COVID-19: Cardiac Arrhythmias / Ending Social Confinement / ED Visits for Life-Threatening Conditions

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH

Take a look at some of the latest findings on COVID-19:

Cardiac arrhythmias: A study in Heart Rhythm lends insight into risks for arrhythmias in COVID-19 patients. Among 700 patients (over 70% Black) admitted to one Pennsylvania hospital, 53 arrhythmic events occurred: 9 cardiac arrests (all in the ICU), 25 atrial fibrillation (AF) events, 9 clinically significant bradyarrhythmias, and 10 non-sustained ventricular tachycardias (NSVTs). After multivariable adjustment, ICU admission was significantly associated with cardiac arrest (odds ratio, 4.7) and NSVT (OR, 8.9). Additionally, each 1-year increase in age was associated with incident AF, and prevalent heart failure was associated with bradyarrhythmias. Only cardiac arrest was an independent predictor of in-hospital mortality. The researchers conclude that "cardiac arrests and arrhythmias are likely the consequence of systemic illness and not solely the direct effect of COVID-19 infection."

Ending social confinement: Population lockdowns should last for at least 60 days to limit the spread of COVID-19 and help prevent or delay a second, larger wave of infections, according to a modeling study in Nature Human Behavior. Strategies that end social confinement gradually — as opposed to abruptly allowing moderate or large proportions of the population to return to typical activities — "always result in a lower number of infections and deaths," the researchers conclude. They emphasize that testing and contact tracing will still be essential to keep transmissions down. In related news, the New York Times reports that 20% of all new COVID-19 infections on Sunday were in the U.S. — even though the country accounts for just 4.3% of the world's population.

Emergency department visits: ED visits for three acute life-threatening conditions declined significantly in the 10 weeks after the U.S. declared a national emergency over COVID-19, relative to the 10 weeks before the declaration, researchers report in MMWR. Using a CDC surveillance database, the researchers found that myocardial infarction visits fell by 23%, stroke visits by 20%, and hyperglycemic crisis visits by 10%. The largest declines in MI and stroke visits were observed among adults aged 65 and older. The authors write, "Clear, frequent, highly visible communication from public health and health care professionals is needed to reinforce the importance of timely care for medical emergencies and to assure the public that EDs are implementing infection prevention and control guidelines."