Cardiac Complications in Patients Hospitalised With COVID-19 in Australia

Objectives Describe the incidence of cardiac complications in patients admitted to hospital with COVID-19 in Australia. Design Observational cohort study. Setting Twenty-one (21) Australian hospitals. Participants Consecutive patients aged >= 18 years admitted to hospital with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Main outcome measures Incidence of cardiac complications. Results Six-hundred-and-forty-four (644) hospitalised patients (62.5 +/- 20.1 yo, 51.1% male) with COVID-19 were enrolled in the study. Overall in-hospital mortality was 14.3%. Twenty (20) (3.6%) patients developed new atrial fibrillation or flutter during admission and 9 (1.6%) patients were diagnosed with new heart failure or cardiomyopathy. Three (3) (0.5%) patients developed high grade atrioventricular (AV) block. Two (2) (0.3%) patients were clinically diagnosed with pericarditis or myopericarditis. Among the 295 (45.8%) patients with at least one troponin measurement, 99 (33.6%) had a peak troponin above the upper limit of normal (ULN). In-hospital mortality was higher in patients with raised troponin (32.3% vs 6.1%, p<0.001). New onset atrial fibrillation or flutter (6.4% vs 1.0%, p=0.001) and troponin elevation above the ULN (50.3% vs 16.4%, p<0.001) were more common in patients 65 years and older. There was no significant difference in the rate of cardiac complications between males and females. Conclusions Among patients with COVID-19 requiring hospitalisation in Australia, troponin elevation was common but clinical cardiac sequelae were uncommon. The incidence of atrial arrhythmias and troponin elevation was greatest in patients 65 years and older.

Automated summary

This observational cohort study conducted in 21 Australian hospitals found that cardiac complications were uncommon in COVID-19 patients requiring hospitalization, but elevated troponin levels were common. New onset atrial arrhythmias and troponin elevation were more common in patients 65 years and older.