Cardiac Arrhythmias in COVID-19 Infection

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus that causes COVID-19, has affected >1 million people worldwide.1 As of this writing, >60 000 people have died as a result of this virus in the United States alone,2 and New York City has over 167 000 confirmed coronavirus disease 2019 (COVID-19) cases, the highest number of any city in the United States. New York City is now considered a COVID-19 epicenter. While this disease predominantly affects the lungs, often leading to pneumonia and acute respiratory distress syndrome, adverse effects on the heart have also been described.3 Electrophysiological issues are increasingly recognized as a disease manifestation, with one study reporting arrhythmias in 44% of individuals with severe illness.4 Sudden cardiac death has also been described anecdotally.5 However, the type and severity of arrhythmias associated with COVID-19 have not been described. In this article, we present 4 cases that highlight the spectrum of arrhythmias observed in patients with COVID-19 infection. New York-Presbyterian/Columbia University Irving Medical Center is located in the New York City COVID19 epicenter and herein, we describe the clinical presentations we have seen and discuss decision-making regarding therapeutic options, acknowledging difficulties pertaining to resource conservation and healthcare worker safety. This study was approved by the Columbia University Institutional Review Board, and procedures followed were in accordance with institutional guidelines. Due to the nature of the study, written informed consent was not required. The authors declare that all supporting data are available within the article. CASE 1: HIGH-GRADE ATRIOVENTRICULAR BLOCK

• Publication year

  2020

• Venue

  Circulation: Arrhythmia and Electrophysiology

• Publication date

  2020-05-20

• Fields of study

  Medicine

• Identifiers
  DOI 10.1161/CIRCEP.120.008719PMID 32434385PMCID 7299099
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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  1980cited by this paper
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  1968cited by this paper
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  1963cited by this paper

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  2022cites this paper
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  2022cites this paper
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  2021cites this paper
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