Abstract 9788: Advanced Atrio-Ventricular Block in Patients with Active Covid-19 Infection

Abstract

Introduction: Cardiac arrhythmia is a frequent complication of COVID-19, However, there are currently only a few case reports of advanced atrioventricular block (AVB). Hypothesis: We sought to describe a case series of AVB as a complication of COVID-19. Methods: We included a series of ten (10) consecutive patients with confirmed COVID-19, who developed advanced AVB in a prospective observational multi-center study. Patients underwent clinical, laboratory evaluation, Holter, telemetry, Echocardiogram, Chest X-Ray, chest CT scan and cardiac MRI. Results: Of the ten (10) patients, 5 were female (50%) with a mean age of 62,7 +- 11,5 years. Eight (8) developed complete AVB, one a 3:1 AVB and one 2:1 AVB. None of the patients had a history of cardiac arrhythmia AVB was not related to medication or intubation. Six patients developed AVB during their hospitalization for COVID-19 and 4 after the first month as a late sequela. Four patients were asymptomatic, one presented syncope, two dyspnea and two dizziness. Six patients presented reverse AVB early by a high dose of corticosteroid in six and colchicine in 3 cases, with no recurrent episodes.Four patients required a permanent pacemaker for persistent conduction defect. Conclusions: Advanced AVB could be a complication of COVID-19. The conduction disturbance was reversed by corticosteroids with or without colchicine in six of ten cases The resolution with corticosteroids of the advanced AVB in these patients could reflect the transient nature of the viral infection and the inflammatory response associated with it in some patients. Four patients required a pacemaker. Physicians should be aware of this complication.