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Acute ECG changes and post-COVID arrhythmia incidence in patients with acute COVID-19 infection

Year 2024, Volume: 37 Issue: 1, 23 - 28, 28.01.2024

Zekeriya Doğan Çiğdem İleri

https://doi.org/10.5472/marumj.1378494

Abstract

Objective: During the COVID-19 pandemic, many patients have experienced cardiovascular complications, including a variety
of arrhythmias. The aim of our study was to evaluate the acute electrocardiography (ECG) changes and post-COVID arrhythmia
incidence in patients with acute COVID-19 infection.
Patients and Methods: One hundred hospitalized COVID-19 patients were consecutively included. Patients were divided into two
groups according to their troponin levels. Thirty subjects were included as controls. All patients underwent daily 12-lead ECG during
hospitalization and were followed up for at least 12 months, by performing ECG and ambulatory ECG monitoring and questioning
their symptoms at 3-month intervals.
Results: Thirty-one patients had elevated high sensitive cardiac troponin I (hs-cTnI). These patients had significantly longer QT
dispersion compared to COVID-19 patients with normal troponin levels and controls. Regardless of troponin elevation, COVID-19
patients had significantly longer Tp-e intervals and P wave (PW) durations compared to controls. During the follow-up period;
palpitation, beta-blocker usage, and inappropriate sinus tachycardia were more common in the COVID-19 group with hs-cTnI than
control group.
Conclusion: Our study did not find any relation between serum fibroblast growth factor-21 levels and carotid intima-media thickness.
Further researches with wider study population are needed.

Keywords

Post-COVID Arrhythmia Electrocardiography Troponin

References

  • Gupta A, Madhavan MV, Sehgal K, et al. Extrapulmonary manifestations of COVID-19. Nat Med 2020;26:1017-32. doi: 10.1038/s41591.020.0968-3
  • Selcuk A, Ilgın CKarakurt S. Association of the changes in pulmonary artery diameters with clinical outcomes in hospitalized patients with COVID-19 infection: A crosssectional study. Marmara Med J 2022;35:355-61. doi:10.5472/marumj.1195539.
  • Lazzerini PE, Capecchi PL, Laghi-Pasini F. Systemic inflammation and arrhythmic risk: lessons from rheumatoid arthritis. Eur Heart J 2017 ;38:1717-27. doi: 10.1093/eurheartj/ ehw208.
  • Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579:270-3. doi: 10.1038/s41586.020.2012-7.
  • Ni W, Yang X, Yang D, et al. Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19. Crit Care 2020;24:422. doi: 10.1186/s13054.020.03120-0.
  • Huseynov A, Akin I, Duerschmied D, Scharf RE. Cardiac arrhythmias in post-covıd syndrome: prevalence, pathology, diagnosis, and treatment. Viruses 2023;15:389. doi: 10.3390/ v15020389.
  • Shah W, Hillman T, Playford ED, Hishmeh L. Managing the long term effects of COVID-19: Summary of NICE, SIGN, and RCGP rapid guideline. BMJ 2021;372:n136. doi: 10.1136/ bmj.n136.
  • Ståhlberg M, Reistam U, Fedorowski A, et al. Post-COVID-19 tachycardia syndrome: a distinct phenotype of post-acute COVID-19 syndrome. Am J Med 2021;134:1451-56. doi: 10.1016/j.amjmed.2021.07.004.
  • Bazett, H. An analysis of the time-relations of electrocardiograms. Heart 1920: 353-70.
  • Sagie A, Larson MG, Goldberg RJ, Bengtson JR, Levy D. An improved method for adjusting the QT interval for heart rate (the Framingham Heart Study). Am J Cardiol 1992;70:797- 801. doi: 10.1016/0002-9149(92)90562-d.
  • Rosenthal TM, Masvidal D, Abi Samra FM, et al. Optimal method of measuring the T-peak to T-end interval for risk stratification in primary prevention. Europace 2018;20:698- 705. doi: 10.1093/europace/euw430.
  • Yuniadi Y, Yugo D, Fajri M, et al. ECG characteristics of COVID-19 patient with arrhythmias: Referral hospitals data from Indonesia. J Arrhythm 2022;38:432-38. doi: 10.1002/ joa3.12718.
  • Mele M, Tricarico L, Vitale E, et al. Electrocardiographic findings and mortality in covid-19 patients hospitalized in different clinical settings. Heart Lung 2022;53:99-103. doi: 10.1016/j.hrtlng.2022.02.007.
  • Shi S, Qin M, Shen B, et al. Association of cardiac ınjury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol 2020;5:802-10. doi: 10.1001/ jamacardio.2020.0950.
  • Babapoor-Farrokhran S, Gill D, Walker J, Rasekhi RT, Bozorgnia B, Amanullah A. Myocardial injury and COVID-19: Possible mechanisms. Life Sci 2020;253:117723. doi: 10.1016/j. lfs.2020.117723.
  • Lazzerini PE, Laghi-Pasini F, Boutjdir M, Capecchi PL. Inflammatory cytokines and cardiac arrhythmias: the lesson from COVID-19. Nat Rev Immunol 2022;22:270-72. doi: 10.1038/s41577.022.00714-3.
  • Zhan Y, Yue H, Liang W, Wu Z. Effects of COVID-19 on arrhythmia. J Cardiovasc Dev Dis 2022;9:292. doi: 10.3390/ jcdd9090292.
  • Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021;397:220-32. doi: 10.1016/S0140- 6736(20)32656-8.
  • Radin JM, Quer G, Ramos E, et al. Assessment of prolonged physiological and behavioral changes associated with COVID-19 Infection. JAMA Netw Open 2021;4:e2115959. doi: 10.1001/jamanetworkopen.2021.15959.
  • Ingul CB, Grimsmo J, Mecinaj A, et al. Cardiac dysfunction and arrhythmias 3 months after hospitalization for COVID-19. J Am Heart Assoc 2022;11:e023473. doi: 10.1161/ JAHA.121.023473.
  • Sheldon RS, Grubb BP 2nd, Olshansky B, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm 2015;12:e41-63. doi: 10.1016/j.hrthm.2015.03.029.
  • Aranyó J, Bazan V, Lladós G F, et al. Inappropriate sinus tachycardia in post-COVID-19 syndrome. Sci Rep 2022;12:298. doi: 10.1038/s41598.021.03831-6.
  • Musikantow DR, Turagam MK, Sartori S, et al. Atrial fibrillation in patients hospitalized with COVID-19: Incidence, predictors, outcomes, and comparison to ınfluenza. JACC Clin Electrophysiol 2021;7:1120-30. doi: 10.1016/j. jacep.2021.02.009.
  • Al-Aly Z, Xie Y, Bowe B. High-dimensional characterization of post-acute sequelae of COVID-19. Nature 2021;594:259-64. doi: 10.1038/s41586.021.03553-9.
  • Huang L, Zhao P, Tang D, et al. Cardiac ınvolvement in patients recovered from COVID-2019 identified using magnetic resonance imaging. JACC Cardiovasc Imaging 2020;13:2330- 39. doi: 10.1016/j.jcmg.2020.05.004.
  • Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of cardiovascular magnetic resonance ımaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020;5:1265-73. doi: 10.1001/ jamacardio.2020.3557.
  • Disertori M, Rigoni M, Pace N, et al. Myocardial fibrosis assessment by lge ıs a powerful predictor of ventricular tachyarrhythmias in ıschemic and nonischemic lv dysfunction: a meta-analysis. JACC Cardiovasc Imaging 2016;9:1046-55. doi: 10.1016/j.jcmg.2016.01.033.

Year 2024, Volume: 37 Issue: 1, 23 - 28, 28.01.2024

Zekeriya Doğan Çiğdem İleri

https://doi.org/10.5472/marumj.1378494

Abstract

References

  • Gupta A, Madhavan MV, Sehgal K, et al. Extrapulmonary manifestations of COVID-19. Nat Med 2020;26:1017-32. doi: 10.1038/s41591.020.0968-3
  • Selcuk A, Ilgın CKarakurt S. Association of the changes in pulmonary artery diameters with clinical outcomes in hospitalized patients with COVID-19 infection: A crosssectional study. Marmara Med J 2022;35:355-61. doi:10.5472/marumj.1195539.
  • Lazzerini PE, Capecchi PL, Laghi-Pasini F. Systemic inflammation and arrhythmic risk: lessons from rheumatoid arthritis. Eur Heart J 2017 ;38:1717-27. doi: 10.1093/eurheartj/ ehw208.
  • Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579:270-3. doi: 10.1038/s41586.020.2012-7.
  • Ni W, Yang X, Yang D, et al. Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19. Crit Care 2020;24:422. doi: 10.1186/s13054.020.03120-0.
  • Huseynov A, Akin I, Duerschmied D, Scharf RE. Cardiac arrhythmias in post-covıd syndrome: prevalence, pathology, diagnosis, and treatment. Viruses 2023;15:389. doi: 10.3390/ v15020389.
  • Shah W, Hillman T, Playford ED, Hishmeh L. Managing the long term effects of COVID-19: Summary of NICE, SIGN, and RCGP rapid guideline. BMJ 2021;372:n136. doi: 10.1136/ bmj.n136.
  • Ståhlberg M, Reistam U, Fedorowski A, et al. Post-COVID-19 tachycardia syndrome: a distinct phenotype of post-acute COVID-19 syndrome. Am J Med 2021;134:1451-56. doi: 10.1016/j.amjmed.2021.07.004.
  • Bazett, H. An analysis of the time-relations of electrocardiograms. Heart 1920: 353-70.
  • Sagie A, Larson MG, Goldberg RJ, Bengtson JR, Levy D. An improved method for adjusting the QT interval for heart rate (the Framingham Heart Study). Am J Cardiol 1992;70:797- 801. doi: 10.1016/0002-9149(92)90562-d.
  • Rosenthal TM, Masvidal D, Abi Samra FM, et al. Optimal method of measuring the T-peak to T-end interval for risk stratification in primary prevention. Europace 2018;20:698- 705. doi: 10.1093/europace/euw430.
  • Yuniadi Y, Yugo D, Fajri M, et al. ECG characteristics of COVID-19 patient with arrhythmias: Referral hospitals data from Indonesia. J Arrhythm 2022;38:432-38. doi: 10.1002/ joa3.12718.
  • Mele M, Tricarico L, Vitale E, et al. Electrocardiographic findings and mortality in covid-19 patients hospitalized in different clinical settings. Heart Lung 2022;53:99-103. doi: 10.1016/j.hrtlng.2022.02.007.
  • Shi S, Qin M, Shen B, et al. Association of cardiac ınjury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol 2020;5:802-10. doi: 10.1001/ jamacardio.2020.0950.
  • Babapoor-Farrokhran S, Gill D, Walker J, Rasekhi RT, Bozorgnia B, Amanullah A. Myocardial injury and COVID-19: Possible mechanisms. Life Sci 2020;253:117723. doi: 10.1016/j. lfs.2020.117723.
  • Lazzerini PE, Laghi-Pasini F, Boutjdir M, Capecchi PL. Inflammatory cytokines and cardiac arrhythmias: the lesson from COVID-19. Nat Rev Immunol 2022;22:270-72. doi: 10.1038/s41577.022.00714-3.
  • Zhan Y, Yue H, Liang W, Wu Z. Effects of COVID-19 on arrhythmia. J Cardiovasc Dev Dis 2022;9:292. doi: 10.3390/ jcdd9090292.
  • Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021;397:220-32. doi: 10.1016/S0140- 6736(20)32656-8.
  • Radin JM, Quer G, Ramos E, et al. Assessment of prolonged physiological and behavioral changes associated with COVID-19 Infection. JAMA Netw Open 2021;4:e2115959. doi: 10.1001/jamanetworkopen.2021.15959.
  • Ingul CB, Grimsmo J, Mecinaj A, et al. Cardiac dysfunction and arrhythmias 3 months after hospitalization for COVID-19. J Am Heart Assoc 2022;11:e023473. doi: 10.1161/ JAHA.121.023473.
  • Sheldon RS, Grubb BP 2nd, Olshansky B, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm 2015;12:e41-63. doi: 10.1016/j.hrthm.2015.03.029.
  • Aranyó J, Bazan V, Lladós G F, et al. Inappropriate sinus tachycardia in post-COVID-19 syndrome. Sci Rep 2022;12:298. doi: 10.1038/s41598.021.03831-6.
  • Musikantow DR, Turagam MK, Sartori S, et al. Atrial fibrillation in patients hospitalized with COVID-19: Incidence, predictors, outcomes, and comparison to ınfluenza. JACC Clin Electrophysiol 2021;7:1120-30. doi: 10.1016/j. jacep.2021.02.009.
  • Al-Aly Z, Xie Y, Bowe B. High-dimensional characterization of post-acute sequelae of COVID-19. Nature 2021;594:259-64. doi: 10.1038/s41586.021.03553-9.
  • Huang L, Zhao P, Tang D, et al. Cardiac ınvolvement in patients recovered from COVID-2019 identified using magnetic resonance imaging. JACC Cardiovasc Imaging 2020;13:2330- 39. doi: 10.1016/j.jcmg.2020.05.004.
  • Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of cardiovascular magnetic resonance ımaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020;5:1265-73. doi: 10.1001/ jamacardio.2020.3557.
  • Disertori M, Rigoni M, Pace N, et al. Myocardial fibrosis assessment by lge ıs a powerful predictor of ventricular tachyarrhythmias in ıschemic and nonischemic lv dysfunction: a meta-analysis. JACC Cardiovasc Imaging 2016;9:1046-55. doi: 10.1016/j.jcmg.2016.01.033.
There are 27 citations in total.

Details

Primary Language English
Subjects Surgery (Other)
Journal Section Original Research
Authors

Zekeriya Doğan 0000-0003-4460-3084

Çiğdem İleri 0000-0002-7974-9406

Publication Date January 28, 2024
Published in Issue Year 2024 Volume: 37 Issue: 1

Cite

APA Doğan, Z., & İleri, Ç. (2024). Acute ECG changes and post-COVID arrhythmia incidence in patients with acute COVID-19 infection. Marmara Medical Journal, 37(1), 23-28. https://doi.org/10.5472/marumj.1378494
AMA Doğan Z, İleri Ç. Acute ECG changes and post-COVID arrhythmia incidence in patients with acute COVID-19 infection. Marmara Med J. January 2024;37(1):23-28. doi:10.5472/marumj.1378494
Chicago Doğan, Zekeriya, and Çiğdem İleri. “Acute ECG Changes and Post-COVID Arrhythmia Incidence in Patients With Acute COVID-19 Infection”. Marmara Medical Journal 37, no. 1 (January 2024): 23-28. https://doi.org/10.5472/marumj.1378494.
EndNote Doğan Z, İleri Ç (January 1, 2024) Acute ECG changes and post-COVID arrhythmia incidence in patients with acute COVID-19 infection. Marmara Medical Journal 37 1 23–28.
IEEE Z. Doğan and Ç. İleri, “Acute ECG changes and post-COVID arrhythmia incidence in patients with acute COVID-19 infection”, Marmara Med J, vol. 37, no. 1, pp. 23–28, 2024, doi: 10.5472/marumj.1378494.
ISNAD Doğan, Zekeriya - İleri, Çiğdem. “Acute ECG Changes and Post-COVID Arrhythmia Incidence in Patients With Acute COVID-19 Infection”. Marmara Medical Journal 37/1 (January 2024), 23-28. https://doi.org/10.5472/marumj.1378494.
JAMA Doğan Z, İleri Ç. Acute ECG changes and post-COVID arrhythmia incidence in patients with acute COVID-19 infection. Marmara Med J. 2024;37:23–28.
MLA Doğan, Zekeriya and Çiğdem İleri. “Acute ECG Changes and Post-COVID Arrhythmia Incidence in Patients With Acute COVID-19 Infection”. Marmara Medical Journal, vol. 37, no. 1, 2024, pp. 23-28, doi:10.5472/marumj.1378494.
Vancouver Doğan Z, İleri Ç. Acute ECG changes and post-COVID arrhythmia incidence in patients with acute COVID-19 infection. Marmara Med J. 2024;37(1):23-8.
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