 2022 were enrolled as the infected group. General electrocardiographic indicators such as P wave and QRS wave, electrocardiographic diagnosis, and the incidence of arrhythmia were compared between the two groups. Subgroup analysis was performed according to the presence or absence of arrhythmia. Results There were no significant differences in age and gender between the infected group and the non-infected group (both P＞0.05). The P wave duration, PR interval, QRS duration, QT interval and QTc interval in the infected group were significantly prolonged compared with the non-infected group (all P＜0.05). The proportion of sinus rhythm in the infected group was lower ［74.3%(469/631) vs 80.5%(1 449/1 801)］(P＜0.05), while the proportions of sinus tachycardia and atrial fibrillation were higher ［7.0%(44/631) vs 3.8%(69/1 801), 6.2%(39/631) vs 3.9%(70/1 801)］(both P＜0.05). Subgroup analysis showed that among patients with sinus rhythm, P wave duration, PR interval, QRS duration and QTc interval in infected patients were significantly longer than those in non-infected patients (all P＜0.05); among patients with arrhythmia, the average heart rate of infected patients was significantly higher than that of non-infected patients (P＜0.05). Conclusion COVID-19 can induce significant but relatively mild electrocardiographic abnormalities, including mild prolongation of conduction intervals, slight widening of QTc interval, and increased incidence of arrhythmias such as atrial fibrillation.