Varshney Amit, Agarwal Navneet
Department of Medicine, United Institute of Medical Sciences, Prayagraj, U.P., India.
Glob Cardiol Sci Pract. 2022 Dec 30;2022(3):e202216. doi: 10.21542/gcsp.2022.16.
Our understanding of arrhythmias is minimal with SARS-CoV-2 virus and with the emergence of its double mutant, virtually nonexistent. Patients with the double mutant (B.1.617) SARS-CoV infection had more cardiac manifestations, including arrhythmias and sudden death, than with the traditional variant. To determine the incidence of arrhythmias in COVID-19 patients with double mutant strain of SARS-CoV-2 virus (B.1.617). We describe a prospective observational study conducted in the Department of Medicine, United Institute of Medical Sciences, Prayagraj, Uttar Pradesh on patients admitted to the hospital during the period March 2021 to May 2021. Different type of arrhythmias were studied in the admitted patients. Sinus bradycardia is the most common arrhythmia, followed by atrial fibrillation. Malignant arrhythmias, such as ventricular tachycardia/ventricular fibrillation and Torsades de pointes due to QT prolongation, were present in small number of patients with high mortality outcomes. Sinus tachycardia and high-grade AV blocks were also present in some of the patients. Current literature lacks studies on arrhythmias secondary to COVID-19 (double mutant) strain and its possible mechanisms. This makes it difficult to distinguish between arrhythmias secondary to COVID-19 (double mutant) infection due to hypoxemia, dyselectrolytemia, SIRS, comorbidities, and medications or direct viral effects on the cardiomyocytes.
我们对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒所致心律失常的了解极少，而随着其双突变体的出现，这方面的了解几乎不存在。感染双突变体（B.1.617）SARS-CoV的患者比感染传统毒株的患者有更多的心脏表现，包括心律失常和猝死。为了确定感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒双突变株（B.1.617）的2019冠状病毒病（COVID-19）患者中心律失常的发生率。我们描述了一项前瞻性观察性研究，该研究于2021年3月至2021年5月期间在北方邦普拉亚格拉杰联合医学科学研究所医学部对入院患者进行。对入院患者研究了不同类型的心律失常。窦性心动过缓是最常见的心律失常，其次是心房颤动。少数患者出现恶性心律失常，如室性心动过速/心室颤动和因QT延长导致的尖端扭转型室速，这些患者死亡率很高。部分患者还出现窦性心动过速和高度房室传导阻滞。目前的文献缺乏关于继发于2019冠状病毒病（双突变体）毒株的心律失常及其可能机制的研究。这使得难以区分继发于2019冠状病毒病（双突变体）感染的心律失常是由低氧血症、电解质紊乱、全身炎症反应综合征、合并症、药物还是病毒对心肌细胞的直接作用所致。
