Key result
Severe COVID-19 shows no significant increase in arrhythmia risk compared to milder illness.
Why the study?
The type and prevalence of arrhythmias in hospitalized patients with mild/moderate and severe COVID-19 illness were unknown from a prospective cohort study.
What is the prevalence and type of arrhythmias in hospitalized patients with mild/moderate versus severe COVID-19?
Cohort (n=305)
What is the prevalence and type of arrhythmias in hospitalized patients with mild/moderate versus severe COVID-19?
Absolute Event Rate: 9.2% vs 3.3%
p-value: p=0.063
Atrial arrhythmias, particularly atrial fibrillation, are the most frequent new-onset arrhythmias in hospitalized COVID-19 patients and are associated with higher ICU admission and in-hospital mortality.
Infrequent arrhythmias in hospitalized COVID-19 suggest selective rather than routine monitoring; leaves open optimal strategies in prospective studies.
Objectives The type of arrhythmias, and their prevalence in mild/moderate and severe COVID-19 patients admitted to the hospital are unknown from a prospective cohort study.Methods We did continuous electrocardiograms along with multiple ECGs in 305 consecutive hospitalized COVID-19 patients.Results The incidence of arrhythmias was 6.8% (21/305) in the target population. The incidence of arrhythmias was 9.2% (17/185) in patients with severe COVID-19 illness and 3.3% (4/120) in patients with mild/moderate COVID-19 illness with no significant difference (p = 0.063). All the arrhythmias were new-onset arrhythmias in this study. 95% (20/21) of these arrhythmias were atrial arrhythmia with 71.42% (15/21) being atrial fibrillation and one episode of sustained polymorphic ventricular tachycardia. No episode of high-grade atrioventricular block, sustained monomorphic ventricular arrhythmia, or torsades de pointes arrhythmias were observed in this study. The patients with arrhythmias were admitted to the intensive care unit (80.9% vs. 50.7%; p: 0.007), were on a ventilator (47.6% vs. 21.4%; p: 0.006), and had high in-hospital mortality (57.1% vs. 21.1%; p: 0.0001) than patients without arrhythmias.Conclusion Atrial arrhythmias were the most frequent arrhythmias in hospital-admitted COVID-19 patients with atrial fibrillation being the most common arrhythmia.Trial registration Clinical Trial Registry India (CTRI) (CTRI/2021/01/030788). (https://www.ctri.nic.in/)
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Gupta et al. (2023) conducted a cohort in COVID-19 (n=305). Severe COVID-19 illness vs. Mild/moderate COVID-19 illness was evaluated on Incidence of arrhythmias (p=0.063). Severe COVID-19 illness was associated with a 9.2% incidence of arrhythmias compared to 3.3% in mild/moderate illness, with no statistically significant difference (p=0.063).
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