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. 2020 Oct;43(10):1139-1148.
doi: 10.1111/pace.14047. Epub 2020 Sep 12.

Syncope and presyncope in patients with COVID-19

Connor P Oates  1 , Mohit K Turagam  2 , Daniel Musikantow  2 , Edward Chu  2 , Poojita Shivamurthy  2 , Joshua Lampert  2 , Iwanari Kawamura  2 , Mahmoud Bokhari  2 , William Whang  2 , Marc A Miller  2 , Subbarao Choudry  2 , Noelle Langan  2 , Aamir Sofi  2 , Srinivas R Dukkipati  2 , Vivek Y Reddy  2 , Jacob S Koruth  2
Affiliations

Syncope and presyncope in patients with COVID-19

Connor P Oates et al. Pacing Clin Electrophysiol. 2020 Oct.

Abstract

Introduction: Recent studies have described several cardiovascular manifestations of COVID-19 including myocardial ischemia, myocarditis, thromboembolism, and malignant arrhythmias. However, to our knowledge, syncope in COVID-19 patients has not been systematically evaluated. We sought to characterize syncope and/or presyncope in COVID-19.

Methods: This is a retrospective analysis of consecutive patients hospitalized with laboratory-confirmed COVID-19 with either syncope or presyncope. This "study" group (n = 37) was compared with an age and gender-matched cohort of patients without syncope ("control") (n = 40). Syncope was attributed to various categories. We compared telemetry data, treatments received, and clinical outcomes between the two groups.

Results: Among 1000 COVID-19 patients admitted to the Mount Sinai Hospital, the incidence of syncope/presyncope was 3.7%. The median age of the entire cohort was 69 years (range 26-89+ years) and 55% were men. Major comorbidities included hypertension, diabetes, and coronary artery disease. Syncopal episodes were categorized as (a) unspecified in 59.4% patients, (b) neurocardiogenic in 15.6% patients, (c) hypotensive in 12.5% patients, and (d) cardiopulmonary in 3.1% patients with fall versus syncope and seizure versus syncope in 2 of 32 (6.3%) and 1 of 33 (3.1%) patients, respectively. Compared with the "control" group, there were no significant differences in both admission and peak blood levels of d-dimer, troponin-I, and CRP in the "study" group. Additionally, there were no differences in arrhythmias or death between both groups.

Conclusions: Syncope/presyncope in patients hospitalized with COVID-19 is uncommon and is infrequently associated with a cardiac etiology or associated with adverse outcomes compared to those who do not present with these symptoms.

Keywords: COVID-19; arrhythmias; coronavirus; dizziness; influenza; presyncope; syncope.

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Conflict of interest statement

The authors have no relevant conflict to disclose. A complete list of all disclosures for authors Vivek Y. Reddy and Jacob S. Koruth is provided in the Supporting Information.

Figures

FIGURE 1
FIGURE 1
Consort diagram [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
Study group details [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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