Why COVID-19 ICU patients may face risk of heart issues

Covid-19 patient

A new study suggests that COVID-19 patients in intensive care units (ICU) are more likely to suffer from cardiac arrests or arrhythmias caused by systemic issues.

New research found that COVID-19 patients in ICU were 10 times more likely to experience arrhythmias (irregular heart rhythms) than COVID-19 patients hospitalized but not admitted to ICU.

The study found that cardiac arrests — a condition in which the heart stops beating suddenly — and arrhythmias in ICU were the consequence of a systemic form of COVID-19, rather than the direct effect of infection with the virus that causes the disease.

The research, published in the journal Heart Rhythm, may help clinicians better treat and manage patients in ICU with COVID-19.

Looking to non-cardiac causes

While the global COVID-19 pandemic shows no signs of abating, scientists continue to gather real-world data on how the virus affects people who contract it.

Gathering good quality data is essential to help scientists find effective treatments that could help people avoid infection, kill the virus, or minimize its effects on the human body.

Initial reports from Wuhan, China, the site of origin of the virus, suggested that all patients who contracted COVID-19 were at higher risk of arrhythmias, which can lead to cardiac arrests, and other serious heart issues.

Researchers believe that cardiac arrests and arrhythmias are likely the consequence of systemic issues, not solely the direct effect of COVID-19 infection.

However, as scientists gather new data, it now seems that patients admitted to ICU with a severe, life threatening case of COVID-19 are at significantly higher risk of serious heart issues.

These are the key findings of new research from the Perelman School of Medicine at the University of Pennsylvania.

According to the study’s senior author, Dr. Rajat Deo, a cardiac electrophysiologist and associate professor of Cardiovascular Medicine at Penn, "[i]n order to best protect and treat patients who develop COVID-19, it’s critical for us to improve our understanding of how the disease affects various organs and pathways within our body — including our heart rhythm abnormalities."

"Our findings suggest that non-cardiac causes, such as systemic infection, inflammation, and illness, are likely to contribute more to the occurrence of cardiac arrest and arrhythmias than damaged or infected heart cells due to the viral infection."

– Dr. Rajat Deo

ICU patients more at risk of heart issues

To determine the risk of cardiac arrests, arrhythmias, and other severe heart issues in COVID-19 patients, the researchers studied data from 700 COVID-19 patients admitted to the Hospital of the University of Pennsylvania from early March to mid-May.

The researchers took a range of data, including possible comorbidities for heart issues, other general demographic information, and each patient’s vitals, treatment, and test results. The patients had an average age of 50, and Black patients made up 71% of the cohort.

During the study window, the researchers found that 53 patients had arrhythmic events. These included 25 incidents of atrial fibrillation that required treatment, nine incidents of bradyarrhythmias, and 10 ventricular tachycardia events.

Of the 700 patients, 11% required admission to the ICU. Of these people, nine experienced a cardiac arrest.

In general, after factoring in demographic variables and comorbidities, the researchers found that the patients admitted to ICU were more likely to experience arrhythmias and cardiac arrests than those hospitalized with COVID-19 but not requiring intensive care.

The researchers noted that a limitation of the study included its focus on a single urban hospital. This means they may not be able to apply their findings to other populations.

They were also unable to determine the long-term consequences of arrhythmias for COVID-19 patients.

Dr. Deo adds, "[m]ore research is needed to assess whether the presence of cardiac arrhythmias has long-term health effects on patients hospitalized for COVID-19."

"In the meantime," he points out, "it’s important that we launch studies to evaluate the most effective and safest strategies for long-term anticoagulation and rhythm management in this population."

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Timothy Huzar for MedicalNewsToday