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Review
. 2020 Sep-Oct;20(5):193-198.
doi: 10.1016/j.ipej.2020.08.001. Epub 2020 Aug 16.

Incidence and impact of cardiac arrhythmias in coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis

Raymond Pranata  1 , Ian Huang  2 , Sunu Budhi Raharjo  3
Affiliations
Review

Incidence and impact of cardiac arrhythmias in coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis

Raymond Pranata et al. Indian Pacing Electrophysiol J. 2020 Sep-Oct.

Abstract

Background: Studies have shown that cardiac arrhythmias may occur in up to 44% of patients with severe coronavirus disease 2019 (COVID-19) and has been associated with an increased risk of death. This systematic review and meta-analysis aimed to evaluate the incidence of cardiac arrhythmias in patients with COVID-19 and their implications on patient prognosis.

Methods: We performed a systematic literature search from PubMed, SCOPUS, Europe PMC, Cochrane Central Databases, and Google Scholar + Preprint Servers. The primary endpoint of the study was poor outcomes including mortality, severe COVID-19, and the need for ICU care.

Results: A total of 4 studies including 784 patients were analyzed. The incidence of arrhythmia in patients with COVID-19 was 19% (9-28%; I2: 91.45). Arrhythmia occurred in 48% (38-57%; I2: 48.08) of patients with poor outcome and 6% (1-12%; I2: 85.33%) of patients without poor outcome. Patients with COVID-19 experiencing arrhythmia had an increased risk of poor outcome (RR 7.96 [3.77, 16.81], p < 0.001; I2: 71.1%). The funnel-plot analysis showed an asymmetrical funnel plot with most of the studies on the right side of the effect estimate. The regression-based Egger's test showed indication of small-study effects (p = 0.001).

Conclusion: Cardiac arrhythmias were significantly associated with an increased risk of poor outcome in COVID-19. Arrhythmias were observed in 19% of patients with COVID-19 and in 48% of patients with COVID-19 and poor outcomes.

Keywords: Arrhythmia; COVID-19; Cardiovascular; Coronavirus; Rhythm; SARS-CoV-2.

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Conflict of interest statement

Declaration of competing interest Authors declare no Conflict of Interests for this article.

Figures

Fig. 1
Fig. 1
Prisma flowchart.
Fig. 2
Fig. 2
Incidence of arrhythmia in COVID-19 patients with COVID 19. The incidence of arrhythmia is 19% (A). Arrhythmia occurs in 48% (B) of the patients with poor outcomes and 6% (C) of the patients without poor outcomes.
Fig. 3
Fig. 3
Arrhythmia and outcome of COVID-19. Patients with COVID-19 experiencing arrhythmia have an increased risk of poor outcome.
Fig. 4
Fig. 4
Publication bias. The funnel-plot analysis shows an asymmetrical funnel plot with most of the studies on the right side of the effect estimate.
See this image and copyright information in PMC

References

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