Sinus Arrest in Asymptomatic COVID-19 Infection

Coronavirus disease 2019 (COVID-19) is a viral respiratory tract syndrome capable of affecting a multitude of major organs in the human body. It is a known cause of severe vascular compromise, myocardial ischemia, myocarditis, and various cardiac dysrhythmias. Dysfunction of the sinoatrial (SA) node, the primary pacemaker of the heart, can arise from structural heart disease, medications, electrolyte abnormalities, and hypothyroidism. We report and discuss a case of a 50-year-old female with no significant past medical history (PMH) and no SA dysfunction risk factors, who experienced multiple syncopal events and an episode of sinus arrest characterized by transient asystole captured with telemetry monitoring. The patient was incidentally found to be COVID-19 positive and displayed no signs or symptoms concerning the viral illness. Despite our patient’s lack of respiratory issues or other symptomatology, a significant and potentially fatal relationship exists between her viral infection and cardiac sequelae.