Maura M Zylla1,2,3, Uta Merle4, Johannes A Vey5, Grigorios Korosoglou6, Eva Hofmann1,7, Michael Müller7,8, Felix Herth7,8, Werner Schmidt9, Erwin Blessing10, Christoph Göggelmann1,11, Norbert Weidner11, Mascha O Fiedler12, Markus A Weigand12, Florian Kälble13, Christian Morath13, Johannes Leiner1,3, Meinhard Kieser5, Hugo A Katus1,2,3, Dierk Thomas1,2,3. 1. Department of Cardiology, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. 2. German Center for Cardiovascular Research (DZHK), Partner site Heidelberg/Mannheim, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. 3. Heidelberg Center for Heart Rhythm Disorders (HCR), Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. 4. Department of Gastroenterology, Hepatology and Infectious Disease, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. 5. Institute of Medical Biometry and Informatics, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany. 6. GRN Klinikum Weinheim, Klinik für Kardiologie, Angiologie und Pneumologie, Röntgenstraße 1, 69469 Weinheim, Germany. 7. Department of Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik, Heidelberg University Hospital, Röntgenstr. 1, 69126 Heidelberg, Germany. 8. German Center for Lung Research (DZL)Translational Lung Resarch Center (TLRCH), University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany. 9. Department of Anaesthesiology, Intensive Care, Pain Therapy, Thoraxklinik, Heidelberg University Hospital, Röntgenstr. 1, 69126 Heidelberg, Germany. 10. SRH Klinikum Karlsbad-Langensteinbach, Abteilung für Innere Medizin, Guttmannstraße 1, 76307 Karlsbad, Germany. 11. Spinal Cord Injury Center, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany. 12. Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. 13. Nierenzentrum Heidelberg, Department of Nephrology, Heidelberg University Hospital, Im Neuenheimer Feld 162, 69120 Heidelberg, Germany.
Abstract
BACKGROUND: Cardiac manifestation of COVID-19 has been reported during the COVID pandemic. The role of cardiac arrhythmias in COVID-19 is insufficiently understood. This study assesses the incidence of cardiac arrhythmias and their prognostic implications in hospitalized COVID-19-patients. METHODS: A total of 166 patients from eight centers who were hospitalized for COVID-19 from 03/2020-06/2020 were included. Medical records were systematically analyzed for baseline characteristics, biomarkers, cardiac arrhythmias and clinical outcome parameters related to the index hospitalization. Predisposing risk factors for arrhythmias were identified. Furthermore, the influence of arrhythmia on the course of disease and related outcomes was assessed using univariate and multiple regression analyses. RESULTS: Arrhythmias were detected in 20.5% of patients. Atrial fibrillation was the most common arrhythmia. Age and cardiovascular disease were predictors for new-onset arrhythmia. Arrhythmia was associated with a pronounced increase in cardiac biomarkers, prolonged hospitalization, and admission to intensive- or intermediate-care-units, mechanical ventilation and in-hospital mortality. In multiple regression analyses, incident arrhythmia was strongly associated with duration of hospitalization and mechanical ventilation. Cardiovascular disease was associated with increased mortality. CONCLUSIONS: Arrhythmia was the most common cardiac event in association with hospitalization for COVID-19. Older age and cardiovascular disease predisposed for arrhythmia during hospitalization. Whereas in-hospital mortality is affected by underlying cardiovascular conditions, arrhythmia during hospitalization for COVID-19 is independently associated with prolonged hospitalization and mechanical ventilation. Thus, incident arrhythmia may indicate a patient subgroup at risk for a severe course of disease.
BACKGROUND: Cardiac manifestation of COVID-19 has been reported during the COVID pandemic. The role of cardiac arrhythmias in COVID-19 is insufficiently understood. This study assesses the incidence of cardiac arrhythmias and their prognostic implications in hospitalized COVID-19-patients. METHODS: A total of 166 patients from eight centers who were hospitalized for COVID-19 from 03/2020-06/2020 were included. Medical records were systematically analyzed for baseline characteristics, biomarkers, cardiac arrhythmias and clinical outcome parameters related to the index hospitalization. Predisposing risk factors for arrhythmias were identified. Furthermore, the influence of arrhythmia on the course of disease and related outcomes was assessed using univariate and multiple regression analyses. RESULTS:Arrhythmias were detected in 20.5% of patients. Atrial fibrillation was the most common arrhythmia. Age and cardiovascular disease were predictors for new-onset arrhythmia. Arrhythmia was associated with a pronounced increase in cardiac biomarkers, prolonged hospitalization, and admission to intensive- or intermediate-care-units, mechanical ventilation and in-hospital mortality. In multiple regression analyses, incident arrhythmia was strongly associated with duration of hospitalization and mechanical ventilation. Cardiovascular disease was associated with increased mortality. CONCLUSIONS:Arrhythmia was the most common cardiac event in association with hospitalization for COVID-19. Older age and cardiovascular disease predisposed for arrhythmia during hospitalization. Whereas in-hospital mortality is affected by underlying cardiovascular conditions, arrhythmia during hospitalization for COVID-19 is independently associated with prolonged hospitalization and mechanical ventilation. Thus, incident arrhythmia may indicate a patient subgroup at risk for a severe course of disease.
Authors: Christian Karagiannidis; Carina Mostert; Corinna Hentschker; Thomas Voshaar; Jürgen Malzahn; Gerhard Schillinger; Jürgen Klauber; Uwe Janssens; Gernot Marx; Steffen Weber-Carstens; Stefan Kluge; Michael Pfeifer; Linus Grabenhenrich; Tobias Welte; Reinhard Busse Journal: Lancet Respir Med Date: 2020-07-28 Impact factor: 30.700
Authors: Nicola Tarantino; Domenico G Della Rocca; Fengwei Zou; Aung Lin; Andrea Natale; Luigi Di Biase Journal: Card Electrophysiol Clin Date: 2021-10-29
Authors: Catherine Vanchiere; Stephen McHugh; Ellen Bedenko; Isaac R Whitman; Chethan Gangireddy; Anuj K Basil; Joshua M Cooper; Daniel Edmundowicz; Meredith Brisco-Bacik; Edmond M Cronin Journal: J Innov Card Rhythm Manag Date: 2022-02-15
Authors: Rhian M Touyz; Marcus O E Boyd; Tomasz Guzik; Sandosh Padmanabhan; Linsay McCallum; Christian Delles; Patrick B Mark; John R Petrie; Francisco Rios; Augusto C Montezano; Robert Sykes; Colin Berry Journal: CJC Open Date: 2021-06-16