tetano
Editor, Senior Moderator
Pacing Clin Electrophysiol
. 2021 Apr 23.
doi: 10.1111/pace.14247. Online ahead of print.
Arrhythmias and Electrocardiographic findings in Coronavirus disease 2019: a systematic review and meta-analysis
Sebastian Garcia-Zamora[SUP] 1 [/SUP], Sharen Lee[SUP] 2 [/SUP], Sohaib Haseeb[SUP] 3 [/SUP], George Bazoukis[SUP] 4 [/SUP], Gary Tse[SUP] 5 [/SUP], Jesus Alvarez-Garcia[SUP] 6 7 [/SUP], Enes Elvin Gul[SUP] 8 [/SUP], G?ksel ?inier[SUP] 9 [/SUP], Bryce Alexander[SUP] 10 [/SUP], Marcelo Martins Pinto-Filho[SUP] 11 [/SUP], Tong Liu[SUP] 5 [/SUP], Adrian Baranchuk[SUP] 10 [/SUP], International Society of Electrocardiology Young Community (ISE-YC)
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) primarily causes lung infection, but recent studies have shown that cardiac involvement is associated with a worse prognosis.
Objectives: We conducted a systematic review and meta-analysis to examine the prevalence of cardiac arrhythmias detected by the electrocardiogram and their relationships with adverse outcomes in patients with COVID-19.
Methods: PubMed and Google were searched for studies that reported on cardiac arrhythmias and/or examined the relationship between arrhythmias and adverse outcomes.
Results: Thirty studies with 12,713 participants were included in the systematic review, and 28 studies (n = 12,499) in the meta-analysis. The mean age was 61.3 ?16.8 years; 39.3% were female. In 25 studies with 7,578 patients, the overall prevalence of cardiac arrhythmias was 10.3% (95% confidence interval [CI]: 8.4% to 12.3%). The most common arrhythmias documented during hospitalization were supraventricular arrhythmias (6.2%, 95% CI: 4.4% to 8.1%) followed by ventricular arrhythmias (2.5%, 95% CI: 1.8% to 3.1%). The incidence of cardiac arrhythmias was higher among critically ill patients (relative risk [RR]: 12.1, 95% CI: 8.5 to 17.3) and among non-survivors (RR: 3.8, 95%, CI: 1.7 to 8.7). Eight studies reported changes in the QT interval. The prevalence of QTc >500 ms was 12.3% (95% CI: 6.9% to 17.8%). ST-segment deviation was reported in eight studies, with a pooled estimate of 8.7% (95% CI: 7.3% to 10.0%).
Conclusion: Our meta-analysis showed that QTc prolongation, ST-segment deviation, and various other cardiac arrhythmias were observed in patients hospitalized with COVID-19. The presence of cardiac arrhythmias was associated with a worse prognosis. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; ECG; atrial fibrillation; ventricular tachyarrhythmias.
. 2021 Apr 23.
doi: 10.1111/pace.14247. Online ahead of print.
Arrhythmias and Electrocardiographic findings in Coronavirus disease 2019: a systematic review and meta-analysis
Sebastian Garcia-Zamora[SUP] 1 [/SUP], Sharen Lee[SUP] 2 [/SUP], Sohaib Haseeb[SUP] 3 [/SUP], George Bazoukis[SUP] 4 [/SUP], Gary Tse[SUP] 5 [/SUP], Jesus Alvarez-Garcia[SUP] 6 7 [/SUP], Enes Elvin Gul[SUP] 8 [/SUP], G?ksel ?inier[SUP] 9 [/SUP], Bryce Alexander[SUP] 10 [/SUP], Marcelo Martins Pinto-Filho[SUP] 11 [/SUP], Tong Liu[SUP] 5 [/SUP], Adrian Baranchuk[SUP] 10 [/SUP], International Society of Electrocardiology Young Community (ISE-YC)
Affiliations
- PMID: 33890684
- DOI: 10.1111/pace.14247
Abstract
Background: Coronavirus disease 2019 (COVID-19) primarily causes lung infection, but recent studies have shown that cardiac involvement is associated with a worse prognosis.
Objectives: We conducted a systematic review and meta-analysis to examine the prevalence of cardiac arrhythmias detected by the electrocardiogram and their relationships with adverse outcomes in patients with COVID-19.
Methods: PubMed and Google were searched for studies that reported on cardiac arrhythmias and/or examined the relationship between arrhythmias and adverse outcomes.
Results: Thirty studies with 12,713 participants were included in the systematic review, and 28 studies (n = 12,499) in the meta-analysis. The mean age was 61.3 ?16.8 years; 39.3% were female. In 25 studies with 7,578 patients, the overall prevalence of cardiac arrhythmias was 10.3% (95% confidence interval [CI]: 8.4% to 12.3%). The most common arrhythmias documented during hospitalization were supraventricular arrhythmias (6.2%, 95% CI: 4.4% to 8.1%) followed by ventricular arrhythmias (2.5%, 95% CI: 1.8% to 3.1%). The incidence of cardiac arrhythmias was higher among critically ill patients (relative risk [RR]: 12.1, 95% CI: 8.5 to 17.3) and among non-survivors (RR: 3.8, 95%, CI: 1.7 to 8.7). Eight studies reported changes in the QT interval. The prevalence of QTc >500 ms was 12.3% (95% CI: 6.9% to 17.8%). ST-segment deviation was reported in eight studies, with a pooled estimate of 8.7% (95% CI: 7.3% to 10.0%).
Conclusion: Our meta-analysis showed that QTc prolongation, ST-segment deviation, and various other cardiac arrhythmias were observed in patients hospitalized with COVID-19. The presence of cardiac arrhythmias was associated with a worse prognosis. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; ECG; atrial fibrillation; ventricular tachyarrhythmias.