Cardiac dysrhythmia in COVID-19 patients; occurrence and risk factors: a retrospective cohort study

Abstract

Objective: In this study, we have evaluated the occurrence and risk factors of cardiac dysrhythmia on admission and during hospitalization in COVID-19 patients.
 Methods: This study was conducted as a retrospective cohort in which 893 electrocardiograms (ECGs) taken at the time of admission, and 328 ECGs taken during hospitalization were evaluated. These ECGs were assessed for cardiac dysrhythmias by a cardiologist. Finally, relationships between clinical characteristics and the occurrence of cardiac dysrhythmias in patients were assessed.
 Results: Most common cardiac dysrhythmias on admission were sinus tachycardia (64.8%), atrial fibrillation (13.5%), and sinus bradycardia (11.3%). Multivariate regression analysis showed that a history of metformin use (RR=0.83; P=0.042) was independently associated with reduced risk of cardiac dysrhythmias on admission, while male sex (RR=1.16; P=0.018), history of cardiovascular diseases (RR=1.16; P=0.017), history of cancer (RR=1.40; P=0.004) and QT interval prolongation on ECG (RR=1.18; P=0.017) were associated with a higher risk of cardiac dysrhythmias on admission. Also, among the 328 patients that had a second ECG, 185 (56.4%) experienced cardiac dysrhythmias during their hospitalization. Multivariate analysis showed that presence of cardiac dysrhythmias on admission (RR=1.85; 95% CI: 1.49,2.35; P<0.001) was the only independent prognostic factor for the occurrence of cardiac dysrhythmias during hospitalization. No significant relationships were observed between treatment regimens and the incidence of cardiac dysrhythmias.
 Conclusion: The present study showed that more than half of COVID-19 patients have cardiac dysrhythmias on admission. Our analyses illustrated that a history of metformin use was associated with a lower risk of cardiac dysrhythmias on admission, while male sex, history of cardiovascular diseases, history of cancer, and QT interval prolongation were associated with a higher rate of cardiac dysrhythmias. Hydroxychloroquine use along with azithromycin and kaletra (lopinavir-ritonavir) had no association with the development of cardiac dysrhythmias during hospitalization.

Risk Factors for Re-admission in Covid-19 Patients from a Tertiary Care Health System: Quality Control (QC) and Quality Improvement (QI) Project

“…A careful analysis of above studies and others [20][21][22] reveals that diabetes, heart disease, hypertension, kidney disease increase risk for readmissions. Noteworthy is the fact that management of patients during initial admission for COVID-19 includes use of intravenous fluids, corticosteroids, and prophylactic anticoagulation, all of which could collectively worsen chronic medical conditions such as congestive heart failure, hypertension, diabetes, and bleeding in elderly from trauma and falls.…”

Body mass index and sex differences for mortality in hospitalized COVID-19 patients: a path analysis using a brazilian national database

“…Hypertension, atherosclerosis-related and other causes of chronic cardiovascular disease are grouped under the single variable CCD in the SIVEP-Gripe. Several studies have shown possible differences in the contributions of hypertension [ 42 ] and other cardiovascular diseases to COVID-19 severity [ 43 ]. Given the large N-data set in SIVEP-Gripe and its evident usefulness in clinical and epidemiological studies, being able to distinguish arterial hypertension from other CCDs would contribute to better illuminate the relationships between CCD and death in COVID-19 [ 43 ].…”

“…Several studies have shown possible differences in the contributions of hypertension [ 42 ] and other cardiovascular diseases to COVID-19 severity [ 43 ]. Given the large N-data set in SIVEP-Gripe and its evident usefulness in clinical and epidemiological studies, being able to distinguish arterial hypertension from other CCDs would contribute to better illuminate the relationships between CCD and death in COVID-19 [ 43 ]. The Mexican Epidemiologic Surveillance Database for Respiratory Viral diseases (Sistema de Vigilancia Epidemiológica de Enfermedades Respiratorias Virales), for instance, distinguishes hypertension from cardiopathy.…”