Abstract
The number of confirmed COVID-19 cases has increased drastically; however, information regarding the impact of this disease on the occurrence of arrhythmias is scarce. The aim of this study was to determine the impact of COVID-19 on arrhythmia occurrence. This prospective study included patients with COVID-19 treated at the Leishenshan Temporary Hospital of Wuhan City, China, from February 24 to April 5, 2020. Demographic, comorbidity, and arrhythmias data were collected from patients with COVID-19 (n = 84) and compared with control data from patients with bacterial pneumonia (n = 84) infection. Furthermore, comparisons were made between patients with severe and nonsevere COVID-19 and between older and younger patients. Compared with patients with bacterial pneumonia, those with COVID-19 had higher total, mean, and minimum heart rates (all P < 0.01). Patients with severe COVID-19 (severe and critical type diseases) developed more atrial arrhythmias compared with those with nonsevere symptoms. Plasma creatine kinase isoenzyme (CKMB) levels (P=0.01) were higher in the severe group than in the nonsevere group, and there were more deaths in the severe group than in the nonsevere group (6 (15%) vs. 3 (2.30%); P=0.05). Premature atrial contractions (PAC) and nonsustained atrial tachycardia (NSAT) were significantly positively correlated with plasma CKMB levels but not with high-sensitive cardiac troponin I or myoglobin levels. Our data demonstrate that COVID-19 patients have higher total, mean, and minimum heart rates compared with those with bacterial pneumonia. Patients with severe or critical disease had more frequent atrial arrhythmias (including PAC and AF) and higher CKMB levels and mortality than those with nonsevere symptoms.
Highlights
Novel coronavirus disease 2019 (COVID-19) is a newly recognized illness that has spread rapidly from Wuhan (Hubei province) to other areas in China and around the world [1, 2] and is considered one of the most serious threats to global health [3]
COVID-19 patients were of similar age and sex and had comparable comorbidities to patients with bacterial pneumonia
Myalgia, fatigue, and headache were more common in the COVID-19 group than in the bacterial pneumonia group (Table 1)
Summary
Novel coronavirus disease 2019 (COVID-19) is a newly recognized illness that has spread rapidly from Wuhan (Hubei province) to other areas in China and around the world [1, 2] and is considered one of the most serious threats to global health [3]. Accumulating evidence indicates that SARSCoV-2 infection has more effects than the typical respiratory symptoms; it can attack multiple organs, including the heart [6], liver [7], and kidney [8], causing multiorgan failure, aggravating the condition and affecting patient prognosis. Few studies have investigated the effects of SARSCoV-2 infection on the heart. We conducted a prospective study to investigate heart rate (total, mean, and minimum) and arrhythmias, including premature atrial contractions (PAC), nonsustained atrial tachycardia (NSAT), atrial fibrillation (AF), premature ventricular contractions (PVC), nonsustained ventricular tachycardia (NSVT), sustained ventricular tachycardia (SVT), paroxysmal supraventricular tachycardia (PSVT), and atrioventricular block (AVB), in patients with COVID-19 or bacterial pneumonia, using a remote mobile electrocardiogram (ECG) monitoring system. Cardiomyocyte injury markers and mortality were analyzed in patients with COVID-19
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