Does the severity of the course of COVID-19 in pts without hospitalization and no history of cardiovascular disease affect of cardiac arrhythmias
Authors: Chudzik M , Babicki M , Kapusta J , Kolat D , Kaluzinska-Kolat Z , Mastalerz-Migas A , Jankowski P 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Many studies have shown that arrhythmias are an independent risk factor for death and the course of COVID-19 in these pts. However, there are no data on the impact of the SARS CoV-2 virus on pts with a domestic course of COVID-19 without a previous history of cardiovascular disease. The aim of the study was to assess whether the severity of the home course of COVID-19 has an impact on cardiac arrhythmias in pts without previous cardiovascular disease.

Methods
The study included only pts after COVID-19 without hospitalization, without previous cardiovascular disease. Pts were divided into two groups depending on the severity of the COVID-19 course: Gr 1 with severe course of disease: symptoms lasting 7, dyspnoea lasting with oxygen saturation below 94 lasting more than 3 days and Gr 2 – pts with mild course of COVID-19 who do not who did not meet the eligibility criteria for Group 1.
In pts, in the post-COVID period (mean 12±6 weeks an standard 12-lead ECG (ECG) and 24-h Holter ECG (Holter) were performed.
Following parameters were analysed in ECG: mean heart rate (mHR); PQ interval (PQ), QRS duration (QRSd); corrected QT interval (QTc); atrial fibrillation (AF); inappropriate sinus tachycardia (ITS), QRS duration &gt; 120ms (QRS&gt;120); LBBB, RBBB, QRS fragmentation (QRSf); STT wave abnormalities (STTabn); presence of premature supraventricular (SVES) and ventricular (VES) complexes; in 24-h Holter ECG: sinus tachycardia (STach), new atrial fibrillation (AFHolter), SVES &gt; 1000/24h (SVES&gt;1000); supraventricular tachycardia (TSV), VES &gt; 1000/24h (VES&gt;1000), Couplet VES (VEScouplet), non-sustained sustained tachycardia (nsVT); ventricular tachycardia (VT), block A-V 2nd typ 2 and/or block A-V 3rd grade (AVdist). Next, all above parameters were compared between both groups.

Results
A total of 1032 patients, (64% women and 36% men), mean age was 47.8± 16.5 were included in the analysis., of whom 336 pts (32,5%) had severe course of COVID-19. There was no significant differences in all except the number of nsVT which were significant more frequent in pts with severe course of COVID-19. (Gr 1 0,056 ±0,482 vs Gr 2=0,007±0,085; p=0,024). In no one pts VT and or VF was found. Results regarding number of pts in both groups and ecg abnormalities and cardiac arrhythmias are summarized in Table 1. Multivariate regression analysis showed that age (RR 1.012, 95%CL 1.002-1.024 p=0,02) and nsVT (RR 3,328 95%CL 1.057-10.481 p=0,039) are significantly related to severe course of non hospitalised COVID-19 pts.

Conclusions
Atrial Fibrillation and nsVT episodes occurred significant more frequent in non hospitalised pts with COVID-19 without history of cardiovascular disease in severe course of disease but in small percentage of pts. Age and episodes of nsVT are significantly related to the severity of COVID-19 in non hospitalised pts with no history of cardiovascular disease.