Incidence of arrhythmias in COVID-19 patients with double mutant strain of SARS-CoV-2 virus: A tertiary care experience

Background: Our understanding of arrhythmias is minimal with SARS-CoV-2 virus and with the emergence of its double mutant, virtually nonexistent. Patients with the double mutant (B.1.617) SARS-CoV infection had more cardiac manifestations, including arrhythmias and sudden death, than with the traditional variant. Objective: To determine the incidence of arrhythmias in COVID-19 patients with double mutant strain of SARS-CoV-2 virus (B.1.617). Materials and methods: We describe a prospective observational study conducted in the Department of Medicine, United Institute of Medical Sciences, Prayagraj, Uttar Pradesh on patients admitted to the hospital during the period March 2021 to May 2021. Different type of arrhythmias were studied in the admitted patients. Results: Sinus bradycardia is the most common arrhythmia, followed by atrial fibrillation. Malignant arrhythmias, such as ventricular tachycardia/ventricular fibrillation and Torsades de pointes due to QT prolongation, were present in small number of patients with high mortality outcomes. Sinus tachycardia and high-grade AV blocks were also present in some of the patients. Conclusions: Current literature lacks studies on arrhythmias secondary to COVID-19 (double mutant) strain and its possible mechanisms. This makes it difficult to distinguish between arrhythmias secondary to COVID-19 (double mutant) infection due to hypoxemia, dyselectrolytemia, SIRS, comorbidities, and medications or direct viral effects on the cardiomyocytes.