The Prevalence and Associated Death of Ventricular Arrhythmia and Sudden Cardiac Death in Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis

Abstract

BackgroundArrhythmia is a very common complication of coronavirus disease 2019 (COVID-19); however, the prevalence of ventricular arrhythmia and associated outcomes are not well-explored. Here, we conducted a systematic review and meta-analysis to determine the prevalence and associated death of ventricular arrhythmia and sudden cardiac death (SCD) in patients with COVID-19.MethodsDatabases of PubMed, Cochrane Library, Embase, and MdeRxiv were searched. Studies that could calculate the prevalence of ventricular arrhythmia/SCD during hospital admission or associated death in patients with COVID-19 were included. The study was registered with the PROSPERO (CRD42021271328).ResultsA total of 21 studies with 13,790 patients were included. The pooled prevalence of ventricular arrhythmia was 5% (95% CI: 4–6%), with a relatively high-SCD prevalence (1.8% in hospitalized COVID-19 and 10% in deceased cases of COVID-19). Subgroup analysis showed that ventricular arrhythmia was more common in patients with elevated cardiac troponin T [ES (effect size): 10%, 95% CI: −0.2 to 22%] and in European (ES: 20%, 95% CI: 11–29%) populations. Besides, ventricular arrhythmia was independently associated with an increased risk of death in patients with COVID-19 [odds ratio (OR) = 2.83; 95% CI: 1.78–4.51].ConclusionVentricular arrhythmia and SCD resulted as a common occurrence with a high prevalence in patients with COVID-19 admitted to the hospital. Furthermore, ventricular arrhythmia significantly contributed to an increased risk of death in hospitalized patients with COVID-19. Clinicians might be vigilant of ventricular arrhythmias for patients with COVID-19, especially for severe cases.Systematic Review Registrationwww.york.ac.uk/inst/crd, identifier: CRD42021271328.

The effect of SARS‐CoV‐2 infection on cardiac function in post‐COVID‐19 survivors: A systematic review and meta‐analysis

“…Several studies illustrated that the cardiac dysfunction parameter is significantly associated with all‐cause mortality in hospitalized patients with COVID‐19 66 and survivors of COVID‐19 67 . In a systematic review and meta‐analysis, Diaz‐Arocutipa et al 68 showed that among cardiac parameters, TAPSE was independently associated with higher mortality.…”

“…In the present systematic review and meta-analysis, we performed a pooled analysis to evaluate the effect of SARS-CoV- indeed, reduced right ventricular function was reported as a risk factor for adverse events in community-acquired pneumonia, 64 as well as in patients with ventricular dysfunction. 65 Several studies illustrated that the cardiac dysfunction parameter is significantly associated with all-cause mortality in hospitalized patients with COVID-19 66 and survivors of COVID-19. 67 In a systematic review and meta-analysis, Diaz-Arocutipa et al 68 showed that among cardiac parameters, TAPSE was independently associated with higher mortality.…”

COVID-19 Cardiovascular Connection: A Review of Cardiac Manifestations in COVID-19 Infection and Treatment Modalities

“…This is suggestive of severe hypoxia and critical illness being the main drivers of cardiac arrest. A multinational analysis of hospitalized COVID patients showed a pooled prevalence of ventricular arrhythmia to be 5% in the perimortem time 30 . Although less frequent when present, ventricular arrhythmias significantly contributed to an increased risk of death in those patients 31 , 32 .…”

Risk and Protective Factors for Sudden Cardiac Death: An Umbrella Review of Meta-Analyses

“…Thus, electrophysiology testing must be considered, especially in the pediatric population ( 68 ). There is evidence of an increased incidence of ventricular arrhythmias and SCD in COVID-19 patients ( 69 ), while a recent meta-analysis found a higher prevalence of SCD during the COVID-19 pandemic compared to the pre-pandemic period ( 70 ). Several mechanisms have been proposed to explain the possible association of SARS-CoV-2 infection with increased SCD risk and arrhythmogenesis, including direct myocardial injury, oxygen demand-supply mismatch due to hypoxia, hypercoagulability, and adverse effects of medications for COVID-19 ( 71 ).…”