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Arrhythmia in patients with severe coronavirus disease (COVID-19): a meta-analysis
1Affiliated Hospital of Hangzhou Normal University, Hangzhou, China. wmw990556@163.com.
Insights
Patients with severe COVID-19 have a significantly higher risk of developing arrhythmia compared to those with non-severe illness. This meta-analysis highlights COVID-19 as a potential risk factor for arrhythmia, with incidence increasing with disease severity.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Arrhythmia has been frequently associated with coronavirus disease (COVID-19).
- However, a comprehensive meta-analysis investigating the link between arrhythmia and COVID-19 severity is lacking.
Purpose of the Study:
- To evaluate the association between arrhythmia and COVID-19 severity.
- To determine the pooled prevalence of arrhythmia in COVID-19 patients.
Main Methods:
- A systematic literature search was conducted on PubMed, Embase, Web of Science, and the Cochrane Library for case-control studies published between January 1 and July 25, 2020.
- A random effects model was employed to calculate the pooled odds ratio for arrhythmia in severe versus non-severe COVID-19 cases.
- Publication bias and heterogeneity were assessed using subgroup analyses, meta-regression, and the trim and fill method.
Main Results:
- The meta-analysis included 5 studies with a total of 1553 COVID-19 patients (22.47% severe, 77.53% non-severe).
- The incidence of arrhythmia was significantly higher in severely ill patients (30.09%) compared to non-severely ill patients (2.82%).
- Arrhythmia was strongly associated with severe COVID-19, with a pooled odds ratio of 17.97 (95% CI: 11.30-28.55, p<0.00001).
Conclusions:
- The incidence of arrhythmia is significantly greater in patients with severe COVID-19 than in those with non-severe COVID-19.
- COVID-19 may act as a risk factor for arrhythmia, with increased incidence correlating with disease progression.
- This meta-analysis provides reliable evidence for further research into COVID-19-associated arrhythmia.
Objective:
Many studies have reported arrhythmia to be associated with coronavirus disease (COVID-19), but no meta-analysis has explored whether arrhythmia is related to COVID-19 severity. Therefore, the purpose of this study was to evaluate arrhythmia in patients with severe and non-severe COVID-19 during the current COVID-19 pandemic.
Materials And Methods:
We searched PubMed, Embase, Web of Science, and the Cochrane Library for case control studies that were published between January 1 and July 25, 2020, and that had data on arrhythmia in patients with COVID-19. Random effects model was used with the odds ratio as the effect size. The frequency of arrhythmia was compared between COVID-19 patients with and without the composite endpoint of severity. We also determined the pooled prevalence of arrhythmia in patients with COVID-19. Publication bias and heterogeneity were considered by using subgroup analyses, meta-regression, and the trim and fill method.
Results:
A total of 1553 patients with COVID-19 were included in the 5 articles we obtained. Of these, 349 cases (22.47%) and 1204 cases (77.53%) were severely ill and non-severely ill inpatients with COVID-19 pneumonia, respectively. There were 790 (50.87%) male patients. A total of 105 cases (30.09%) of severely ill inpatients with COVID-19 pneumonia had arrhythmia complications, and 34 cases (2.82%) of non-severely ill inpatients with COVID-19 pneumonia had arrhythmia complications. We found arrhythmia to be significantly associated with severely ill inpatients with COVID-19 pneumonia, with a pooled odds ratio of 17.97 (95% CI (11.30, 28.55), p<0.00001).
Conclusions:
This study showed that the incidence of arrhythmia in patients with severe COVID-19 was greater than that of those with non-severe COVID-19. Patients with severe COVID-19 had a higher risk of arrhythmia complications, which further showed that COVID-19 may be a risk factor for arrhythmia and that the incidence of arrhythmia may increase with the progression of the disease. More importantly, this meta-analysis graded the reliability of evidence for further basic and clinical research into arrhythmia in patients with COVID-19.
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