Bradyarrhythmia in Hospitalized Patients With SARS-CoV-2 Infection: A Systematic Scoping Review and Clustering...

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Research

Background:

• Bradyarrhythmia is a concern in SARS-CoV-2 infection, often necessitating urgent pacing.
• Limited data exists on patient characteristics and clinical outcomes for COVID-19-associated bradyarrhythmia.

Purpose of the Study:

• To systematically review and analyze data on bradyarrhythmia in COVID-19 patients.
• To characterize patient demographics, clinical variables, and outcomes associated with different types of bradyarrhythmia.

Main Methods:

• Systematic literature search for bradyarrhythmia and COVID-19 cases up to December 2024.
• Quality assessment using Joanna Briggs Institute tools; data extraction on bradyarrhythmia type, clinical variables, and outcomes.
• Comparative analysis between bradyarrhythmia groups and cluster analyses (k-means, hierarchical).

Main Results:

• 151 patients (103 reports) with sinus node dysfunction (76) or atrioventricular block (AVB) (75) were identified; 10.6% were pediatric.
• 24.5% required mechanical ventilation, and 11.3% died; sinus node dysfunction linked to antiviral therapy.
• Permanent AVB patients were older, with higher mortality (23.1%) vs. transient AVB (5.6%); cluster analysis revealed inflammatory profiles in younger patients with AVB and left ventricular dysfunction.

Conclusions:

• COVID-19 can cause sinus node dysfunction or AVB, even in young, highly inflammatory patient populations.
• Mechanical ventilation and mortality rates were significant.
• Sinus node dysfunction correlated with antiviral use; permanent AVB indicated higher mortality risk.