Investigation of the risk of cardiac arrhythmia during long COVID-19

Abstract

Background: Long COVID-19 occurs in 10-30% of SARS-CoV-2 cases, 50-70% of hospitalized patients, and 10-12% of vaccinated individuals. Therefore, there is an urgent need to detect and investigate some factors that affect cardiac repolarization changes after Long COVID-19, and to seek opportunities to prevent and treat arrhythmias and other complications resulting from cardiac repolarization changes, which is the reason for this research. Aim: Detecting predominant cardiac changes in Long COVID-19 and assessing the risk of arrhythmias. 1. To investigate changes in electrocardiogram and echocardiography in patients with Long COVID-19 symptoms 2. Assessing risk of arrhythmias by comparing repolarization and pericardial changes during Long COVID-19 with control group Materials and Methods: The study was included using a hospital-based cross sectional and case-control model and included 120 patients who had COVID-19 test result and received medical care at the cardiology outpatient clinic of the “Mongolian-Japanese Hospital” of MNUMS from January to July 2023. From these patients, 60 patients who met the criteria of the case group and 60 patients without changes in long COVID-19 were selected for the control group. The changes in repolarization, TpTe interval, QTc interval were evaluated by ECG (Nihon Kohden, 2016), furthermore reactive pericarditis, contractility and relaxation of the heart were evaluated by echocardiography (Xario 200, Canon, 2018), some laboratory parameters were collected, and statistical calculation was done by SPSS 25.0 program. Results: The average age of the participants was 45.70±13.44 years. 35.7% of patients had increased pericardial echogenicity, 23.3% had suspected reactive pericarditis, and 41% were not increased pericardial echogenecity. 37.9% of the patients had I grade of diastolic dysfunction, 0.9% had II grade of diastolic dysfunction, and 61.2% were normal. The TpTe interval indicating cardiac repolarization in the case group (0.139±0.020 sec) was significantly higher than the control group (0.089±0.010 sec) (p<0.001). The QTc interval was prolonged by 0.559±0.080 sec in the case group (QTc interval prolongation >0.480 sec), and there was a significant difference in the control group by 0.421±0.030 seconds (p<0.001). In the laboratory analysis of participants, C-reactive protein was significantly higher in the case group (2.81±0.91 mg/L) than in the control group (0.93±0.19). Conclusions: 1. During Long COVID-19, reactive pericarditis and repolarization changes [prolonged QTc, TpTe interval] may occur in the heart. 2. Consequently, reactive pericarditis and prolonged QTc, TpTe interval may increase the risk of life-threatening arrhythmias.