cardiac dysrhythmia in covid-19 patients; occurrence and risk factors: a retrospective cohort study

Objective: in this study, we have evaluated the occurrence and risk factors of cardiac dysrhythmia on admission and during hospitalization in covid-19 patients. methods: this study was conducted as a retrospective cohort in which 893 electrocardiograms (ecgs) taken at the time of admission, and 328 ecgs taken during hospitalization were evaluated. these ecgs were assessed for cardiac dysrhythmias by a cardiologist. finally, relationships between clinical characteristics and the occurrence of cardiac dysrhythmias in patients were assessed. results: most common cardiac dysrhythmias on admission were sinus tachycardia (64.8%), atrial fibrillation (13.5%), and sinus bradycardia (11.3%). multivariate regression analysis showed that a history ofmetformin use (rr=0.83; p=0.042) was independently associated with reduced risk of cardiac dysrhythmias on admission,while male sex (rr=1.16; p=0.018), history of cardiovascular diseases (rr=1.16; p=0.017), history of cancer (rr=1.40; p=0.004) and qt interval prolongation on ecg (rr=1.18; p=0.017) were associated with a higher risk of cardiac dysrhythmias on admission. also, among the 328 patients that had a second ecg, 185 (56.4%) experienced cardiac dysrhythmias during their hospitalization. multivariate analysis showed that presence of cardiac dysrhythmias on admission (rr=1.85; 95% ci: 1.49,2.35; p<0.001) was the only independent prognostic factor for the occurrence of cardiac dysrhythmias during hospitalization. no significant relationships were observed between treatment regimens and the incidence of cardiac dysrhythmias. conclusion: the present study showed that more than half of covid-19 patients have cardiac dysrhythmias on admission. our analyses illustrated that a history of metformin use was associated with a lower risk of cardiac dysrhythmias on admission, while male sex, history of cardiovascular diseases, history of cancer, andqt interval prolongation were associated with a higher rate of cardiac dysrhythmias. hydroxychloroquine use along with azithromycin and kaletra (lopinavir-ritonavir) had no association with the development of cardiac dysrhythmias during hospitalization.