Prevalence of arrhythmia in COVID-19 patients with mild/moderate and severe illness: a prospective cohort study

ABSTRACT

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/)

KEYWORDS:

• Atrial arrhythmias
• COVID-19
• Electrocardiogram
• Severe acute respiratory syndrome-coronavirus-2
• Arrhythmias
• Troponin
• N-terminal pro-brain natriuretic peptide

Acknowledgments

We acknowledge the role of Dr. Monica Sharma (Consultant & associate professor, Department of Hematology), Ram Niwas Sonali (Lab technicians, Department of Hematology), all the consultants, junior residents, and senior residents from the Department of Anesthesia and critical care (Dr. Usha Ganpathy, Dr. Ira Balakrishnan, Dr. Pramod, Dr. Shruti, Dr. Amandeep, Dr. Aditi Narang, Dr. Anjali, & Dr. Yasna), Department of Cardiology (Dr. HS Isser, Dr. Ansari, Dr. Arvind, Dr. Preeti Gupta, & Dr. Navnita Kisku), and the Department of Medicine (Dr. Monindar Narang, Dr. Rupali, & Dr. Ankit), Department of Community Medicine (Dr. Namita Srivastava & Dr. Anita) (Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India), and Dr. Rajiv Narang (Department of Cardiology, AIIMS, New Delhi) in conducting this study.

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.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

P Gupta: Study conceptualisatio, design, methodology, visualization, data collection, data analysis, data interpretation, writing original draft, writing-review & editing. S Bansal: Writing original draft, writing-review & editing, data interpretation. A Gupta: Writing original draft, writing-review & editing, data collection, data interpretation. K Gupta: Writing original draft, writing-review & editing, data collection, data interpretation. S Kumar Kattumannil: Data analysis. S. Saluja: Data collection.

Ethical approval and patient consent

This study was approved by the Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi ethical committee (IEC/VMMC/SJH/Project/2020–12/CC-92) and written informed consent from the patients was taken according to the Declaration of Helsinki.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [P. Gupta], upon reasonable request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14779072.2023.2216456.

Additional information

Funding

This paper was not funded.