Arrhythmia patterns during and after hospitalization for COVID-19 infection detected via patch-based mobile cardiac telemetry

Abstract

Background Coronavirus infection is the cause of the current world-wide pandemic. Cardiovascular complications occur in 20–30% of patients with COVID-19 infection including myocardial injury and arrhythmias. Current understanding of specific arrhythmia type and frequency is limited. Objective We aimed to analyze arrhythmia type and frequency in patients with COVID infection, identifying arrhythmia patterns over time during hospitalization and post discharge utilizing a patch based mobile cardiac telemetry system. Methods A prospective cohort study during the COVID-19 pandemic was performed. We included in our study patients hospitalized with COVID-19 infection who had a patch-based mobile telemetry device placed for cardiac monitoring. Results Quantitative reports for 59 patients were available for analysis. Arrhythmias were detected in 72.9% of patients and at a consistent frequency throughout the monitoring period in 52.9%–89.5% of patients daily. The majority of arrhythmias were SVT (59.3% of patients) and AF (22.0%). New onset AF was noted in 15.0% of all patients and was significantly associated with older age (OR 1.4 for 5 yrs. difference; 95% CI 1.03–2.13). Of 9 patients who were discharged with continued patch monitoring, 7 (78%) had arrhythmic events during their outpatient monitoring period. Conclusion In COVID-19 patients arrhythmias were observed throughout hospitalization with a consistent daily frequency. Patients continued to exhibit cardiac arrhythmias after hospital discharge of a type and frequency similar to that seen during hospitalization. These findings suggest that the risk of arrhythmia associated with COVID infection remains elevated throughout the hospital course as well as following hospital discharge.

Frequent Cardiovascular Manifestations Associated With SARS Cov-2 Infection: Experience at a Tertiary Hospital In Cali, Colombia

“…9 Current studies confirm the presence of these findings using telemetry devices, identifying at least one episode of arrhythmia in 73% of cases analyzed, with a possible increase during the evolution of the disease. 41 Other findings, such as changes in the ST segment, have also been reported during COVID-19, either mimicking an acute coronary syndrome or as a manifestation of other cardiovascular complications, including myocarditis or pericarditis. 42 Another important aspect is use of pharmacological therapies with effects on the cardiovascular system, such as macrolides and hydroxychloroquine, which have been reported in our study in 46.5% and 11.5% of cases, respectively, compared with the results of other studies that reported frequency of use of up to 80%.…”

Detection of SARS-CoV-2 Antigens in the AV-Node of a Cardiac Conduction System—A Case Report

“…As COVID-19 is a systemic hyperinflammatory disease significantly impairing respiratory function, and the latter factors have long been known as being pro-arrhythmic in many other clinical entities, these assumptions are fully justified, while the mentioned mechanisms most likely contribute to the development of COVID-19-driven arrhythmias. However, mechanistic studies on the arrhythmia pathogenesis in the specific context of SARS-CoV-2 infection are lacking, and an abnormal heart rhythm has been found to be frequent in recovered patients [ 7 ], as well as in patients with mild symptomatology [ 3 ], who are not hypoxemic and do not have a hyperinflammatory response.…”

COVID-19: a cardiovascular approach

“…As arritmias cardíacas relacionadas ao COVID-19 apresentam-se como segunda maior complicação da infecção, perdendo apenas para Hipertensão Arterial (HONARDOOST, et al, 2021), sendo as atriais as mais comuns e indutoras de quadros mais graves que as arritmias ventriculares (REYNBAKH, et al, 2022). Em estudo conduzido com 241 pacientes internados por COVID-19, as arritmias pós infecção se desenvolveram em 21% deles (PIMENTEL, et al, 2021).…”