Cardiac dysrhythmia in COVID-19 patients; occurrence and risk factors

Abstract

Objective: In this study, we have evaluated the occurrence and risk factors of cardiac dysrhythmia on admission and during hospitalization in COVID-19 patients. Methods: This study was conducted as a retrospective cohort in which 893 electrocardiograms (ECGs) taken at the time of admission and 328 ECGs taken during hospitalization were evaluated. These ECGs were assessed for cardiac dysrhythmias by a cardiologist. Finally, relationships between clinical characteristics and the occurrence of cardiac dysrhythmias in patients were assessed. Results: Most common cardiac dysrhythmias on admission were sinus tachycardia (64.8%), atrial fibrillation (13.5%), and sinus bradycardia (11.3%). Multivariate regression analysis showed that a history of metformin use (RR=0.83; p=0.042) was independently associated with reduced risk of cardiac dysrhythmias on admission, while male sex (RR=1.16; p=0.018), history of cardiovascular diseases (RR=1.16; p=0.017), history of cancer (RR=1.40; p=0.004) and QT prolongation on ECG (RR=1.18; p=0.017) were associated with a higher risk of cardiac dysrhythmias on admission. Also, from the 328 patients that had a second ECG, 185 (56.4%) experienced cardiac dysrhythmias during their hospitalization. Multivariate analysis showed that presence of cardiac dysrhythmias on admission (RR=1.85; 95% CI; 1.49-2.35; p<0.001) was the only independent prognostic factor for the occurrence of cardiac dysrhythmias during hospitalization. no significant relationships were observed between treatment regimens and the incidence of cardiac dysrhythmias. Conclusion: The present study showed that more than half of COVID-19 patients have cardiac dysrhythmias on admission. Our analyses illustrated that a history of metformin use was associated with a lower risk of cardiac dysrhythmias on admission, while male sex, history of cardiovascular diseases, history of cancer, and QT prolongation were associated with a higher rate of cardiac dysrhythmias. Hydroxychloroquine use along with azithromycin and Kaletra (Lopinavir-Ritonavir) had no association with the development cardiac dysrhythmias during hospitalization.

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IssueVol 6 No 3 (2022): Summer (July) QRcode
SectionOriginal article
DOI 10.18502/fem.v6i3.9399
Keywords
Cardiac arrhythmia COVID-19 Electrocardiography Risk factors
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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1.
Haji Aghajani M, Haghighi M, Sistanizad M, Asadpoordezaki Z, Toloui A, Madani Neishaboori A, Pourhoseingholi A, Nasiri-Afrapoli F, Heydari A, Miri R, Yousefifard M. Cardiac dysrhythmia in COVID-19 patients; occurrence and risk factors. Front Emerg Med. 2022;6(3):e37.

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