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Background  Arrhythmia is a significant clinical modifier in COVID‐19 patient outcomes. Currently, data on arrhythmia and ECG characteristics in COVID‐19 from lower middle‐income countries are limited.    Methods  COVID‐19 was confirmed by polymerase chain reaction testing of a nasopharyngeal sample. All clinical records were systematically evaluated to obtain demographic characteristics and medical comorbidities. The ECG was recorded on admission, in‐hospital, and at discharge.    Results  Total documented arrhythmia events account for 22% of patients, comprising 6% of new‐onset arrhythmia and 16% of existing arrhythmia. Atrial fibrillation is the most common arrhythmia. The ECG changes were a decrease in heart rate (91 ± 22 vs. 83 ± 20,  p  < .001) and an increase in the QT interval (354.7 ± 53.70 vs. 371.4 ± 59.48 msec,  p  < .001) from hospital admission to hospital discharge, respectively. The in‐hospital HR of 85 bpm or higher increases the risk of death (OR = 2.69,  p  = .019).    Conclusion  The incidence of arrhythmias in COVID‐19 patients at COVID‐19 referral hospitals in Indonesia is 22%. Atrial fibrillation is the most common arrhythmia in COVID‐19 patients. Prolongation of QRS duration from admission to discharge was related to the occurrence of new‐onset arrhythmia. The in‐hospital HR of 85 bpm or higher increased the risk of death.

ECG characteristics of COVID ‐19 patient with arrhythmias: Referral hospitals data from Indonesia