Effects of COVID-19 on Arrhythmia
Yujia Zhan1, Honghua Yue1, Weitao Liang1
1Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610017, China.
Insights
COVID-19 (coronavirus disease 2019) can cause cardiac arrhythmias, affecting 10-20% of patients. Understanding these heart rhythm issues and their causes is crucial for effective patient management and improving outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- The World Health Organization declared COVID-19 a pandemic on March 11, 2020.
- Cardiovascular complications, including arrhythmia, are significant in COVID-19 patients, impacting prognosis.
- Arrhythmia occurs in 10-20% of COVID-19 cases, presenting as a major non-respiratory symptom.
Purpose of the Study:
- To review the incidence of cardiac arrhythmia in COVID-19 patients.
- To explore the potential mechanisms underlying COVID-19-associated arrhythmias.
- To discuss management strategies for arrhythmia in COVID-19.
Main Methods:
- Literature review of studies on COVID-19 and cardiac arrhythmia.
- Analysis of reported incidence rates of arrhythmia in COVID-19 cohorts.
- Synthesis of proposed pathophysiological mechanisms for arrhythmia development.
Main Results:
- Cardiac arrhythmia is a common complication in COVID-19, with reported incidence between 10% and 20%.
- Potential mechanisms include viral effects on angiotensin-converting enzyme 2, myocarditis, cytokine storm, and direct cardiac injury.
- Other contributing factors: hypoxemia, myocardial strain, electrolyte imbalances, and drug-related issues.
Conclusions:
- Cardiac arrhythmia is a significant comorbidity in COVID-19 patients.
- Multiple interconnected mechanisms contribute to the development of arrhythmia.
- Integrated management strategies are essential for addressing COVID-19-related arrhythmias.
Abstract:
The World Health Organization announced that COVID-19, with SARS-CoV-2 as its pathogen, had become a pandemic on 11 March 2020. Today, the global epidemic situation is still serious. With the development of research, cardiovascular injury in patients with COVID-19, such as arrhythmia, myocardial injury, and heart failure, is the second major symptom in addition to respiratory symptoms, and cardiovascular injury is related to the prognosis and mortality of patients. The incidence of arrhythmia in COVID-19 patients ranges from 10% to 20%. The potential mechanisms include viral infection-induced angiotensin-converting enzyme 2 expression change, myocarditis, cytokine storm, cardiac injury, electrophysiological effects, hypoxemia, myocardial strain, electrolyte abnormalities, intravascular volume imbalance, drug toxicities and interactions, and stress response caused by virus infection. COVID-19 complicated with arrhythmia needs to be accounted for and integrated in management. This article reviews the incidence, potential mechanisms, and related management measures of arrhythmia in COVID-19 patients.
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