Abstract 16223: Cardiac Arrhythmias in Hospitalized Patients With COVID-19

Abstract

Introduction: Arrhythmias have been reported frequent in COVID-19 patients, but the incidence and nature have not been well characterized. Hypothesis: Atrial and ventricular arrhythmias are common complications of patients with COVID-19. Methods: Patients admitted with COVID-19 and monitored by telemetry were prospectively enrolled in the study. Baseline characteristics, hospital course, treatment and complications were collected from the patients’ medical records. Telemetry was monitored to detect the incidence of cardiac arrhythmias. The incidence and types of cardiac arrhythmias were analyzed and compared between survivors and non-survivors. Results: Among 143 patients admitted with telemetry monitoring, overall in-hospital mortality was 23.1% (33/143 patients) during the period of observation (mean follow up 19.9 ± 13.7 days). Survivors were younger (68.1 ± 17.2 vs. 77.6 ± 15.9 years old, p=0.006), had higher body mass index (28.1 ± 8.3 vs. 24.3 ± 6.2, p=0.019), were less tachycardic on initial presentation (heart rate 90.6 ± 19.4 vs. 99.8 ± 23.7 bpm, p=0.026) and had lower troponin (peak troponin 0.03 vs. 0.14 ng/ml. p=0.006) and interleukin-6 levels (peak interleukin-6 32 vs. 264 pg/ml, p=0.001). Sinus tachycardia, the most common arrhythmia (occurring in 39.9% [57/143] of patients), occurred more frequently in non-survivors (57.6% vs. 34.5% in survivors, p=0.018). Premature ventricular complexes occurred in 28.7% (41/143), and non-sustained ventricular tachycardia in 15.4% (22/143) of patients, with no difference between survivors and non-survivors. Sustained ventricular tachycardia and ventricular fibrillation were rare (seen only in 1.4% and 0.7% of patients, respectively). Conclusions: In this prospective observational study of hospitalized and monitored patients with COVID-19, sinus tachycardia was the most common rhythm disorder, and its presence was associated with higher mortality. Sustained ventricular tachycardia or ventricular fibrillation were infrequent, contradicting previous reports that malignant ventricular arrhythmias are commonly seen in patients hospitalized with COVID-19.