Predictors of heart rhythm disorders in the patients with severe COVID-infection

Abstract

Annotation. The severe course of COVID-19 infection often leads to complications of cardiovascular system. Among them, heart rhythm disorders are one of the main ones requiring careful examination and improvement of management of the patients with COVID-19 infection. The purpose of the work was to establish the probable predictors of cardiac rhythm disorders of the patients with severe COVID infection. In the study were examined 133 patients with severe COVID-19 infection, who were in the intensive care unit of the city clinical hospital №1 in Vinnytsia for 9 months 2020 and as a result of treatment with improved health were discharged from the hospital. Statistical processing of the obtained data was performed using the statistical software package SPSS 12.0 for Windows using parametric and non-parametric methods of statistical analysis. It was found that the prevalence of heart rhythm disorders in patients with severe COVID-19 is 86 (64.7%) patients. The predictors of arrhythmias were: the presence of stroke in anamnesis; acute thrombophlebitis during a hospital treatment; the term of being in the intensive care unit and the overall term of hospitalization. Among all rhythm disorders, tachyarrhythmias were in – 68 (51.1%), sinus tachycardia 45 (33.8%) and atrial fibrillation 19 (14.3%) were dominated in the structure of tachyarrhythmia. There were no significant predictors of tachyarrhythmias. The prevalence of bradyarrhythmias is 60 (45.1%), sinus bradycardia (12%) and the right branch of His bundle block – 30 (22.6%) were prevalent in the structure of bradyarrhythmias. Predictors of the bradyarrhythmias were: the presence of ischemic heart disease (IHD) in anamnesis; acute thrombophlebitis in anamnesis; diseases of the gastrointestinal tract; stroke while staying in a hospital; post-infarction cardiosclerosis; combination of arterial hypertension and IHD; the term of staying in the hospital and in the intensive care unit. Also, ECG predictors of bradyarrhythmia were: depression of the ST segment; pathological Q wave; hypertrophy of the left ventricle; hypertrophy of the right ventricle; extension of QT interval. The prevalence of violations of repolarization according to ECG were in 119 (89.5%) patients, among them the presence of inversion of T wave in 91 (68.4%) and depression of the ST segment – in 54 (40.6%) patients respectively. The predictors of which are: reducing of glomerular filtration rate <60 ml/min/1.73 m2; the duration of hospitalization; the old age of the patients.