Outcomes in patients with COVID-19 and new onset heart blocks: Insight from the National Inpatient Sample database

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Coronavirus disease 2019 (COVID-19) is a global health crisis caused by SARS-CoV-2.
• While COVID-19's effect on cardiomyocytes is known, its impact on the cardiac conduction system requires further understanding.

Purpose of the Study:

• To investigate the association between COVID-19 and major cardiovascular complications in patients with new-onset heart blocks or bundle branch blocks (BBB).

Main Methods:

• Utilized the 2020 National Inpatient Sample (NIS) database, identifying COVID-19 patients with new high-degree atrioventricular blocks (HDAVB) or BBB using ICD-10 codes.
• Excluded patients with pre-existing pacemakers.
• Analyzed inpatient mortality, total hospital charges, length of stay, and other cardiac outcomes using regression analyses.

Main Results:

• COVID-19 patients with new HDAVB showed significantly higher odds of in-hospital mortality, cardiac arrest, cardiogenic shock, sepsis, arrhythmias, and acute kidney injury.
• COVID-19 patients with new BBB had increased odds of arrhythmias, acute kidney injury, sepsis, need for mechanical ventilation, and cardiogenic shock, but not significantly higher mortality.
• No significant difference in cerebral infarction or pulmonary embolism odds was observed for either group.

Conclusions:

• COVID-19 patients with new HDAVB face significantly higher risks of mortality and various cardiac complications.
• COVID-19 patients with new BBB also experience increased risks for several adverse cardiac events and complications, though mortality risk was not significantly elevated compared to those without BBB.
• Healthcare providers must recognize the potential for worse outcomes in COVID-19 patients presenting with new-onset HDAVB or BBB.