Cardiac Arrhythmias in Patients with COVID-19
Mauricio Pimentel1, Ana Paula Arbo Magalhães1, Camila Valvassori Novak1
1Hospital de Clinicas de Porto Alegre, Porto Alegre, RS - Brasil.
Insights
COVID-19 patients hospitalized with arrhythmias had higher mortality. Heart failure increased arrhythmia risk, and cardiac arrest during hospitalization resulted in death.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) is linked to cardiovascular issues, including arrhythmias.
- Understanding these cardiac complications is crucial for patient management.
Purpose of the Study:
- To determine the incidence of cardiac arrhythmias and cardiac arrest (CA) in hospitalized COVID-19 patients.
- To identify risk factors and outcomes associated with these cardiac events.
Main Methods:
- Retrospective analysis of electronic medical records from a tertiary university-affiliated hospital.
- Inclusion of 241 consecutive COVID-19 patients.
Main Results:
- Cardiac arrhythmias occurred in 8.7% of patients, primarily atrial tachyarrhythmia.
- Patients with arrhythmias had significantly higher mortality (52.4% vs. 24.1%).
- Heart failure (HF) was the only independent predictor of arrhythmias (HR, 11.9).
- Cardiac arrest (CA) occurred in 3.3% of patients, all of whom died.
Conclusions:
- The incidence of cardiac arrhythmias in hospitalized COVID-19 patients was 8.7%, with atrial tachyarrhythmia being most frequent.
- Heart failure is a significant risk factor for developing arrhythmias in COVID-19 patients.
- Cardiac arrest in COVID-19 patients carries a very high mortality rate.
Background:
The coronavirus disease 2019 (COVID-19) is associated with cardiovascular clinical manifestations, including cardiac arrhythmias.
Objective:
To assess the incidence of cardiac arrhythmias (atrial tachyarrhythmia, bradyarrhythmia, and sustained ventricular tachycardia) and cardiac arrest (CA) in a cohort of patients hospitalized with COVID-19 in a tertiary university-affiliated hospital.
Methods:
Cohort study with retrospective analysis of electronic medical records. For comparison between groups, a value of p <0.05 was considered statistically significant.
Results:
We included 241 consecutive patients diagnosed with COVID-19 (mean age, 57.8 ± 15.0 years; 51.5% men; 80.5% white), 35.3% of whom received invasive mechanical ventilation (MV). The overall mortality was 26.6%, being 58.8% among those on MV. Cardiac arrhythmias were identified in 8.7% of the patients, the most common being atrial tachyarrhythmia (76.2%). Patients with arrhythmias had higher mortality (52.4% versus 24.1%, p = 0.005). On multivariate analysis, only the presence of heart failure (HF) was associated with a higher risk of arrhythmias (hazard ratio, 11.9; 95% CI: 3.6-39.5; p <0.001). During hospitalization, 3.3% of the patients experienced CA, with a predominance of non-shockable rhythms. All patients experiencing CA died during hospitalization.
Conclusions:
The incidence of cardiac arrhythmias in patients admitted with COVID-19 to a Brazilian tertiary hospital was 8.7%, and atrial tachyarrhythmia was the most common. Presence of HF was associated with an increased risk of arrhythmias. Patients with COVID-19 experiencing CA have high mortality.
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