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Arrhythmias and electrocardiographic findings in Coronavirus disease 2019: A systematic review and meta‐analysis
Author(s) -
GarciaZamora Sebastian,
Lee Sharen,
Haseeb Sohaib,
Bazoukis George,
Tse Gary,
AlvarezGarcia Jesus,
Gul Enes Elvin,
Çinier Göksel,
Alexander Bryce,
Martins PintoFilho Marcelo,
Liu Tong,
Baranchuk Adrian
Publication year - 2021
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.14247
Subject(s) - medicine , meta analysis , confidence interval , supraventricular arrhythmia , qt interval , incidence (geometry) , cardiology , cardiac arrhythmia , relative risk , sudden cardiac death , atrial fibrillation , physics , optics
Background Coronavirus disease 2019 (COVID‐19) primarily causes lung infection, but recent studies have shown that cardiac involvement is associated with a worse prognosis. Objectives We conducted a systematic review and meta‐analysis to examine the prevalence of cardiac arrhythmias detected by the electrocardiogram and their relationships with adverse outcomes in patients with COVID‐19. Methods PubMed and Google were searched for studies that reported on cardiac arrhythmias and/or examined the relationship between arrhythmias and adverse outcomes. Results Thirty studies with 12,713 participants were included in the systematic review, and 28 studies ( n = 12,499) in the meta‐analysis. The mean age was 61.3 ± 16.8 years; 39.3% were female. In 25 studies with 7578 patients, the overall prevalence of cardiac arrhythmias was 10.3% (95% confidence interval [CI]: 8.4%–12.3%). The most common arrhythmias documented during hospitalization were supraventricular arrhythmias (6.2%, 95% CI: 4.4%–8.1%) followed by ventricular arrhythmias (2.5%, 95% CI: 1.8%–3.1%). The incidence of cardiac arrhythmias was higher among critically ill patients (relative risk [RR]: 12.1, 95% CI: 8.5–17.3) and among non‐survivors (RR: 3.8, 95%, CI: 1.7–8.7). Eight studies reported changes in the QT interval. The prevalence of QTc > 500 ms was 12.3% (95% CI: 6.9%–17.8%). ST‐segment deviation was reported in eight studies, with a pooled estimate of 8.7% (95% CI: 7.3% to 10.0%). Conclusion Our meta‐analysis showed that QTc prolongation, ST‐segment deviation, and various other cardiac arrhythmias were observed in patients hospitalized with COVID‐19. The presence of cardiac arrhythmias was associated with a worse prognosis.