Coronavirus disease 2019 (COVID-19) and cardiac arrhythmias
Keywords:
Coronavirus 2019, COVID-19, SARS-CoV-2, ArrhythmiaAbstract
Introduction The cardiovascular manifestation can occur commonly in patient who suffering
from the coronavirus disease 2019 (also known as, COVID-19). This review will examine and focus
on the cardiac arrhythmias in the patients with COVID-19 which is one of the cardiovascular
manifestations, considered as one of the prognostic factors.
Aims This literature will emphasis on incidence, pathogenesis, pathophysiology, association of
COVID-19 and inherited cardiac arrhythmia, management and adverse effects of medication,
and the guidance to minimized arrhythmic risk in the patients with COVID-19.
Methods A literature review was done using PubMed and Google search engines to prepare a
narrative review on this topic.
Results The author has found that the chance of arrhythmia incidence in COVID-19 patients was
5.9% to 16.7%. The directly myocardial injury, hypoxemia, electrolyte disturbance, and systemic
inflammation were considered as mechanism of arrhythmia in these patients. Especially patients
who have inherited arrhythmia, particularly Long QT syndrome and Brugada syndrome will
requires special attention in this circumstance. Furthermore, we found that the medication used
for COVID-19 treatment, including hydroxychloroquine, chloroquine, azithromycin, and lopinavir/
ritonavir may increase the risk of cardiac arrhythmia via the QT prolongation mechanism. To
prevent this, closely monitoring, withhold or withdrawal these medication as indicated, till the
normalization of the electrolyte level; is the key role to minimized arrhythmic risk strategies.
Conclusion The cardiac arrhythmias are not uncommon manifestation in the COVID-19 patients
and may be considered as one of the prognostic factors. Realization and risk management are
fundamental to ensuring efficiency in dealing with CODVID-19 patient.
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