16 TIMES HIGHER RISK OF LIFE-THREATENING HEART RHYTHM AMONG SEVERE COVID-19 PATIENTS

According to research presented at EHRA 2023, a scientific congress of the European Society of Cardiology, patients with severe COVID-19 needing mechanical ventilation are 16 times more likely to develop ventricular tachycardia within six months compared to their peers without severe infection (ESC). Other heart rhythm disorders posed increased risks as well.

According to study author Dr Marcus Stahlberg of the Karolinska Institute in Stockholm, Sweden, "the actual likelihood of developing ventricular tachycardia or other arrhythmias after severe COVID-19 is low for the individual patient, but much higher than in those without severe infection."

The goal of this study was to look into the possibility of developing arrhythmias in the future after leaving an intensive care unit (ICU) for COVID-19 patients who needed mechanical ventilation. All COVID-19 patients treated with mechanical ventilation and released alive from an ICU between March 2020 and June 2021 were identified by the researchers using the Swedish ICU register.

Each patient was matched by age, sex and district of residence with up to 10 people in the general population. After patients were discharged from the intensive care unit, new arrhythmia diagnoses were entered into a number of mandatory national registries.

Hospitalization for ventricular tachycardia, atrial fibrillation, other tachyarrhythmias, bradycardia, or pacemaker implantation was the main outcome. Ventricular tachycardia is a potentially fatal heart rhythm disorder that develops when the ventricle beats too quickly to pump blood to the body adequately, depriving it of enough oxygen.

Shortness of breath and an increased risk of stroke are two effects of atrial fibrillation, an irregular and rapid heartbeat. Fast heartbeats that aren't brought on by atrial fibrillation are referred to as "other tachyarrhythmias." "Bradycardia or pacemaker implantation" refers to both a slow heartbeat and the need for a pacemaker as a result of a slow heartbeat.

The risk of developing each arrhythmia in patients with severe COVID-19 was analysed and compared to that of patients without severe COVID-19. Age, sex, high blood pressure, diabetes, high blood lipids, chronic kidney disease, and socioeconomic status(education level, marital status and income) were all taken into account when performing the analyses.

The study included 28,463 people from the general population with COVID-19 who had not previously been in an ICU and 3,023 patients with severe COVID-19 who required mechanical ventilation at a Swedish ICU (control group). The participants' average age was 62, and 30% of them were female. According to Dr Stahlberg, "higher age and male sex are two important risk factors for getting severely ill with COVID-19," which was evident in the study subjects.

Nine months on average were spent following up. The incidence rates of ventricular tachycardia, atrial fibrillation, other tachyarrhythmias, and bradycardia/pacemaker implantation were 15.4, 78.4, 99.3, and 8.5, respectively, in patients with severe COVID-19. Accordingly, the control group's incidence rates were 0.9, 6.0, 6.7, and 0.9.

Patients with severe COVID-19 who required mechanical ventilation had a 16-fold increased risk of ventricular tachycardia, a 13-fold increased risk of atrial fibrillation, a 14-fold increased risk of other tachyarrhythmias, and a 9-fold increased risk of bradycardia/pacemaker implantation compared to the control group.

Dr Stahlberg said: “COVID-19 patients who need mechanical ventilation often have other conditions and adding a heart rhythm disorder may lead to worsened health. These patients should seek medical attention if they develop palpitations or irregular heartbeats after hospital discharge so they can be evaluated for possible arrhythmias.”

He concluded: “An increased risk of arrhythmias following COVID-19 has also been reported previously in the bulk of COVID-19 patients not requiring ICU treatment. With our new data and considering that we globally have 650 million reported COVID-19 cases, hospital systems should prepare for an increase in patients requiring management for new-onset arrhythmias.”