Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.

Katsoularis I, Jerndal H, Kalucza S, Lindmark K, Fonseca-Rodríguez O, Connolly AF

Eur Heart J Open 3 (6) oead120 [2023-11-00; online 2023-11-21]

COVID-19 increases the risk of cardiovascular disease, especially thrombotic complications. There is less knowledge on the risk of arrhythmias after COVID-19. In this study, we aimed to quantify the risk of arrhythmias following COVID-19. This study was based on national register data on all individuals in Sweden who tested positive for SARS-CoV-2 between 1 February 2020 and 25 May 2021. The outcome was incident cardiac arrhythmias, defined as international classification of diseases (10th revision) codes in the registers as follows: atrial arrhythmias; paroxysmal supraventricular tachycardias; bradyarrhythmias; and ventricular arrhythmias. A self-controlled case series study and a matched cohort study, using conditional Poisson regression, were performed to determine the incidence rate ratio and risk ratio, respectively, for an arrhythmia event following COVID-19.A total of 1 057 174 exposed (COVID-19) individuals were included in the study as well as 4 074 844 matched unexposed individuals. The incidence rate ratio of atrial tachycardias, paroxysmal supraventricular tachycardias, and bradyarrhythmias was significantly increased up to 60, 180, and 14 days after COVID-19, respectively. In the matched cohort study, the risk ratio during Days 1-30 following COVID-19/index date was 12.28 (10.79-13.96), 5.26 (3.74-7.42), and 3.36 (2.42-4.68), respectively, for the three outcomes. The risks were generally higher in older individuals, in unvaccinated individuals, and in individuals with more severe COVID-19. The risk of ventricular arrhythmias was not increased. There is an increased risk of cardiac arrhythmias following COVID-19, and particularly increased in elderly vulnerable individuals, as well as in individuals with severe COVID-19.

Category: Health

Funder: Hjärt-Lungfonden

Funder: VR

Type: Journal article

PubMed 38089855

DOI 10.1093/ehjopen/oead120

Crossref 10.1093/ehjopen/oead120

pmc: PMC10711544
pii: oead120

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