Vol. 50 | No. 1 | January-June 2022 Back

Open Access

COVID and the Heart–Arrhythmia in COVID-19: A Case Report

Nicy F. Narvas, Emma Y. Gaspar-Trinidad
Jun 2022 DOI 10.69944/pjc.b411ac6efb

Abstract

BACKGROUND: A 65-year-old man, Filipino, with comorbidities consulted because of  shortness of breath. Chest computed tomography scan showed ground-glass opacities and  crazy paving patterns (computed tomography severity score = 29). He required oxygen at  4 L/min, with bradycardia. Cardiac enzymes and transthoracic echocardiogram did not show  abnormalities. Serial electrocardiogram and electrolytes showed arrhythmia and electrolyte  imbalance.  

Accumulated evidence showed that cardiac involvement is common in patients with  COVID-19. Atrial and ventricular arrhythmia is common even if there is no history of arrhythmia,  normal cardiac biomarkers, and transthoracic echocardiogram. Different mechanisms have been  proposed for the cause of electrolyte imbalance (see Discussion) that may lead to arrhythmia.  Both potassium and calcium were used as a marker of clinical severity and worse prognosis in  patients with COVID-19. 

CONCLUSION: Arrhythmia in COVID-19 patients are more frequent in elderly with comorbidities.  Close monitoring and correction of electrolyte imbalance are important to prevent arrhythmia, which can sometimes be fatal.

References
  1. World Health Organization. WHO Clinical management of COVID-19: interim guidance. Published May 27, 2020. https://apps.who.int/iris/handle/10665/33219.
  2. ESC Guidance for the Diagnosis and Management of CV Disease During the COVID-19 Pandemic. Last updated June 10, 2020. The European Society of Cardiology 2020. https://www.escardio.org/Education/COVID-19-and Cardiology.
  3. Babapoor-Farrokhran S, Tarighati Rasekhi R, Gill D, Babapoor S, Amanullah A. Arrhythmia in COVID-19 [published online August 14, 2020]. SN Compr Clin Med 2020;2(9):1430–1435.
  4. Liu J, Han P, Wu J, Gong J, Tian D. Prevalence and predictive value of hypocalcemia in severe COVID-19 patients [published online June 22, 2020]. J Infect Public Health. 2020;13(9):1224–1228. doi: 10.1016/j. jiph.2020.05.029.
  5. Dherange P, Lang JM, Qian P, et al. Arrhythmias and COVID-19: a review. JACC Clin Electrophysiol 2020;6(9):1193–1204.
  6. Cappellini F, Brivio R, Casati M, Cavallero A, Contro E, Brambilla P. Low levels of total and ionized calcium in blood of COVID-19 patients. Clin Chem Lab Med 2020;58(9):e171– e173. https://doi.org/10.1515/cclm-2020-0611.
License

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which permits use, share — copy and redistribute the material in any medium or format, adapt — remix, transform, and build upon the material, as long as you give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/.