Low incidence of cardiac complications among Australians hospitalised with COVID-19

The incidence of cardiac complications is reassuringly low in patients hospitalised with COVID‐19 in Australia, a review has found

AUS‐COVID investigators led by Dr Kunwarde Bhatia, a cardiology advanced trainee at Royal North Shore Hospital, analysed data from 644 consecutive patients included in the Australian Cardiovascular COVID-19 Registry by 28 January 2021.

They found that 125 patients (19%) were admitted to intensive care units, and 70 patients (11%) required intubation; 92 patients (14%) died in hospital. Outcomes for 15 patients (2%) transferred to other hospitals were not known, Dr Bhatia and colleagues reported in the MJA.

Twenty of 553 patients (4%) without histories of atrial fibrillation or flutter were diagnosed with the condition. And of 588 patients who did not have permanent pacemakers or implantable cardioverter defibrillators, three (0.5%) developed high grade atrioventricular block. No patients developed torsades de pointes.

Of the 572 patients without prior diagnoses of heart failure or cardiomyopathy, nine (2%) were diagnosed with new heart failure or cardiomyopathy. Of the six who underwent echocardiography, four had left ventricular ejection fractions of less than 50%, one was reported as having mild left ventricular impairment but no ejection fraction was recorded, and one had elevated levels of B-type natriuretic peptide.

Dr Bhati and colleagues from five hospitals noted that two patients had clinical diagnoses of pericarditis; the troponin level was mildly elevated in one (less than five times the upper limit of normal), suggesting possible myopericarditis. Neither patient underwent echocardiography, cardiac magnetic resonance imaging, or biopsy.

The investigators cautioned that their study did not capture subclinical complications, and that there was no comparator group, so they could not compare the incidence of cardiac complications with those for other viral illnesses.

Nevertheless, they said the AUS‐COVID Registry data showed a low incidence of known cardiac complications such as arrhythmias, myopericarditis, and cardiomyopathy among patients hospitalised with COVID‐19.

“While clinicians should remain vigilant, the incidence of clinical cardiac complications during index hospitalisations was reassuringly low in our multicentre study of more than 600 consecutive patients admitted to hospital with COVID-19 in Australia,” they colleagues concluded.


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