tetano
Editor, Senior Moderator
J Arrhythm
. 2020 Jul 26;36(5):827-836.
doi: 10.1002/joa3.12405. eCollection 2020 Oct.
Cardiac arrhythmias in patients with COVID-19
Yueying Wang[SUP] 1 [/SUP], Zhaojia Wang[SUP] 1 [/SUP], Gary Tse[SUP] 1 [/SUP], Lin Zhang[SUP] 2 [/SUP], Elaine Y Wan[SUP] 3 [/SUP], Yutao Guo[SUP] 4 [/SUP], Gregory Y H Lip[SUP] 4 5 [/SUP], Guangping Li[SUP] 1 [/SUP], Zhibing Lu[SUP] 2 [/SUP], Tong Liu[SUP] 1 [/SUP]
Affiliations
Abstract
The emergence of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a major global public health concern. Although SARS-CoV-2 causes primarily respiratory problems, concurrent cardiac injury cannot be ignored since it may be an independent predictor for adverse outcomes. Cardiac arrhythmias are often observed in patients with COVID-19, especially in severe cases, and more likely contribute to the high risk of adverse outcomes. Arrhythmias should be regarded as one of the main complications of COVID-19. Mechanistically, a number of ion channels can be adversely affected in COVID-19, leading to alterations in cardiac conduction and/or repolarization properties, as well as calcium handling, which can predispose to cardiac arrhythmogenesis. In addition, several antimicrobials that are currently used as potential therapeutic agents for COVID-19, such as chloroquine, hydroxychloroquine and azithromycin, have uncertain benefit, and yet may induce electrocardiographic QT prolongation with potential ventricular pro-arrhythmic effects. Continuous electrocardiogram monitoring, accurate and prompt recognition of arrhythmias are important. The present review focuses on cardiac arrhythmias in patients with COVID-19, its underlying mechanisms, and proposed preventive and therapeutic strategies.
Keywords: COVID‐19; QT interval; SARS‐CoV‐2; angiotensin‐converting enzyme‐2; arrhythmia; electrocardiogram.
. 2020 Jul 26;36(5):827-836.
doi: 10.1002/joa3.12405. eCollection 2020 Oct.
Cardiac arrhythmias in patients with COVID-19
Yueying Wang[SUP] 1 [/SUP], Zhaojia Wang[SUP] 1 [/SUP], Gary Tse[SUP] 1 [/SUP], Lin Zhang[SUP] 2 [/SUP], Elaine Y Wan[SUP] 3 [/SUP], Yutao Guo[SUP] 4 [/SUP], Gregory Y H Lip[SUP] 4 5 [/SUP], Guangping Li[SUP] 1 [/SUP], Zhibing Lu[SUP] 2 [/SUP], Tong Liu[SUP] 1 [/SUP]
Affiliations
- PMID: 33024460
- PMCID: PMC7532267
- DOI: 10.1002/joa3.12405
Abstract
The emergence of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a major global public health concern. Although SARS-CoV-2 causes primarily respiratory problems, concurrent cardiac injury cannot be ignored since it may be an independent predictor for adverse outcomes. Cardiac arrhythmias are often observed in patients with COVID-19, especially in severe cases, and more likely contribute to the high risk of adverse outcomes. Arrhythmias should be regarded as one of the main complications of COVID-19. Mechanistically, a number of ion channels can be adversely affected in COVID-19, leading to alterations in cardiac conduction and/or repolarization properties, as well as calcium handling, which can predispose to cardiac arrhythmogenesis. In addition, several antimicrobials that are currently used as potential therapeutic agents for COVID-19, such as chloroquine, hydroxychloroquine and azithromycin, have uncertain benefit, and yet may induce electrocardiographic QT prolongation with potential ventricular pro-arrhythmic effects. Continuous electrocardiogram monitoring, accurate and prompt recognition of arrhythmias are important. The present review focuses on cardiac arrhythmias in patients with COVID-19, its underlying mechanisms, and proposed preventive and therapeutic strategies.
Keywords: COVID‐19; QT interval; SARS‐CoV‐2; angiotensin‐converting enzyme‐2; arrhythmia; electrocardiogram.