COVID-19 Patients in ICU 10 Times More Likely to Experience Heart Rhythm Disorders, Finds Study

Patients with COVID-19 who were admitted to an intensive care unit were 10 times more likely than other hospitalized COVID-19 patients to suffer cardiac arrest or heart rhythm disorders, according to a new study.

According to researchers from the Perelman School of Medicine at the University of Pennsylvania (Philadelphia, PA, USA) who conducted the study, the results suggest that cardiac arrests and arrhythmias suffered by some patients with COVID-19 are likely triggered by a severe, systemic form of the disease and are and not the sole consequence of the viral infection. The findings, which differ significantly from early reports that showed a high incidence of arrhythmias among all COVID-19 patients, provide more clarity about the role of the novel coronavirus, SARS-COV-2, and the disease it causes, COVID-19, in the development of arrhythmias, including irregular heart rate (atrial fibrillation), slow heart rhythms (bradyarrhythmia) or rapid heart rate that stops by itself within 30 seconds (non-sustained ventricular tachycardia).

To evaluate the risk and incidence of cardiac arrest and arrhythmias among hospitalized patients with COVID-19, the researchers evaluated 700 patients with COVID-19 who were admitted to the Hospital of the University of Pennsylvania between early March and mid-May. The researchers evaluated cardiac telemetry and clinical records for patient demographics and medical comorbidities, such as heart disease, diabetes and chronic kidney disease, and recorded patient vitals, test results and treatment. Researchers identified a total of 53 arrhythmic events: nine patients who suffered cardiac arrest, 25 patients with atrial fibrillation who required treatment, nine patients with clinically significant bradyarrhythmias and 10 non-sustained ventricular tachycardia events. The team did not identify any cases of heart block, sustained ventricular tachycardia or ventricular fibrillation. Of the 700 patients hospitalized, about 11% were admitted to the ICU. None of the other hospitalized patients suffered a cardiac arrest. After controlling for underlying demographic and clinical factors, researchers found cardiac arrest and arrhythmias were more likely to occur among patients in an ICU compared to the other hospitalized patients.

“In order to best protect and treat patients who develop COVID-19, it’s critical for us to improve our understanding of how the disease affects various organs and pathways within our body—including our heart rhythm abnormalities,” said the study’s senior and corresponding author Rajat Deo, MD, MTR, a cardiac electrophysiologist and an associate professor of Cardiovascular Medicine at Penn. “Our findings suggest that non-cardiac causes such as systemic infection, inflammation and illness are likely to contribute more to the occurrence of cardiac arrest and arrhythmias than damaged or infected heart cells due to the viral infection.”

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Perelman School of Medicine at the University of Pennsylvania