J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 16, Number 5, May 2024, pages 243-250

Predictors of Premature Ventricular Contractions Development in Patients With SARS-CoV-2 Infection

Figure 1. The influence of the presence of premature ventricular contractions (PVCs) on the onset of cardiovascular complications within the studied cohort. AMI: acute myocardial infarction, PE: pulmonary embolism; RR: risk ratio; CI: confidence interval.

Figure 2. The ROC curve depicting the reduction in peripheral capillary oxygen saturation (SpO₂) upon admission, specifically less than 95%, as a predictive measure for the onset of premature ventricular contractions (PVCs) in individuals afflicted with COVID-19 (AUC: 0.641). SpO₂: the average value of oxygen saturation measured by a pulse oximeter; ROC: receiver operating characteristic; COVID-19: coronavirus disease 2019; AUC: area under the curve.

Figure 3. The ROC curve depicting the extent of lung tissue damage to predict the development of premature ventricular contractions (PVCs) in patients afflicted with COVID-19 (AUC: 0.576). ROC: receiver operating characteristic; COVID-19: coronavirus disease 2019; AUC: area under the curve.

**Table 1.** Characteristics of the Cohort
Clinical characteristics	Group I	Group II	P
HTN: hypertension; CHD: coronary heart disease; PICS: post-infarction cardiosclerosis; CHF: congestive heart failure; T2DM: type 2 diabetes mellitus.
Number of patients	172 (100%)	1442 (100%)	-
Average age, years	69.53 ± 11.88	57.11 ± 15.76	< 0.001
Female	79 (46%)	743 (52%)	0.229
Male	93 (54%)	699 (48%)	0.165
HTN	140 (81%)	831 (58%)	< 0.001
Stage 1	2 (1%)	188 (13%)
Stage 2	20 (12%)	202 (14%)
Stage 3	118 (69%)	443 (31%)
CHD	84 (49%)	418 (29%)	< 0.001
PICS	52 (30%)	127 (9%)	< 0.001
CHF	127 (74%)	420 (29%)	< 0.001
T2DM	47 (27%)	235 (16%)	0.018
Obesity	24 (25%)	303 (22%)	0.504

Table 1. Characteristics of the Cohort

Clinical characteristics

Group I

Group II

HTN: hypertension; CHD: coronary heart disease; PICS: post-infarction cardiosclerosis; CHF: congestive heart failure; T2DM: type 2 diabetes mellitus.

Number of patients

172 (100%)

1442 (100%)

Average age, years

69.53 ± 11.88

57.11 ± 15.76

< 0.001

Female

79 (46%)

743 (52%)

0.229

Male

93 (54%)

699 (48%)

0.165

HTN

140 (81%)

831 (58%)

< 0.001

Stage 1

2 (1%)

188 (13%)

Stage 2

20 (12%)

202 (14%)

Stage 3

118 (69%)

443 (31%)

CHD

84 (49%)

418 (29%)

< 0.001

PICS

52 (30%)

127 (9%)

< 0.001

CHF

127 (74%)

420 (29%)

< 0.001

T2DM

47 (27%)

235 (16%)

0.018

Obesity

24 (25%)

303 (22%)

0.504

**Table 2.** Cardiovascular Complications in the Study Groups, Observed During the Admission
	Group I	Group II	P
Death cases from cardiovascular complications	25 (14.5%)	13 (1%)	< 0.001
Non-fatal acute myocardial infarction	26 (15.1%)	55 (3.8%)	< 0.001
Non-fatal pulmonary artery thromboembolism	24 (14%)	65 (4.5%)	< 0.001
Non-fatal acute cerebrovascular accident	1 (0.6%)	2 (0.1%)	0.203

Table 2. Cardiovascular Complications in the Study Groups, Observed During the Admission

Group I

Group II

Death cases from cardiovascular complications

25 (14.5%)

13 (1%)

< 0.001

Non-fatal acute myocardial infarction

26 (15.1%)

55 (3.8%)

< 0.001

Non-fatal pulmonary artery thromboembolism

24 (14%)

65 (4.5%)

< 0.001

Non-fatal acute cerebrovascular accident

1 (0.6%)

2 (0.1%)

0.203

**Table 3.** Inflammation Markers in Group I and II Patients (Median (Q1 - Q3))
	Group I	Group II	p
C-reactive protein, mg/L	88.55 (18.7, 125.51)	68.48 (12.6, 100.9)	0.002
Interleukin-6, pg/mL	226.50 (9.7, 247.5)	144.54 (16.7, 186.6)	< 0.001
Fibrinogen, g/L	6.34 (4.43, 7.41)	5.83 (4.3, 7)	0.386

Table 3. Inflammation Markers in Group I and II Patients (Median (Q1 - Q3))

Group I

Group II

C-reactive protein, mg/L

88.55 (18.7, 125.51)

68.48 (12.6, 100.9)

0.002

Interleukin-6, pg/mL

226.50 (9.7, 247.5)

144.54 (16.7, 186.6)

< 0.001

Fibrinogen, g/L

6.34 (4.43, 7.41)

5.83 (4.3, 7)

0.386

**Table 4.** Parameters of Echocardiography in Group I and II Patients (Median (Q1 - Q3))
	Group I	Group II	P
LVEF: left ventricular ejection fraction; LV EDV: left ventricular end-diastolic volume; LV ESV: left ventricular end-systolic volume; LVMI: left ventricular mass index; LA: left atrium; sPAP: systolic pulmonary artery pressure.
LVEF, %	53.1 (47.0, 61)	56.62 (53, 62)	< 0.001
LV EDV, mL	112.19 (101, 119.5)	110.66 (101, 113)	0.853
LV ESV, mL	51.78 (41, 58)	48.03 (41, 50)	0.016
LVMI, g/m²	124.5 (104, 137)	105.18 (92, 129)	0.256
LA volume, mL	68.63 (58.5, 78)	64.39 (58, 69)	0.003
sPAP, mm Hg	32.53 (25, 39)	30.62 (22, 33)	0.015

Table 4. Parameters of Echocardiography in Group I and II Patients (Median (Q1 - Q3))

Group I

Group II

LVEF: left ventricular ejection fraction; LV EDV: left ventricular end-diastolic volume; LV ESV: left ventricular end-systolic volume; LVMI: left ventricular mass index; LA: left atrium; sPAP: systolic pulmonary artery pressure.

LVEF, %

53.1 (47.0, 61)

56.62 (53, 62)

< 0.001

LV EDV, mL

112.19 (101, 119.5)

110.66 (101, 113)

0.853

LV ESV, mL

51.78 (41, 58)

48.03 (41, 50)

0.016

LVMI, g/m²

124.5 (104, 137)

105.18 (92, 129)

0.256

LA volume, mL

68.63 (58.5, 78)

64.39 (58, 69)

0.003

sPAP, mm Hg

32.53 (25, 39)

30.62 (22, 33)

0.015

**Table 5.** Predictors of PVCs Development in Severe Cases of SARS-CoV-2 Infection
	RR	95% CI	P
PVCs: premature ventricular contractions; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; RR: risk ratio; CI: confidence interval; CHD: coronary heart disease; PICS: post-infarction cardiosclerosis; CHF: congestive heart failure; LVEF: left ventricular ejection fraction; SpO₂: oxygen saturation.
Age over 60 years	4.576	3.224 - 6.495	< 0.001
CHD in history	2.099	1.587 - 2.777	< 0.001
PICS	3.462	2.601 - 4.608	< 0.001
CHF with reduced LVEF	5.505	3.981 - 7.612	< 0.001
SpO₂ upon admission < 95%	2.318	1.714 - 3.136	< 0.001
Extent of lung tissue damage > 50%	2.826	2.139 - 3.733	< 0.001
Presence of a “cytokine storm” based on the REPROGRAM criteria	4.469	2.907 - 6.868	< 0.001

Table 5. Predictors of PVCs Development in Severe Cases of SARS-CoV-2 Infection

95% CI

PVCs: premature ventricular contractions; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; RR: risk ratio; CI: confidence interval; CHD: coronary heart disease; PICS: post-infarction cardiosclerosis; CHF: congestive heart failure; LVEF: left ventricular ejection fraction; SpO₂: oxygen saturation.

Age over 60 years

4.576

3.224 - 6.495

< 0.001

CHD in history

2.099

1.587 - 2.777

< 0.001

PICS

3.462

2.601 - 4.608

< 0.001

CHF with reduced LVEF

5.505

3.981 - 7.612

< 0.001

SpO₂ upon admission < 95%

2.318

1.714 - 3.136

< 0.001

Extent of lung tissue damage > 50%

2.826

2.139 - 3.733

< 0.001

Presence of a “cytokine storm” based on the REPROGRAM criteria

4.469

2.907 - 6.868

< 0.001