ECG characteristics of COVID-19 patient with arrhythmias: Referral hospitals data from Indonesia

J Arrhythm. 2022 Apr 21;38(3):432-438. doi: 10.1002/joa3.12718. eCollection 2022 Jun.


Background: Arrhythmia is a significant clinical modifier in COVID-19 patient outcomes. Currently, data on arrhythmia and ECG characteristics in COVID-19 from lower middle-income countries are limited.

Methods: COVID-19 was confirmed by polymerase chain reaction testing of a nasopharyngeal sample. All clinical records were systematically evaluated to obtain demographic characteristics and medical comorbidities. The ECG was recorded on admission, in-hospital, and at discharge.

Results: Total documented arrhythmia events account for 22% of patients, comprising 6% of new-onset arrhythmia and 16% of existing arrhythmia. Atrial fibrillation is the most common arrhythmia. The ECG changes were a decrease in heart rate (91 ± 22 vs. 83 ± 20, p < .001) and an increase in the QT interval (354.7 ± 53.70 vs. 371.4 ± 59.48 msec, p < .001) from hospital admission to hospital discharge, respectively. The in-hospital HR of 85 bpm or higher increases the risk of death (OR = 2.69, p = .019).

Conclusion: The incidence of arrhythmias in COVID-19 patients at COVID-19 referral hospitals in Indonesia is 22%. Atrial fibrillation is the most common arrhythmia in COVID-19 patients. Prolongation of QRS duration from admission to discharge was related to the occurrence of new-onset arrhythmia. The in-hospital HR of 85 bpm or higher increased the risk of death.

Keywords: Covid‐19; ECG; arrhythmia; heart rate.