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Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. (Krister Lindmark)ORCID-id: 0009-0009-8239-2442
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi. (Anne-Marie Fors Connolly)ORCID-id: 0000-0002-5328-9536
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi. (Anne-Marie Fors Connolly)
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden. (Krister Lindmark)ORCID-id: 0000-0002-5756-7791
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2023 (Engelska)Ingår i: European Heart Journal Open, E-ISSN 2752-4191, Vol. 3, nr 6, artikel-id oead120Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aims: 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.

Methods and Results: 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.

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 day 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, unvaccinated individuals and in individuals with more severe COVID-19. The risk of ventricular arrhythmias was not increased.

Conclusion: 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.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2023. Vol. 3, nr 6, artikel-id oead120
Nyckelord [en]
COVID-19, SARS-CoV-2, cardiology, arrhythmia, atrial arrhythmias, paroxysmal supraventricular tachycardias, bradyarrhythmias, ventricular arrhythmias, nationwide study, matched cohort study, self-controlled case series study
Nationell ämneskategori
Klinisk medicin
Forskningsämne
infektionssjukdomar; folkhälsa; epidemiologi; kardiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-217231DOI: 10.1093/ehjopen/oead120Scopus ID: 2-s2.0-85180103321OAI: oai:DiVA.org:umu-217231DiVA, id: diva2:1815026
Projekt
Risks of arrhythmias after covid-19: nationwide self-controlled cases series and matched cohort studyCardiovascular complications following covid-19: population-based register studies
Forskningsfinansiär
Region Västerbotten, RV-967545Region Västerbotten, RV-967738Region Västerbotten, RV-982300Vetenskapsrådet, 2021-06536Hjärt-Lungfonden, 20220179Hjärt-Lungfonden, 202207232Riksförbundet HjärtLung, FA 2022/6Kempestiftelserna, SMK21-0014Petrus och Augusta Hedlunds Stiftelse, M-2022-1753
Anmärkning

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Tillgänglig från: 2023-11-27 Skapad: 2023-11-27 Senast uppdaterad: 2023-12-27Bibliografiskt granskad

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Katsoularis, IoannisJerndal, HannaKalucza, SebastianLindmark, KristerFonseca Rodriguez, OsvaldoFors Connolly, Anne-Marie

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Katsoularis, IoannisJerndal, HannaKalucza, SebastianLindmark, KristerFonseca Rodriguez, OsvaldoFors Connolly, Anne-Marie
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Institutionen för folkhälsa och klinisk medicinInstitutionen för klinisk mikrobiologi
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