Review Article: Cardiac Arrhythmia among Hospitalized COVID-19 Patients

Abstract

Cardiac arrhythmia is one of the common complications among hospitalized COVID-19 patients. The incidence of arrhythmia in COVID-19 varies from 5.9% to 16.7%. This literature review to explore the epidemiology, risk factors, clinical manifestation, pathophysiology, outcomes, and management of hospitalized COVID -19 patients with cardiac arrhythmia. The literature search and review of the literature was performed on PubMed and Google Scholar from January 2020 to July 2021. Age, comorbidities, and COVID-19 disease severity may increase the risk to develop arrhythmia. Hypertension, coronary artery disease, heart failure, diabetes mellitus, and renal disease are more frequently observed patients with arrhythmia. The proposed pathophysiology of arrhythmia in COVID-19 are myocardial injury, hypoxia, cytokine storm, and drugs side effects. In addition, comorbidity, pre-existing scar or conduction defect, history of previous arrhythmia, electrolyte abnormalities may play a role in the pathophysiology of tachyarrhythmia and bradyarrhythmia. The in-hospital mortality, need of intensive care unit, need of mechanical ventilation or non-invasive ventilation, hypotension, and thromboembolic event were higher in hospitalized COVID-19 patients with arrhythmia. The general managements were to treat the underlying COVID-19 infection and to tackle the hemodynamic disturbances due to tachyarrhythmia or bradyarrhythmia. Cardiac arrhythmia is a common complication among hospitalized COVID-19 patients. Hospitalized COVID-19 patients with tachyarrhythmia or bradyarrhythmia had worse in-hospital outcomes compared with patients without arrhythmia.

Cardiovascular Comorbidities in COVID-19: Comprehensive Analysis of Key Topics

“…Considering its importance in cardiovascular disease, a population-based study showed that higher ACE2 plasma levels are associated with a greater risk of severe cardiovascular disease [20]. COVID-19 has been found to increase the risk of cardiogenic shock [21,22], cardiac arrhythmias [23,24], acute myocardial injury [25,26] and sometimes sudden death in patients with cardiovascular disease [15,27,28], and at the same time, patients with cardiovascular disease have a higher risk of mortality due to COVID-19.…”