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Association of Arrhythmia and Acute Cardiac Injury with COVID-19 Severity

Abstract

Foad Alzoughool*, Suhad Abumweis, Ali Atoom, Lo’ai Alanagreh, Manar Atoum

Background: Our study evaluates the published literature of the overall contribution of COVID-19 in the occurrence cardiac arrhythmia and acute cardiac injury in addition to their relation to COVID-19 severity.

Methods: The international web databases, including PubMed, Science Direct, and Scopus, were electronically searched between January 1, 2020, and August 18, 2020, to identify studies describing subjects with cardiac complications in COVID-19 infection in particular arrhythmia and acute cardiac injury. Studies that provided adequate details on cardiac arrhythmia and acute cardiac injury as outcomes complication in positively diagnosed COVID-19 were included. The Joanna Briggs Institute (JBI) critical appraisal checklist for case series to assess the risk of bias. Random-effect models were used to estimate the pooled event rates of arrhythmia and acute cardiac injury.

Results: Relevant data regarding the event rate of cardiac manifestations particularly arrhythmia and acute cardiac injury in 4,355 patients with COVID-19 were collected from 13 studies. The pooled prevalence of arrhythmia as a complication of COVID-19 was 19% (95%CI: 12% to 29%), while the pooled prevalence of acute cardiac injury as a complication of COVID-19 was 9% (95%CI: 5% to 18%). Arrhythmia was found to increase the severity of COVID-19 about ten-folds significantly. In contrast, acute cardiac injury significantly increased the severity of COVID-19 with nearly 15-folds. No significant publication bias was indicated by either the visual symmetry or the Egger’s test.

Conclusion: In conclusion, cardiac arrhythmias and acute cardiac injury are highly associated with the severity and the mortality rate of COVID-19.

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