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

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.