The Prevalence and Associated Death of Ventricular Arrhythmia and Sudden Cardiac Death in Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis

Background:& nbsp;Arrhythmia is a very common complication of coronavirus disease 2019 (COVID-19); however, the prevalence of ventricular arrhythmia and associated outcomes are not well-explored. Here, we conducted a systematic review and meta-analysis to determine the prevalence and associated death of ventricular arrhythmia and sudden cardiac death (SCD) in patients with COVID-19.& nbsp;Methods:& nbsp;Databases of PubMed, Cochrane Library, Embase, and MdeRxiv were searched. Studies that could calculate the prevalence of ventricular arrhythmia/SCD during hospital admission or associated death in patients with COVID-19 were included. The study was registered with the PROSPERO (CRD42021271328).& nbsp;Results:& nbsp;A total of 21 studies with 13,790 patients were included. The pooled prevalence of ventricular arrhythmia was 5% (95% CI: 4-6%), with a relatively high-SCD prevalence (1.8% in hospitalized COVID-19 and 10% in deceased cases of COVID-19). Subgroup analysis showed that ventricular arrhythmia was more common in patients with elevated cardiac troponin T [ES (effect size): 10%, 95% CI: -0.2 to 22%] and in European (ES: 20%, 95% CI: 11-29%) populations. Besides, ventricular arrhythmia was independently associated with an increased risk of death in patients with COVID-19 [odds ratio (OR) = 2.83; 95% CI: 1.78-4.51].& nbsp;Conclusion:& nbsp;Ventricular arrhythmia and SCD resulted as a common occurrence with a high prevalence in patients with COVID-19 admitted to the hospital. Furthermore, ventricular arrhythmia significantly contributed to an increased risk of death in hospitalized patients with COVID-19. Clinicians might be vigilant of ventricular arrhythmias for patients with COVID-19, especially for severe cases.

Automated summary

In this study, a systematic review and meta-analysis were conducted to investigate the prevalence and associated death of ventricular arrhythmia and sudden cardiac death (SCD) in patients with COVID-19. The findings showed that ventricular arrhythmia was common in COVID-19 patients, with a high prevalence and an increased risk of death. Elevated levels of cardiac troponin T and European populations were associated with a higher occurrence of ventricular arrhythmia. Clinicians should be vigilant and monitor for ventricular arrhythmias in COVID-19 patients, particularly in severe cases.