The clinical implications of sinus tachycardia in mild COVID-19 infection: A retrospective cohort study

Abstract

Objectives: This study aims to estimate the prevalence of sinus tachycardia in hospitalized patients with mild COVID-19 infection and to identify the clinical, radiological, and biological characteristics associated with sinus tachycardia. Methods: A retrospective cohort study was conducted on patients with mild COVID-19 infection and sinus tachycardia during hospitalization. Outcomes measured included incidences of venous thromboembolism, high-dependency/intensive care unit admission, laboratory parameters, and radiological findings. Results: A total of 236 COVID-19 positive patients admitted to Singapore General Hospital isolation general wards from 1 June 2020 to 30 June 2020 were included in this study. Ninety-seven (41.1%) patients had sinus tachycardia on or during their admission. All patients were monitored in general wards and discharged to community quarantine facilities. None required oxygen support or high-dependency/intensive care unit admission. Sinus tachycardia was associated with increased C-reactive protein level (odds ratio = 1.033, 95% confidence interval = 1.002–1.066), abnormal chest X-ray findings (odds ratio = 3.142, 95% confidence interval = 1.390–7.104), and longer hospitalization (odds ratio = 1.117, 95% confidence interval = 1.010–1.236). There was no significant statistical association between sinus tachycardia and incidences of venous thromboembolism. Conclusion: This study suggests that patients with mild COVID-19 infection and concurrent sinus tachycardia are more likely to have higher inflammatory marker levels, abnormal imaging, and prolonged hospitalization. However, no significant association between sinus tachycardia and thromboembolism is identified in mild COVID-19 infection.

Arrhythmias in COVID-19/SARS-CoV-2 Pneumonia Infection: Prevalence and Implication for Outcomes

“…In our cohort we found an incidence of baseline ARs around 20%, in line with data in the literature; these patients experienced a 2-fold risk of mortality, as reported in the results section. High heart rate, particularly sinus tachycardia, has been associated with higher inflammatory biomarkers and prolonged hospitalization in COVID-19 patients, but not with higher risk of thromboembolic events [ 23 ]. Sinus tachycardia resulted the most common ARs in a small cohort of COVID-19 patients, and survivors were less tachycardic than non-survivors [ 24 ].…”

Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review

“…After removing duplicates, 1585 results remained and were evaluated for title and abstract check. Therefore, 65 reports were considered in the full-text review stage, and 20 of those were included in the systematic review [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48], while 45 reports were excluded: 2 papers written in Russian [49,50], 5 conference papers [51][52][53][54][55], 3 comments [56][57][58], 4 case reports or case series [59][60][61][62], 2 literature reviews [63,64], 1 study protocol [65], 12 studies that did not perform a formal evaluation of autonomic functions [66][67][68][69][70][71][72][73][74][75]…”

“…Details regarding the selection process are available in the PRISMA diagram (Figure 1). [66][67][68][69][70][71][72][73][74][75][76][77]; not acute COVID-19 population-Refs. [78][79][80][81][82][83][84][85][86][87][88][89][90]; not in English or Italian-Refs.…”

“…The PRISMA diagram of the systematic review. Reports excluded: Not formal assessment of dysautonomia-Refs [66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90]…”

Risk factors for mortality in patients with dengue: A systematic review and meta‐analysis

“…Pathologic causes, such as infections, bleeding, and shock, are usually related to increased sympathetic activity and hypoxia [54]. Sinus tachycardia in febrile viral illnesses is known to be caused by several factors, including fever, hypoxia, hypotension, anaemia, inflammatory response, and anxiety [55]. In patients with dengue, as vascular permeability and haemorrhagic phenomena ensue, hypovolemia may result in circulatory collapse and shock.…”