Arrhythmia in COVID-19

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COVID-19

Arrhythmia in COVID-19 Savalan Babapoor-Farrokhran 1 & Roozbeh Tarighati Rasekhi 2 & Deanna Gill 3 & Shaghayegh Babapoor 4 & Aman Amanullah 1,5 Accepted: 10 August 2020 # Springer Nature Switzerland AG 2020

Abstract The current outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) also known as coronavirus disease 2019 (COVID-19) has quickly progressed to a global pandemic. There are well-documented cardiac complications of COVID-19 in patients with and without prior cardiovascular disease. The cardiac complications include myocarditis, heart failure, and acute coronary syndrome resulting from coronary artery thrombosis or SARS-CoV-2-related plaque ruptures. There is growing evidence showing that arrhythmias are also one of the major complications. Myocardial inflammation caused by viral infection leads to electrophysiological and structural remodeling as a possible mechanism for arrhythmia. This could also be the mechanism through which SARS-CoV-2 leads to different arrhythmias. In this review article, we discuss arrhythmia manifestations in COVID-19. Keywords Coronavirus disease 2019 . Arrhythmias . Severe acute respiratory syndrome . Middle east respiratory syndrome . Viral infection . Ventricular arrhythmias . Ventricular tachycardia . Ventricular fibrillation . Sinus tachycardia . Sinus bradycardia . Atrial fibrillation . QT prolongation . Torsade de pointes

Introduction The current outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) also known as coronavirus disease 2019 (COVID-19) has quickly progressed to a global pandemic. As of June 2020, 7.4 million people worldwide have been infected with the virus since its origin in December 2019, according to the Johns Hopkins COVID-19 Resource Center [1]. Respiratory distress is the most

This article is part of the Topical Collection on COVID-19 * Savalan Babapoor-Farrokhran [email protected] 1

Department of Medicine, Division of Cardiology, Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141, USA

2

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA

3

Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA

4

Department of Dermatology, Sina Hospital, Tabriz, Iran

5

Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA

significant manifestation of COVID-19. In addition, there are well-documented cardiac complications of COVID-19 in patients with and without prior cardiovascular disease. The cardiac complications include myocarditis, heart failure, and acute coronary syndrome resulting from coronary artery thrombosis or SARS-CoV-2-related plaque ruptures [2]. There is growing evidence showing that arrhythmias are also one of the major complications. Liu et al. reported that about 7% of patients report palpitations as a presenting symptom [3]. In a recent report from Wuhan, China, 16.7% of hospitalized and 44.4% of ICU patients with COVID-19 had cardiac arrhythmias [4]. Rec