Cardiac arrhythmias associated with COVID-19 infection: state of the art review

ABSTRACT

Introduction

COVID-19 infection is associated with many different systemic complications. Among these, cardiovascular system complications are particularly important as these are associated with significant mortality. There are many different subgroups of cardiovascular complications, with Arrhythmias being one of them. Arrhythmias are especially important as there are a substantial percentage of patients who have arrhythmia after a COVID-19 infection, and these patients are seen with an increased mortality rate. The main interest of this review is understanding some of the specific post-COVID-19 arrhythmic complications and their predisposing factors.

Areas covered

This paper will highlight the findings of studies on cardiovascular system disease after COVID-19 infection, different specific arrhythmic complications of COVID-19, and changes in electrophysiologic interventions post-COVID-19 outbreak in different centers around the world. An extensive literature search was made to find pertinent articles.

Expert Opinion

Studies show us that a significant percentage of COVID-19 patients have arrhythmia. Many distinct types of arrhythmias are associated with COVID-19 infection, and specific risk factors of these arrhythmias are important as this information can be used to detect and prioritize certain at-risk patients for early treatment, which can mean life or death in some cases.

KEYWORDS:

• COVID-19
• cardiovascular system
• arrhythmias
• electrophysiology

Article highlights

• Increase in COVID-19 disease severity was associated with an increased arrhythmia prevalence.

• History of atrial fibrillation, male sex, age, and hypoxia on presentation were separately related to arrhythmias. Any type of arrhythmia was separately related to a 30-day all-cause mortality.

• Existence of thorax CT diffuse lung infiltration was the biggest separate parameter related to new-onset atrial fibrillation formation.

• Combination of high-sensitivity cardiac troponin T ≥20 ng/L and abnormal ECG was related to a rise in the 30-day mortality rate relative to normal ECG and high-sensitivity cardiac troponin T <20 ng/L.

• Different studies from many centers around the world reported that they had decreased numbers of electrophysiological procedures.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties

Additional information

Funding

This paper was not funded.