Dataset Information

Malignant Arrhythmias in Patients With COVID-19: Incidence, Mechanisms, and Outcomes.

ABSTRACT:

Background

Patients with coronavirus disease 2019 (COVID-19) who develop cardiac injury are reported to experience higher rates of malignant cardiac arrhythmias. However, little is known about these arrhythmias-their frequency, the underlying mechanisms, and their impact on mortality.

Methods

We extracted data from a registry (NCT04358029) regarding consecutive inpatients with confirmed COVID-19 who were receiving continuous telemetric ECG monitoring and had a definitive disposition of hospital discharge or death. Between patients who died versus discharged, we compared a primary composite end point of cardiac arrest from ventricular tachycardia/fibrillation or bradyarrhythmias such as atrioventricular block.

Results

Among 800 patients with COVID-19 at Mount Sinai Hospital with definitive dispositions, 140 patients had telemetric monitoring, and either died (52) or were discharged (88). The median (interquartile range) age was 61 years (48-74); 73% men; and ethnicity was White in 34%. Comorbidities included hypertension in 61%, coronary artery disease in 25%, ventricular arrhythmia history in 1.4%, and no significant comorbidities in 16%. Compared with discharged patients, those who died had elevated peak troponin I levels (0.27 versus 0.02 ng/mL) and more primary end point events (17% versus 4%, P=0.01)-a difference driven by tachyarrhythmias. Fatal tachyarrhythmias invariably occurred in the presence of severe metabolic imbalance, while atrioventricular block was largely an independent primary event.

Conclusions

Hospitalized patients with COVID-19 who die experience malignant cardiac arrhythmias more often than those surviving to discharge. However, these events represent a minority of cardiovascular deaths, and ventricular tachyarrhythmias are mainly associated with severe metabolic derangement. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04358029.

SUBMITTER: Turagam MK

PROVIDER: S-EPMC7668347 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Malignant Arrhythmias in Patients With COVID-19: Incidence, Mechanisms, and Outcomes.

Turagam Mohit K MK Musikantow Daniel D Goldman Martin E ME Bassily-Marcus Adel A Chu Edward E Shivamurthy Poojita P Lampert Joshua J Kawamura Iwanari I Bokhari Mahmoud M Whang William W Bier Benjamin Aaron BA Malick Waqas W Hashemi Helen H Miller Marc A MA Choudry Subbarao S Pumill Christopher C Ruiz-Maya Tania T Hadley Michael M Giustino Gennaro G Koruth Jacob S JS Langan Noelle N Sofi Aamir A Dukkipati Srinivas R SR Halperin Jonathan L JL Fuster Valentin V Kohli-Seth Roopa R Reddy Vivek Y VY

Circulation. Arrhythmia and electrophysiology 20201007 11

<h4>Background</h4>Patients with coronavirus disease 2019 (COVID-19) who develop cardiac injury are reported to experience higher rates of malignant cardiac arrhythmias. However, little is known about these arrhythmias-their frequency, the underlying mechanisms, and their impact on mortality.<h4>Methods</h4>We extracted data from a registry (NCT04358029) regarding consecutive inpatients with confirmed COVID-19 who were receiving continuous telemetric ECG monitoring and had a definitive dispositi ...[more]

PMID: 33026892

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Dataset Information

Malignant Arrhythmias in Patients With COVID-19: Incidence, Mechanisms, and Outcomes.

Background

Methods

Results

Conclusions

Publications

Malignant Arrhythmias in Patients With COVID-19: Incidence, Mechanisms, and Outcomes.

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