What does this research mean for the field?

Dysrhythmias are common in patients with severe COVID-19, with 43.3% of patients exhibiting significant cardiac rhythm abnormalities during a Holter study. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

The research aims to identify the prevalence and types of cardiac dysrhythmias in patients with severe COVID-19.

March 1, 2026Open Access

The Rate and Characteristics of Dysrhythmia in Patients With Severe Covid-19, a Holter Study

Key Points

The research aims to identify the prevalence and types of cardiac dysrhythmias in patients with severe COVID-19.
Descriptive cross-sectional study design
Conducted at Al-Yarmouk Teaching Hospital
Included 60 patients with severe COVID-19 based on WHO criteria
Utilized 24-hour Holter monitoring, echocardiography, and biochemical tests for inflammatory markers
Monitored and categorized types of dysrhythmias detected during Holter study
43.3% of patients exhibited significant dysrhythmia during Holter monitoring
Most common dysrhythmias included sinus tachycardia (33.3%) and sinus bradycardia (28.3%)
Patients with arrhythmias showed significantly elevated levels of inflammatory markers: ferritin, D-Dimer, CRP, and troponin
56% of patients showed no significant arrhythmia
Arrhythmias were often paroxysmal and only detected during Holter monitoring

Abstract

Background: covid-19 disease caused by the newly emergent corona virus proved to have a myriad of pulmonary and extra-pulmonary manifestations including cardiovascular manifestations through multiple mechanisms and many patients developed different types of cardiac injury and arrhythmia and some of which proved to have a worse outcome in the clinical course of the disease. Aim of study: to determine the rate and characteristics of cardiac rhythm abnormality in patients with severe covid-19 infection using a 24 hour-holter monitor. Methods: A descriptive cross-sectional study conducted in Al-Yarmouk Teaching Hospital Baghdad, Iraq for a period of six months from 1st December 2020 to 30th June 2021, where 60 patients with severe covid-19 according to WHO criteria for severe disease were enrolled and underwent a 24-hour holter study, echocardiography electrocardiography and biochemical investigations for relevant inflammatory markers of covid19. Results: In this study the percentage of patients with significant dysrhythmia during a Holter study was 43.3%(26 patients) and distributed as follows: 20 cases (33.3%) of sinus tachycardia; 17 cases (28.3%) of sinus bradycardia, 9 cases (15%) of paroxysmal AF and 6 cases (10%) of bigeminy; 7 cases (11.6%) of PVC; 6 cases (10%) of NSVT; one case (1.7%) of SVT(some patients had more than one type of arrhythmia during a holter study) while 56% (34 patients) no significant arrhythmia was observed, Patients who had cardiac arrhythmias had significantly higher levels of ferritin, D-Dimer, CRP, and troponin compared to those without cardiac arrhythmias. Conclusion: dysrhythmias are common in patients with severe covid-19 disease, and Most of the clinically significant arrhythmia like atrial fibrillation and non-sustained ventricular tachycardia were paroxysmal and detected only during a holter study. patients with High levels of inflammatory marker (CRP, Ferritin, troponin, d-dimer) had significant relation to clinically severe covid-19 and risk of developing significant arrhythmias.

The Rate and Characteristics of Dysrhythmia in Patients With Severe Covid-19, a Holter Study

Key Points

Abstract

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