E.V. KHAZOVA¹, R.V. VALIAKHMETOV¹, O.V. BULASHOVA¹, M.I. MALKOVA^{1, 2}

 ¹Kazan State Medical University, Kazan

²City Clinical Hospital No. 7, Kazan

 Contact details:

Khazova E.V. — PhD (medicine), Associate Professor of the Department of Department of Propedeutics of Internal Diseases named after Prof. S.S. Zimnitsky

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-905-313-97-10, e-mail: hazova_elena@mail.ru

The article presents a literary review of the effect of the new coronavirus infection (COVID-19) on the cardiovascular system, namely cardiac arrhythmias. Probable etiopathogenetic factors of arrhythmia formation in patients with COVID-19 infections are described. The analysis of clinical forms of rhythm disturbances in patients with COVID-19 is presented. It was found that the probability of developing arrhythmias is associated with the patient’s age, their stay in an intensive care unit, and the presence of comorbid pathology. The data of foreign authors who note such rhythm disturbances as atrial fibrillation and fluttering, ventricular tachycardia, and high degree intermittent atrioventricular blockade as the most common among patients with a new coronavirus infection are presented. There was an association between malignant arrhythmias, including ventricular tachycardia / ventricular fibrillation and an increase in troponin T levels compared to patients with normal troponin T levels. The problem of side effects of the drugs used in COVID-19 treatment, namely arrhythmias, is stated. The dependence is shown between concomitant diseases, low PaO₂/FiO₂ balance and occurrence of arrhythmias in the form of a new atrial fibrillation.

Key words: cardiac arrhythmias, COVID-19, heart failure, new atrial fibrillation, postural orthostatic tachycardia syndrome.

 REFERENCES

1. Yu C.M., Wong R.S., Wu E.B. et al. Cardiovascular complications of severe acute respiratory syndrome. Postgrad. Med. J, 2006, vol. 82 (964), rr. 140‒144.
2. Alhogbani T. Acute myocarditis associated with novel Middle east respiratory syndrome coronavirus. Ann. Saudi Med, 2016, vol. 36, pp. 78‒80.
3. Wang D., Hu B., Hu C. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA, 2020, vol. 323 (11), pp. 1061‒1069.
4. Goyal P., Choi J.J., Pinheiro L.C. et al. Clinical characteristics of Covid-19 in New York City. N Engl J Med, 2020, vol. 382 (24), pp. 2372–2374.
5. Kochi A.N., Tagliari A.P., Forleo G.B. et al. Cardiac and arrhythmic complications in patients with COVID-19. J Cardiovasc Electrophysiol, 2020, vol. 31, pp. 1003–1008.
6. Gawałko M., Kapłon-Cieślicka A., Hohl M. et al. COVID-19 associated atrial fibrillation: Incidence, putative mech- anisms and potential clinical implications. Int J Cardiol Heart Vasc, 2020, vol. 30, pp. 1–6.
7. Zeng Y., Cai Z., Xianyu Y. et al. Prognosis when using extracorporeal membrane oxygenation (ECMO) for critically ill COVID-19 patients in China: a retrospective case series. Crit Care, 2020, vol. 24, pp. 1–3.
8. Oudit G.Y., Kassiri Z., Jiang C. et al. SARS‐coronavirus modulation of myocardial ACE2 expression and inflammation in patients with SAR. Eur J Clin Invest, 2009, vol. 39, pp. 618–625.
9. Huang C., Wang Y., Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020, vol. 395, pp. 497–506.
10. Wong C.K., Lam C.W., Wu A.K. et al. Plasma inflammatory cytokines and chemokines in severe acute respiratory syndrome. Clin Exp Immunol, 2004, vol. 136, pp. 95–103.
11. Cameron M.J., Bermejo‐Martin J.F., Danesh A. M. et al. Human immunopathogenesis of severe acute respiratory syndrome (SARS). Virus Res., 2008, vol. 133, pp. 13‐19.
12. Kir D., Mohan C., Sancassani R. Heart break: an unusual cardiac manifestation of coronavirus disease 2019 (COVID-19). JACC Case Rep, 2020, vol. 2, pp. 1252–1255.
13. Peigh G., Leya M.V., Baman J.R. et al. Novel coronavirus 19 (COVID-19) associated sinus node dysfunction: a case series. Eur Heart J, Case Rep, 2020, vol. 10, pp. 1–6.
14. Baldi E., Sechi G.M., Mare C. et al. Lombardia CARe Researchers. Out-of-Hospital Cardiac Arrest during the Covid-19 Outbreak in Italy. N Engl J Med, 2020, vol. 383 (5), pp. 496–498.
15. Baldi E., Sechi G.M., Mare C. et al Lombardia CARe researchers. COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests. Eur Heart J, 2020, vol. 41 (32), pp. 3045–3054.
16. Seecheran R., Narayansingh R., Giddings S. et al. Atrial arrhythmias in a patient presenting with coronavirus disease-2019 (COVID-19) infection. J Investig Med High Impact Case Rep., 2020, vol. 8, pp. 1–6.
17. Gopinathannair R., Merchant F.M., Lakkireddy D.R. et al. COVID-19 and cardiac arrhythmias: a global perspective on arrhythmia characteristics and management strategies. J Interv Card Electrophysiol, 2020, vol. 10, pp. 1–8.
18. Sanz A.P., Tahoces L.S., Pérez R.O. et al. New-onset atrial fibrillation during COVID-19 infection predicts poor prognosis. Cardiol J, 2021, vol. 28 (1), pp. 34–40.
19. Colon C.M., Barrios J.G., Chiles J.W., et al. Atrial arrhythmias in COVID-19 patients. JACC: Clinical Electrophysiology, 2020, vol. 10, pp. 1189–1190.
20. Johansson M., Ståhlberg M., Runold M. et al. Long-Haul Post-COVID-19 Symptoms Presenting as a Variant of Postural Orthostatic Tachycardia Syndrome: The Swedish Experience. JACC Case Rep, 2021, vol. 3 (4), pp. 573–580.
21. Fedorowski A. Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management. J Intern Med, 2019, vol. 285, pp. 352–366.
22. Bryarly M., Phillips L.T., Fu Q. et al. Postural orthostatic tachycardia syndrome. JACC focus seminar. J Am Col lCardiol, 2019, vol. 73, pp. 1207–1228.
23. Bhatla A., Mayer M.M., Adusumalli S. et al. COVID-19 and cardiac arrhythmias. Heart Rhythm, 2020, vol. 17 (9), pp. 1439–1444.
24. Ergün B., Ergan B., Sözmen M.K. et al. New-onset atrial fibrillation in critically ill patients with coronavirus disease 2019 (COVID-19). J Arrhythm, 2021, vol. 37 (5), pp. 1196–1204.
25. Guo T., Fan Y., Chen M. et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol, 2020, vol. 5 (7), rr. 1–8.
26. Aghagoli G., Gallo M. B., Soliman L. B. et al. Cardiac involvement in COVID-19 patients: Risk factors, predictors, and complications: A review. J. Card. Surg, 2020, vol. 35, pp. 1302–1305.
27. Driggin E., Madhavan M.V., Bikdeli B. et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. J. Am. Coll. Cardiol., 2020, vol. 75 (18), pp. 2352‒2371.
28. Long B., Brady W.J., Koyfman A. et al. Cardiovascular complications in COVID-19. Am. J. Emerg. Med, 2020, vol. 38 (7), pp. 1504–1507.
29. Mehra M.R., Desai S.S., Ruschitzka F. et al. Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. Lancet, 2020, available at: https://pubmed.ncbi.nlm.nih.gov/29, https://pubmed.ncbi.nlm.nih.gov/32450107/Vol
30. Chorin E., Dai M., Shulman E. et al. The QT interval in patients with COVID-19 treated with hydroxychloroquine and azithromycin. Nat Med, 2020, vol. 26, pp. 808–809.
31. Mercuro N.J, Yen C.F, Shim D.J. Risk of QT interval prolongation associated with use of hydroxychloroquine with or without concomitant azithromycin among hospitalized patients testing positive for coronavirus disease 2019 (COVID-19). JAMA Cardiol, 2020, vol. 5, pp. 1036–1041.