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Published on: February 26, 2013
Incidence of Atrioventricular Blocks and its Association with In-Hospital Mortality and Morbidity in Patients with
Nicole Lao1, Joseph Lim1, Hanad Bashir1
1Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA.
Insights
This study found that 5.5% of hospitalized COVID-19 patients developed new atrioventricular blocks (AV blocks). However, these AV blocks did not correlate with increased hospital stay, intubation, or mortality, suggesting careful monitoring is key.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- The cardiovascular impact of coronavirus disease 2019 (COVID-19) is a significant area of clinical research.
- Understanding sequelae is crucial for managing patients during and after infection.
Purpose of the Study:
- To determine the incidence of new atrioventricular block (AV block) in patients hospitalized with COVID-19.
- To investigate the association between new-onset AV block and in-hospital morbidity and mortality.
Main Methods:
- Compared electrocardiograms (ECGs) of 438 COVID-19 patients to identify new-onset AV blocks.
- Followed patients post-discharge to assess AV block resolution.
- Analyzed demographic, clinical characteristics, and major complications (e.g., respiratory failure, sepsis, mortality).
Main Results:
- The incidence of new-onset AV block in hospitalized COVID-19 patients was 5.5%.
- New AV blocks were not linked to prolonged hospital or ICU stays.
- No association found between new AV blocks and increased intubation rates or mortality.
Conclusions:
- While new AV blocks in COVID-19 patients may be multifactorial, clinicians should monitor for symptomatic bradycardia and arrhythmias.
- Routine cardiac event monitoring post-discharge is likely unnecessary.
- Thorough patient history, including family and drug history, is vital due to potential arrhythmogenic effects of COVID-19 therapies.
Background:
Cardiovascular sequelae of coronavirus disease 2019 (COVID-19) infection have been explored by clinicians and researchers all over the world.
Objective:
The purpose of this study was to evaluate the incidence of atrioventricular block (AV) in patients hospitalized for COVID-19 and its association between in-hospital morbidity and mortality.
Methods:
In-hospital electrocardiograms (ECGs) of 438 patients were compared with their prior or baseline ECGs to ascertain the development of new onset AV block. Patients who developed new AV blocks were then followed at 30 and 90 days post-discharge to check for resolution of AV block. Demographic characteristics, clinical characteristics, and complications during their hospital stay were evaluated. Major complications including respiratory failure requiring oxygen supplementation and mechanical ventilation, sepsis, deep vein thrombosis, elevated troponins, hospital and intensive care unit (ICU) length of stay, as well as death were compared between those who developed new onset AV blocks and those who did not.
Results:
Based on our single center study, the incidence of new onset AV blocks among patients admitted for COVID-19 during the study period was 5.5 cases per 100 patients. New onset AV blocks were not associated with longer hospital and ICU length of stay, increased intubation rates, or increased mortality.
Conclusion:
Although the development of a new onset AV block is most likely multifactorial and not solely due to COVID-19, it is still important for clinicians to be mindful about the possibility of developing symptomatic bradycardia and life-threatening arrhythmias in patients admitted for COVID-19. This can be achieved by appropriate rhythm monitoring in-patient but the need for a cardiac event monitor upon discharge is unlikely to be necessary. Careful history taking, including family and drug use history is also of great importance as emerging drug therapies for COVID-19 have potential arrhythmogenic effects.
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