COVID-19: is SARS-CoV-2 the direct culprit in cardiac arrests, arrhythmias?

  • Bhatla A & al.
  • Heart Rhythm
  • 20 Jun 2020

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • In this analysis of cardiac arrests and arrhythmias among patients hospitalized with COVID-19, systemic illness rather than direct infection appears to be responsible for the heart burden.

Why this matters

  • As cardiac effects emerged with COVID-19, whether SARS-CoV-2 or systemic inflammation was directly responsible has been unclear.
  • These authors view the higher event rates in more severe disease as arguing against a direct cardiac effect of the virus.

Key results

  • 71% of the 700 patients were Black; 45% were men; 6% had Afib history.
  • 11% were admitted to ICU; they had more cardiovascular, kidney, pulmonary, and liver disease, more diabetes, worse cardiac, inflammatory biomarkers.
    • ICU patients were also more likely to receive hydroxychloroquine or remdesivir.
  • 9 cardiac arrests, 25 Afib events, 9 significant bradyarrhythmias, 10 nonsustained ventricular tachycardias (NSVTs).
  • 4% overall died during 74 days: 23% of those in ICU vs 2% of those not in ICU (P<.001>
  • All arrests were in ICU, the only events linked to acute, in-hospital mortality:
    • aOR, 34.99 (95% CI, 3.49-350.69).
  • Afib was more likely in ICU patients: aOR, 4.68 (95% CI, 1.66-13.18).
  • NSVT was also more likely in ICU patients: aOR, 8.92 (95% CI, 1.73-46.06).

Study design

  • Data reviewed for patients with COVID-19 admitted to a US hospital.
  • Funding: Winkelman Family Fund in Cardiovascular Innovation.

Limitations

  • Single urban hospital.