Cardiac arrhythmias in patients with COVID-19

Yueying Wang, Zhaojia Wang, Gary Tse, Lin Zhang, Elaine Y. Wan, Yutao Guo, Gregory Y.H. Lip, Guangping Li, Zhibing Lu, Tong Liu

Research output: Contribution to journalReview articlepeer-review

61 Citations (Scopus)


The emergence of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a major global public health concern. Although SARS-CoV-2 causes primarily respiratory problems, concurrent cardiac injury cannot be ignored since it may be an independent predictor for adverse outcomes. Cardiac arrhythmias are often observed in patients with COVID-19, especially in severe cases, and more likely contribute to the high risk of adverse outcomes. Arrhythmias should be regarded as one of the main complications of COVID-19. Mechanistically, a number of ion channels can be adversely affected in COVID-19, leading to alterations in cardiac conduction and/or repolarization properties, as well as calcium handling, which can predispose to cardiac arrhythmogenesis. In addition, several antimicrobials that are currently used as potential therapeutic agents for COVID-19, such as chloroquine, hydroxychloroquine and azithromycin, have uncertain benefit, and yet may induce electrocardiographic QT prolongation with potential ventricular pro-arrhythmic effects. Continuous electrocardiogram monitoring, accurate and prompt recognition of arrhythmias are important. The present review focuses on cardiac arrhythmias in patients with COVID-19, its underlying mechanisms, and proposed preventive and therapeutic strategies.

Original languageEnglish
Pages (from-to)827-836
Number of pages10
JournalJournal of Arrhythmia
Issue number5
Publication statusPublished - 1 Oct 2020
Externally publishedYes


  • COVID-19
  • QT interval
  • SARS-CoV-2
  • angiotensin-converting enzyme-2
  • arrhythmia
  • electrocardiogram


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