Introduction:

arrhythmia is one of the most common extrapulmonary complications of coronavirus 2019 (COVID-19).

Objectives:

this study aimed to assess the outcomes of hospitalized COVID-19 patients with and without arrhythmia from asymptomatic to life-threatening disease severity and the predictors of the in-hospital outcomes.

Material and methods:

a total of 257 patients with confirmed COVID-19 who had at least one electrocardiogram recording from April 01 to December 31, 2021, were enrolled in this cross-sectional study.

Results:

arrhythmia occurred in 36.6% of patients. The mean age of patients with arrhythmia was 52.48 ± 13.936 years, with a male preponderance (57.4%). The most common arrhythmia was sinus tachycardia (69.1%). Pre-existing atrial fibrillation (AF) and new-onset AF occurred in 10.6% and 2.1% of patients, respectively. Total atrioventricular block occurred in 2.1% of patients. Heart failure (20.2%), previous arrhythmia (10.6%), hypertension (46.8%), diabetes mellitus (DM) (42.6%), and chronic kidney disease (55.3%) were more prevalent in patients with arrhythmia. Patients with arrhythmia had a significantly higher need for Intensive Care Unit (ICU) (50%), need for intubation and mechanical ventilation (MV) (7.4%), hypotension requiring vasopressor (16%), and in-hospital mortality (44.7%) compared to patients without arrhythmia. After multivariate analysis, DM was associated with a higher need for ICU, hypotension requiring vasopressor, and in-hospital mortality. History of stroke/transient ischemic attack (TIA) and thrombocytopenia during admission was associated with a higher need for intubation and MV.

Conclusions:

the in-hospital outcomes in patients with COVID-19 and arrhythmia are the worst. In patients with arrhythmia, DM is associated with higher need for ICU, hypotension requiring vasopressor, and in-hospital mortality. A history of stroke/TIA and thrombocytopenia during admission are associated with higher need for intubation and MV.