Syncope and presyncope in patients with COVID-19

Link to article at PubMed

Pacing Clin Electrophysiol. 2020 Aug 25. doi: 10.1111/pace.14047. Online ahead of print.


INTRODUCTION: Recent studies have described several cardiovascular manifestations of COVID-19 including myocardial ischemia, myocarditis, thromboembolism, malignant arrhythmias etc. However, to our knowledge, syncope in COVID-19 patients has not been systematically evaluated. We sought to characterize syncope and/or presyncope in COVID-19 METHODS: This is a retrospective analysis of consecutive patients hospitalized with laboratory-confirmed COVID-19 with either syncope and/or pre-syncope. This 'study' group (n = 37) was compared with an age and gender-matched cohort of patients without syncope ('control') (n = 40). Syncope was attributed to various categories. We compared telemetry data, treatments received, and clinical outcomes between the two groups.

RESULTS: Among 1,000 COVID-19 patients admitted to the Mount Sinai Hospital, the incidence of syncope/presyncope was 3.7%. The median age of the entire cohort was 69 years (range 26 - 89+ years) and 55% were men. Major comorbidities included hypertension, diabetes and coronary artery disease. Syncopal episodes were categorized as i) unspecified in 59.4%, ii) neurocardiogenic in 15.6%, iii) hypotensive in 12.5% and iv) cardiopulmonary in 3.1% with fall vs syncope and seizure vs syncope in 2/32 (6.3%) and 1/33 (3.1%) patients respectively. Compared with the 'control' group, there were no significant differences in both admission and peak blood levels of d-dimer, troponin-I and CRP in the 'study' group. Additionally, there were no differences in arrhythmias or death between both groups.

CONCLUSIONS: Syncope/presyncope in patients hospitalized with COVID-19 is uncommon and is infrequently associated with a cardiac etiology nor associated with adverse outcomes compared to those who do not present with these symptoms. This article is protected by copyright. All rights reserved.

PMID:32840325 | DOI:10.1111/pace.14047

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