Critically ill COVID-19 patients are 10 times more likely to develop
cardiac arrhythmias
Study suggests cardiac arrests and arrhythmias are likely triggered by systemic illness, not solely due to the viral infection itself

Date:
June 22, 2020
Source:
University of Pennsylvania School of Medicine
Summary:
Patients with COVID-19 who were admitted to an intensive care
unit were 10 times more likely than other hospitalized COVID-19
patients to suffer cardiac arrest or heart rhythm disorders,
according to a new study.



FULL STORY ========================================================================== Patients with COVID-19 who were admitted to an intensive care unit were
10 times more likely than other hospitalized COVID-19 patients to suffer cardiac arrest or heart rhythm disorders, according to a new study
from researchers in the Perelman School of Medicine at the University
of Pennsylvania.


========================================================================== Researchers say the results suggest that cardiac arrests and arrhythmias suffered by some patients with COVID-19 are likely triggered by a severe, systemic form of the disease and are and not the sole consequence of the
viral infection. The findings -- which differ significantly from early
reports that showed a high incidence of arrhythmias among all COVID-19
patients -- provide more clarity about the role of the novel coronavirus, SARS-COV-2, and the disease it causes, COVID-19, in the development
of arrhythmias, including irregular heart rate (atrial fibrillation),
slow heart rhythms (bradyarrhythmia) or rapid heart rate that stops by
itself within 30 seconds (non-sustained ventricular tachycardia).

The study was published today in the Heart Rhythm Journal -- the official journal of the Heart Rhythm Society.

"In order to best protect and treat patients who develop COVID-19, it's critical for us to improve our understanding of how the disease affects
various organs and pathways within our body -- including our heart rhythm abnormalities," said the study's senior and corresponding author Rajat
Deo, MD, MTR, a cardiac electrophysiologist and an associate professor of Cardiovascular Medicine at Penn. "Our findings suggest that non-cardiac
causes such as systemic infection, inflammation and illness are likely
to contribute more to the occurrence of cardiac arrest and arrhythmias
than damaged or infected heart cells due to the viral infection."
Recent studies from China have suggested that COVID-19 is associated with
a high incidence of cardiac arrhythmias, particularly among critically
ill patients -- early reports showed 44 percent of patients admitted to
the ICU suffered arrhythmias. Heart rhythm problems occur when electrical impulses that coordinate your heartbeats don't work properly, causing
your heart to beat too fast, too slow, or irregularly. If left untreated, cardiac arrhythmias can lead to serious medical conditions, including
stroke and cardiac arrest -- the abrupt loss of heart function.

To evaluate the risk and incidence of cardiac arrest and arrhythmias
among hospitalized patients with COVID-19, the Penn team evaluated
700 patients with COVID-19 who were admitted to the Hospital of the
University of Pennsylvania between early March and mid-May. Researchers evaluated cardiac telemetry and clinical records for patient demographics
and medical comorbidities -- such as heart disease, diabetes and chronic
kidney disease -- and recorded patient vitals, test results and treatment.

The cohort of patients had a mean age of 50 years, with Black patients accounting for more than 70 percent of the population. Researchers
identified a total of 53 arrhythmic events: nine patients who suffered
cardiac arrest, 25 patients with atrial fibrillation who required
treatment, nine patients with clinically significant bradyarrhythmias
and 10 non-sustained ventricular tachycardia events. The team did not
identify any cases of heart block, sustained ventricular tachycardia or ventricular fibrillation.

Of the 700 patients hospitalized, about 11 percent were admitted to
the ICU.

None of the other hospitalized patients suffered a cardiac arrest. After controlling for underlying demographic and clinical factors, researchers
found cardiac arrest and arrhythmias were more likely to occur among
patients in an ICU compared to the other hospitalized patients.

Researchers noted that the study has several limitations, including
that the analysis was conducted from a single center serving a large
urban population.

"More research is needed to assess whether the presence of cardiac
arrhythmias have long-term health effects on patients who were
hospitalized for COVID-19," Deo said. "In the meantime, it's important
that we launch studies to evaluate the most effective and safest
strategies for long-term anticoagulation and rhythm management in this population." Additional Penn authors include Anjali Bhatla, Michael
M. Mayer, Srinath Adusumalli, Matthew C. Hyman, Eric Oh, Ann Tierney,
Juwann Moss, Anwar A Chahal, George Anesi, Srinivas Denduluri, Christopher
M. Domenico, Jeffrey Arkles, Benjamin S. Abella, John R. Bullinga,
David J. Callans, Sanjay Dixit, Andrew E. Epstein, David S. Frankel,
Fermin C. Garcia, Ramanan Kumareswaram, Saman Nazarian, Michael P. Riley, Pasquale Santangeli, Robert D. Schaller, Gregory E. Supple, David Lin,
and Francis Marchlinski.

The research was supported, in part, by the Winkelman Family Fund in Cardiovascular Innovation.


========================================================================== Story Source: Materials provided by University_of_Pennsylvania_School_of_Medicine. Note: Content may be
edited for style and length.


========================================================================== Journal Reference:
1. Anjali Bhatla, Michael M. Mayer, Srinath Adusumalli, Matthew
C. Hyman,
Eric Oh, Ann Tierney, Juwann Moss, Anwar A. Chahal, George Anesi,
Srinivas Denduluri, Christopher M. Domenico, Jeffrey Arkles,
Benjamin S.

Abella, John R. Bullinga, David J. Callans, Sanjay Dixit, Andrew E.

Epstein, David S. Frankel, Fermin C. Garcia, Ramanan Kumareswaram,
Saman Nazarian, Michael P. Riley, Pasquale Santangeli, Robert
D. Schaller, Gregory E. Supple, David Lin, Francis Marchlinski,
Rajat Deo. COVID-19 and Cardiac Arrhythmias. Heart Rhythm, 2020;
DOI: 10.1016/ j.hrthm.2020.06.016 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/06/200622133006.htm

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