Background
Covid-19 has been a global pandemic with evidence of significant cardiovascular involvement including myocarditis, coronary thrombosis, heart failure, and atrial and ventricular arrhythmias. Given the need for rapid data release, most of these reports are from small case series and little is still known about the incidence of potentially lethal ventricular arrhythmias in the various states of Covid-19 cardiac involvement.
Objective
The objective of this study is to determine the incidence of VT/VF in Covid-19.
Methods
A Systematic Review was conducted in PubMed, Embase, and CINAHL from Jan. 2019-Jan. 2021 using the search terms Ventricular tachycardia (VT) or Ventricular Fibrillation (VF) and Covid-19, SARS-CoV-2, or Severe acute respiratory syndrome coronavirus 2. The primary endpoint of presence of ventricular arrhythmia was extracted in the individual patient populations: outpatient, hospitalized, ICU, and presence of myocardial involvement.
Results
31 studies (n = 15,305 patients) were included. The overall incidence of VT/VF in hospitalized patients not in an ICU was 0.73% (95% CI 0.59-0.87%). Covid-19 patients with myocarditis and troponin elevation had increased incidence of VT/VF of 9.5% (95% CI 0-22.1%) and 6.5% (95% CI 3.44-9.62%) respectively. ICU patients had 1.2% (95% CI 0.03- 2.29%) incidence of VT/VF. No outpatient Covid-19 patients had documented ventricular arrhythmias.
Conclusion
VT/VF is an important complication of Covid-19. VT/VF had an increased incidence in those with myocarditis and myocardial injury.
