Clinical characteristics and prognosis of hospitalized COVID‐19 patients with incident sustained tachyarrhythmias: A multicenter observational study

• Published in: European journal of clinical investigation 2020-12, Vol.50 (12), p.e13387-n/a
• Main Authors: Russo, Vincenzo, Di Maio, Marco, Mottola, Filiberto Fausto, Pagnano, Gianpiero, Attena, Emilio, Verde, Nicoletta, Di Micco, Pierpaolo, Silverio, Angelo, Scudiero, Fernando, Nunziata, Luigi, Fele, Nunzia, D'Andrea, Antonello, Parodi, Guido, Albani, Stefano, Scacciatella, Paolo, Nigro, Gerardo, Severino, Sergio
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Arrhythmia; Arrhythmias, Cardiac - epidemiology; Atrial Fibrillation; Atrial Fibrillation - epidemiology; Cardiac arrhythmia; COVID-19; COVID-19 - mortality; COVID-19 - physiopathology; Covid‐19 and arrhythmia; Covid‐19 and cardiovascular complications; Covid‐19 and cardiovascular System; Emergency medical care; Emergency medical services; Female; Hospital Mortality; Hospitalization; Humans; Incidence; Italy - epidemiology; Male; Middle Aged; Mortality; Multivariate Analysis; Observational studies; Original; Original Papers; Patients; Prognosis; Recurrence; Renal Insufficiency, Chronic - epidemiology; Respiratory Distress Syndrome - epidemiology; Respiratory Distress Syndrome - physiopathology; Retrospective Studies; SARSCoV‐2 and ventricular arrhythmias; SARS‐CoV‐2; Severity of Illness Index; Tachyarrhythmia; Tachycardia, Supraventricular - epidemiology; Tachycardia, Ventricular - epidemiology
• ISSN: 0014-2972; 1365-2362
• DOI: 10.1111/eci.13387

Introduction Little is still known about the prognostic impact of incident arrhythmias in hospitalized patients with COVID‐19. The aim of this study was to evaluate the incidence and predictors of sustained tachyarrhythmias in hospitalized patients with COVID‐19, and their potential association with disease severity and in‐hospital mortality. Materials and methods This was a retrospective multicenter observation study including consecutive patients with laboratory confirmed COVID‐19 admitted to emergency department of ten Italian Hospitals from 15 February to 15 March 2020. The prevalence and the type of incident sustained arrhythmias have been collected. The correlation between the most prevalent arrhythmias and both baseline characteristics and the development of ARDS and in‐hospital mortality has been evaluated. Results 414 hospitalized patients with COVID‐19 (66.9 ± 15.0 years, 61.1% male) were included in the present study. During a median follow‐up of 28 days (IQR: 12‐45), the most frequent incident sustained arrhythmia was AF (N: 71; 17.1%), of which 50 (12.1%) were new‐onset and 21 (5.1%) were recurrent, followed by VT (N: 14, 3.4%) and supraventricular arrhythmias (N: 5, 1.2%). Incident AF, both new‐onset and recurrent, did not affect the risk of severe adverse events including ARDS and death during hospitalization; in contrast, incident VT significantly increased the risk of in‐hospital mortality (RR: 2.55; P: .003). Conclusions AF is the more frequent incident tachyarrhythmia; however, it not seems associated to ARDS development and death. On the other hand, incident VT is a not frequent but independent predictor of in‐hospital mortality among hospitalized COVID‐19 patients.