Does Cardiac Arrhythmia Predict Worse Outcome in Mild or Moderate Covid-19 Infection?
Abraham Speedie, Anand Manickavasagam, Sirish Chandra Srinath Patloori, Reka Karuppusamy, Rintu James, Mahalakshmi S, David Chase, John Roshan Jacob
Author Information
Abraham Speedie: Department of Cardiology, Cardiac Electrophysiology Unit, Christian Medical College and Hospital, Vellore, TN 632004 India.
Anand Manickavasagam: Department of Cardiology, Cardiac Electrophysiology Unit, Christian Medical College and Hospital, Vellore, TN 632004 India.
Sirish Chandra Srinath Patloori: Department of Cardiology, Cardiac Electrophysiology Unit, Christian Medical College and Hospital, Vellore, TN 632004 India.
Reka Karuppusamy: Department of Biostatistics, Christian Medical College and Hospital, Vellore, TN 632004 India.
Rintu James: Department of Cardiology, Cardiac Electrophysiology Unit, Christian Medical College and Hospital, Vellore, TN 632004 India.
Mahalakshmi S: Department of Cardiology, Cardiac Electrophysiology Unit, Christian Medical College and Hospital, Vellore, TN 632004 India.
David Chase: Department of Cardiology, Cardiac Electrophysiology Unit, Christian Medical College and Hospital, Vellore, TN 632004 India.
John Roshan Jacob: Department of Cardiology, Cardiac Electrophysiology Unit, Christian Medical College and Hospital, Vellore, TN 632004 India. ORCID
Covid-19 is a multisystem disease with the lungs being predominantly affected. Cardiac involvement is mostly seen as a rise in troponins, arrhythmias, and ventricular dysfunction. This study aimed to estimate the incidence of arrhythmias seen in Covid-19 infection and assess if arrhythmias predict worsening or mortality Prospective observational study involving patients with mild to moderate Covid illness admitted in a tertiary care centre. Among the 85 patients (Mean age 45.8 + 14.1 years; 75.31% men), worsening of Covid-19 illness was seen in 29 (34.1%) patients. New onset arrhythmias were detected on Holter in 9 (10.5%) patients. Supraventricular tachycardia was seen in 7 (8.2%) patients of whom 6 showed worsening which was statistically significant (-value-0.006). Risk factors associated with worsening on univariate analysis were male gender (OR [95%CI] = 6.93(1.49-32.31), -value - 0.014), new onset supraventricular tachycardia (OR [95% CI] = 14.35 [1.64-125.94], -value - 0.016) and D-dimer elevation (OR [95% CI] = 1.00(1.00-1.01), -value - 0.02). On multivariate analysis D-dimer (OR [95% CI] = 1.00(1.00-1.01; -value 0.046) and supraventricular arrhythmias (OR [95% CI] = 11.12 (1.22-101.14); -value - 0.033) were independently associated with worsening. Covid-19 infection can lead to cardiac arrhythmias. The development of supraventricular tachycardia in patients with Covid-19 infection predicts higher morbidity and worsening.
