Zylla Maura M, Merle Uta, Vey Johannes A, Korosoglou Grigorios, Hofmann Eva, Müller Michael, Herth Felix, Schmidt Werner, Blessing Erwin, Göggelmann Christoph, Weidner Norbert, Fiedler Mascha O, Weigand Markus A, Kälble Florian, Morath Christian, Leiner Johannes, Kieser Meinhard, Katus Hugo A, Thomas Dierk
Department of Cardiology, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
German Center for Cardiovascular Research (DZHK), Partner site Heidelberg/Mannheim, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
J Clin Med. 2021 Jan 2;10(1):133. doi: 10.3390/jcm10010133.
Cardiac manifestation of COVID-19 has been reported during the COVID pandemic. The role of cardiac arrhythmias in COVID-19 is insufficiently understood. This study assesses the incidence of cardiac arrhythmias and their prognostic implications in hospitalized COVID-19-patients.
A total of 166 patients from eight centers who were hospitalized for COVID-19 from 03/2020-06/2020 were included. Medical records were systematically analyzed for baseline characteristics, biomarkers, cardiac arrhythmias and clinical outcome parameters related to the index hospitalization. Predisposing risk factors for arrhythmias were identified. Furthermore, the influence of arrhythmia on the course of disease and related outcomes was assessed using univariate and multiple regression analyses.
Arrhythmias were detected in 20.5% of patients. Atrial fibrillation was the most common arrhythmia. Age and cardiovascular disease were predictors for new-onset arrhythmia. Arrhythmia was associated with a pronounced increase in cardiac biomarkers, prolonged hospitalization, and admission to intensive- or intermediate-care-units, mechanical ventilation and in-hospital mortality. In multiple regression analyses, incident arrhythmia was strongly associated with duration of hospitalization and mechanical ventilation. Cardiovascular disease was associated with increased mortality.
Arrhythmia was the most common cardiac event in association with hospitalization for COVID-19. Older age and cardiovascular disease predisposed for arrhythmia during hospitalization. Whereas in-hospital mortality is affected by underlying cardiovascular conditions, arrhythmia during hospitalization for COVID-19 is independently associated with prolonged hospitalization and mechanical ventilation. Thus, incident arrhythmia may indicate a patient subgroup at risk for a severe course of disease.
在新冠疫情期间，已有关于新型冠状病毒肺炎（COVID-19）心脏表现的报道。目前对COVID-19中心律失常的作用了解不足。本研究评估了住院COVID-19患者心律失常的发生率及其预后意义。
纳入了2020年3月至2020年6月期间在8个中心因COVID-19住院的166例患者。系统分析病历，以获取与本次住院相关的基线特征、生物标志物、心律失常及临床结局参数。确定心律失常的易感危险因素。此外，使用单因素和多因素回归分析评估心律失常对疾病进程和相关结局的影响。
20.5%的患者检测到心律失常。心房颤动是最常见的心律失常。年龄和心血管疾病是新发心律失常的预测因素。心律失常与心脏生物标志物显著升高、住院时间延长、入住重症监护病房或中级护理病房、机械通气及院内死亡相关。在多因素回归分析中，新发心律失常与住院时间和机械通气密切相关。心血管疾病与死亡率增加相关。
心律失常是与COVID-19住院相关的最常见心脏事件。老年和心血管疾病易导致住院期间发生心律失常。虽然院内死亡率受潜在心血管疾病影响，但COVID-19住院期间的心律失常与住院时间延长和机械通气独立相关。因此，新发心律失常可能提示患者亚组有疾病重症化风险。
