Key result
Fatal COVID-19 cases show ~9% AV block prevalence linked to fragmented QRS and axis deviation.
Why the study?
Electrophysiological manifestations and the prevalence of arrhythmias and conduction system disease in COVID-19 patients remain debated in the literature.
Observational (n=432)
No
In a retrospective cohort of fatal COVID-19 cases, a notable prevalence of conduction system disease and myocardial injury was observed on electrocardiograms, highlighting the electrophysiological impact of the virus.
Findings in deceased patients should not change practice; hypothesis-generating for arrhythmia burden in severe COVID-19.
Background: Electrophysiological-related manifestation of COVID-19 is a matter of debate in the literature nowadays. A wide spectrum of arrhythmias was observed among patients who have been infected with COVID-19. Objectives: This study discussed the prevalence of arrhythmias and conduction system disease in patients with COVID-19. Method: In this retrospective study, demographic and electrocardiographic data of 432 expired COVID-19 patients who had been admitted to Faghihi Hospital of Shiraz University of Medical Sciences from August 2020 until December 2020 were reviewed. Results: Atrioventricular nodal block (AVB) was found in 40(9.3%) patients. Furthermore, 28(6.5%) of them suffered from the first degree of AVB, and 12(2.8%) suffered from complete heart block (CHB). Among 189 cases (59.0%) ST-T changes agreed with myocardial infarction or localized myocarditis. Findings of myocardial injury including fragmented QRS and prolonged QTc were observed among 91 (21.1%) and 28 (6.5%) respectively. In victims of COVID-19, conduction disease was not related to any comorbidities. Fragmented QRS, axis deviation, presence of S1Q3T3, and poor R wave progression were significantly related to conduction system abnormalities in victims of COVID-19 (P-value > 0.05) Conclusion: Our findings can serve in future studies that aim to develop a risk stratification method for susceptible COVID-19 patients. The myocardial injury appears to role significantly in COVID-19 morbidity and mortality. Consequently, we recommend health policymakers consider separate catheterization laboratories that provide service only to COVID-19 patients.
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Sarejloo et al. (2022) conducted an observational in COVID-19 (n=432). COVID-19 was evaluated on Atrioventricular nodal block (AVB). Among expired COVID-19 patients, atrioventricular nodal block was found in 9.3%, and conduction abnormalities were related to fragmented QRS, axis deviation, S1Q3T3, and poor R wave progression.
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