J-waves in acute COVID-19: A novel disease characteristic and predictor of mortality?

Background J-waves represent a common finding in routine ECGs (5–6%) and are closely linked to ventricular tachycardias. While arrhythmias and non-specific ECG alterations are a frequent finding in COVID-19, an analysis of J-wave incidence in acute COVID-19 is lacking. Methods A total of 386 patients consecutively, hospitalized due to acute COVID-19 pneumonia were included in this retrospective analysis. Admission ECGs were analyzed, screened for J-waves and correlated to clinical characteristics and 28-day mortality. Results J-waves were present in 12.2% of patients. Factors associated with the presence of J-waves were old age, female sex, a history of stroke and/or heart failure, high CRP levels as well as a high BMI. Mortality rates were significantly higher in patients with J-waves in the admission ECG compared to the non-J-wave cohort (J-wave: 14.9% vs. non-J-wave 3.8%, p = 0.001). After adjusting for confounders using a multivariable cox regression model, the incidence of J-waves was an independent predictor of mortality at 28-days (OR 2.76 95% CI: 1.15–6.63; p = 0.023). J-waves disappeared or declined in 36.4% of COVID-19 survivors with available ECGs for 6–8 months follow-up. Conclusion J-waves are frequently and often transiently found in the admission ECG of patients hospitalized with acute COVID-19. Furthermore, they seem to be an independent predictor of 28-day mortality.

Shear-wave Anisotropy in the Earth’s Inner Core

Earth’s inner core anisotropy is widely used to infer the deep Earth's evolution and present dynamics. Many compressional-wave anisotropy models have been proposed based on seismological observations. In contrast, inner-core shear-wave (J-wave) anisotropy – on a par with the compressional-wave anisotropy – has been elusive. Here we present a new class of the J-wave anisotropy observations utilizing earthquake coda-correlation wavefield. We establish that the coda-correlation feature I2-J, sensitive to J-wave speed, exhibits time and amplitude changes when sampling the inner core differently. J-waves traversing the inner core near its center travel faster for the oblique than equatorial angles relative to the Earth’s rotation axis by at least ~5 s. The simplest explanation is the J-wave cylindrical anisotropy with a minimum strength of ~0.8%, formed through the lattice-preferred-orientation mechanism of iron. Although we cannot uniquely determine its stable iron phase, the new observations rule out one of the body-centered-cubic iron models.