Список литературы

2687-0940

Challenges in modern medicine

2687-0940

10.52575/2687-0940-2025-48-1-15-28

226

CARDIOLOGY

<strong>Mechanisms of Arrhythmia Development in COVID-19</strong> <strong>Patients</strong>

Kamyshnikova

Lyudmila A.

Kamyshnikova

Lyudmila A.

Davydova

Irina V.

Davydova

Irina V.

Gordienko

Yulia A.

Gordienko

Yulia A.

Baiduk

Diana V.

Baiduk

Diana V.

Pribylov

Sergey A.

Pribylov

Sergey A.

Payudis

Alexey N.

Payudis

Alexey N.

2025

48100

Arrhythmia is a common cardiovascular complication in patients with the coronavirus disease 2019 (COVID-19). According to studies, the incidence of arrhythmia ranges from 16.7% to 19.6% among those hospitalized with COVID-19. The aim of this review is to study the mechanisms of arrhythmia occurrence in COVID-19 patients, to provide physicians with a comprehensive basis for the prevention and treatment of these arrhythmias. Materials and methods. A search was conducted for articles over the past 5 years in the PubMed, Google Scholar, and eLIBRARY databases by keywords in Russian and English, articles were selected in accordance with the purpose of the study. Results. The occurrence of arrhythmias in patients with COVID-19 may be associated with local and systemic inflammatory reactions caused by a viral infection, leading to damage to cardiomyocytes, pericarditis, impaired immune response, cytokine storms, structural changes in the heart and cardiac conduction disturbances, which ultimately leads to the development of arrhythmias. But there are also other factors: electrolyte imbalance, myocardial ischemia/hypoxia, proarrhythmic side effects of drugs used to treat COVID-19, dysfunction of the autonomic nervous system. Conclusion. Each of the described mechanisms of arrhythmia development influences other mechanisms, the greatest number of influences are: myocarditis and impaired regulation of the immune response. To prevent arrhythmias associated with COVID-19, it is necessary to monitor the underlying disease, provide early detection and treatment of myocardial damage and other organ dysfunctions, prevent hypoxia, prevent systemic inflammation and reduce the use of drugs that prolong the QT interval.

arrhythmiaSARS-CoV-2COVID-19pathogenesis

Список литературы

Vishnevskij V.I., Panina J.N., Vishnevskij M.V. 2022. The Effect of Electrolyte Deficiency on Cardiac Arrhythmias Against the Background of a New Coronavirus Infection Challenges in Modern Medicine. 45(1): 55–64 (in Russian). doi: 10.52575/2687-0940-2022-45-1-55-64

Kamyshnikova L.А., Efremova O.A. 2017. Impact of Comorbidities on Myocardial Remodeling and Dysfunction in Heart Failure with Preserved Ejection Fraction. Clinical Medicine. 95(12): 1070–1076 (in Russian).

Kamyshnikova L.A., Efremova O.A., Fentisov V.V., Bolkhovitina O.A., Churnosov M.I. 2024. Genetic Determinants of Angiotensin-Converting Enzyme Levels (Data from Genome-Wide Studies). Arterial’naya Gipertenziya = Arterial Hypertension. 30(6): 537–552. doi:10.18705/1607-419X-2024-2446

Osipova O.A., Shepel R.N., Karutskaya O.A., Komisov A.A., Demko V.V., Belousova O.N., Chupakha M.V. 2023. The Role of Circulating Biomarkers in Post-COVID-19 Patients. Challenges in Modern Medicine. 46(3): 231–244 (in Russian). doi: 10.52575/2687-0940-2023-46-3-231-244

Babapoor-Farrokhran S., Gill D., Walker J., Rasekhi R.T., Bozorgnia B., Amanullah A. 2020. Myocardial Injury and COVID-19: Possible Mechanisms. Life Sci. 253: 117723. doi: 10.1016/j.lfs.2020.117723

Bhatla A., Mayer M.M., Adusumalli S., Hyman M.C., Oh E., Tierney A., Moss J., Chahal A.A., Anesi G., Denduluri S., Domenico C.M., Arkles J., Abella B.S., Bullinga J.R., Callans D.J., Dixit S., Epstein A.E., Frankel D.S., Garcia F.C., Kumareswaram R., Nazarian S., Riley M.P., Santangeli P., Schaller R.D., Supple G.E., Lin D., Marchlinski F., Deo R. 2020. COVID-19 and Cardiac Arrhythmias. Heart Rhythm. 17:1439–1444. doi: 10.1016/j.hrthm.2020.06.016

Boehmer T.K., Kompaniyets L., Lavery A.M., Hsu J., Ko J.Y., Yusuf H., Romano S.D., Gundlapalli A.V., Oster M.E., Harris A.M. 2021. Association Between COVID-19 and Myocarditis Using Hospital-Based Administrative Data – United States, March 2020 – January 2021. MMWR Morb Mortal Wkly Rep. 70: 1228–1232. doi: 10.15585/mmwr.mm7035e5

Bojkova D., Wagner J.U.G., Shumliakivska M., Aslan G.S., Saleem U., Hansen A., Luxán G., Günther S., Pham M.D., Krishnan J., Harter P.N., Ermel U.H., Frangakis A.S., Milting H., Zeiher A.M., Klingel K., Cinatl J., Dendorfer A., Eschenhagen T., Tschöpe C., Ciesek S., Dimmeler S. SARS-CoV-2 Infects and Induces Cytotoxic Effects in Human Cardiomyocytes. Cardiovasc Res. 2020; 116: 2207–2215. doi: 10.1093/cvr/cvaa267

Boulos P.K., Freeman S.V., Henry T.D., Mahmud E., Messenger J.C. 2023. Interaction of COVID-19 with Common Cardiovascular Disorders. Circ Res. 132: 1259–1271. doi: 10.1161/CIRCRESAHA.122.321952

Castiello T., Georgiopoulos G., Finocchiaro G., Claudia M., Gianatti A., Delialis D., Aimo A., Prasad S. 2022. COVID-19 and Myocarditis: A Systematic Review and Overview of Current Challenges. Heart Fail Rev. 27: 251–261. doi: 10.1007/s10741-021-10087-9

Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y., Qiu Y., Wang J., Liu Y., Wei Y., Xia J., Yu T., Zhang X., Zhang L. 2020. Epidemiological and Clinical Characteristics of 99 Cases of 2019 Novel Coronavirus Pneumonia in Wuhan, China: A Descriptive Study. Lancet. 395: 507–513. doi: 10.1016/S0140-6736(20)30211-7

Chung M.K., Zidar D.A., Bristow M.R., Cameron S.J., Chan T., Harding C.V. 3rd, Kwon D.H., Singh T., Tilton J.C., Tsai E.J., Tucker N.R., Barnard J., Loscalzo J. 2021. COVID-19 and Cardiovascular Disease: From Bench to Bedside. Circ Res. 128: 1214–1236. doi: 10.1161/CIRCRESAHA.121.317997

DePace N.L., Colombo J. 2022. Long-COVID Syndrome and the Cardiovascular System: A Review of Neurocardiologic Effects on Multiple Systems. Curr Cardiol Rep. 24:1711–1726. doi: 10.1007/s11886-022-01786-2

Dherange P., Lang J., Qian P., Oberfeld B., Sauer W.H., Koplan B., Tedrow U. 2020. Arrhythmias and COVID-19: A Review. JACC Clin Electrophysiol. 6: 1193–1204. doi: 10.1016/j.jacep.2020.08.002

Donniacuo M., De Angelis A., Rafaniello C., Cianflone E., Paolisso P., Torella D., Sibilio G., Paolisso G., Castaldo G., Urbanek K., Rossi F., Berrino L., Cappetta D. 2023. COVID-19 and Atrial Fibrillation: Intercepting Lines. Front Cardiovasc Med. 10: 1093053. doi: 10.3389/fcvm.2023.1093053

Driggin E., Madhavan M.V., Bikdeli B., Chuich T., Laracy J., Biondi-Zoccai G., Brown T.S., Der Nigoghossian C., Zidar D.A., Haythe J., Brodie D., Beckman J.A., Kirtane A.J., Stone G.W., Krumholz H.M., Parikh S.A. 2020. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic. J. Am. Coll. Cardiol. 75: 2352–2371. doi: 10.1016/j.jacc.2020.03.031

El-Ghiaty M.A., Shoieb S.M., El-Kadi A.O.S. 2020. Cytochrome P450-mediated drug interactions in COVID-19 Patients: Current Findings and Possible Mechanisms. Med Hypotheses. 144: 110033. doi: 10.1016/j.mehy.2020.110033

Fairweather D., Beetler D.J., Di Florio D.N., Musigk N., Heidecker B., Cooper L.T. Jr. 2023. COVID-19, Myocarditis and Pericarditis. Circ Res. 132: 1302–1319. doi: 10.1161/CIRCRESAHA.123.321878

Gupta A., Madhavan M.V., Sehgal K., Nair N., Mahajan S., Sehrawat T.S., Bikdeli B., Ahluwalia N., Ausiello J.C., Wan E.Y., Freedberg D.E., Kirtane A.J., Parikh S.A., Maurer M.S., Nordvig A.S., Accili D., Bathon J.M., Mohan S., Bauer K.A., Leon M.B., Krumholz H.M., Uriel N., Mehra M.R., Elkind M.S.V., Stone G.W., Schwartz A., Ho D.D., Bilezikian J.P., Landry D.W. 2020. Extrapulmonary Manifestations of COVID-19. Nat Med. 26: 1017–1032. doi: 10.1038/s41591-020-0968-3

Guzik T.J., Mohiddin S.A., Dimarco A., Patel V., Savvatis K., Marelli-Berg F.M., Madhur M.S., Tomaszewski M., Maffia P., D'Acquisto F., Nicklin S.A., Marian A.J., Nosalski R., Murray E.C., Guzik B., Berry C., Touyz R.M., Kreutz R., Wang D.W., Bhella D., Sagliocco O., Crea F., Thomson E.C., McInnes I.B. 2020. COVID-19 and the Cardiovascular System: Implications for Risk Assessment, Diagnosis, and Treatment Options. Cardiovasc Res. 116: 1666–1687. doi: 10.1093/cvr/cvaa106

Han Y., Zhu J., Yang L., Nilsson-Payant B.E., Hurtado R., Lacko L.A., Sun X., Gade A.R., Higgins C.A., Sisso W.J., Dong X., Wang M., Chen Z., Ho D.D., Pitt G.S., Schwartz R.E., tenOever B.R., Evans T., Chen S. 2022. SARS-CoV-2 Infection Induces Ferroptosis of Sinoatrial Node Pacemaker Cells. Circ Res. 130:963–977. doi: 10.1161/CIRCRESAHA.121.320518

Husayn S.S., Brown J.D., Presley C.L., Boghean K., Waller J.D. 2022. Hydroxychloroquine Alternatives for Chronic Disease: Response to a Growing Shortage Amid the Global COVID-19 Pandemic. J. Pharm. Pract. 35: 120–125. doi: 10.1177/0897190020942658

Kole C., Stefanou Ε., Karvelas N., Schizas D., Toutouzas K.P. 2024. Acute and Post-Acute COVID-19 Cardiovascular Complications: A Comprehensive Review. Cardiovasc Drugs Ther. 38, 1017–1032. https://doi.org/10.1007/s10557-023-07465-w

Lazzerini P.E., Boutjdir M., Capecchi P.L. 2020. COVID-19, Arrhythmic Risk, and Inflammation: Mind the Gap! Circulation. 142: 7–9. doi: 10.1161/CIRCULATIONAHA.120.047293

Lazzerini P.E., Laghi-Pasini F., Boutjdir M., Capecchi P.L. 2019. Cardioimmunology of Arrhythmias: The Role of Autoimmune and Inflammatory Cardiac Channelopathies. Nat Rev Immunol. 19: 63–64. doi: 10.1038/s41577-018-0098-z

Lazzerini P.E., Laghi-Pasini F., Boutjdir M., Capecchi P.L. 2022. Inflammatory Cytokines and Cardiac Arrhythmias: The Lesson from COVID-19. Nat Rev Immunol. 22: 270–272. doi: 10.1038/s41577-022-00714-3

Li J., Huang Q., Liang Y., Jiang J., Yang Y., Feng J., Tan X., Li T. 2024 The Potential Mechanisms of Arrhythmia in Coronavirus Disease – 2019. Int. J. Med. Sci. 19; 21(7): 1366–1377. doi: 10.7150/ijms.94578

Manolis A.A., Manolis T.A., Apostolopoulos E.J., Apostolaki N.E., Melita H., Manolis A.S. 2021. The Role of the Autonomic Nervous System in Cardiac Arrhythmias: The Neuro-Cardiac Axis, More Foe than Friend? Trends Cardiovasc Med. 31: 290–302. doi: 10.1016/j.tcm.2020.04.011

Manolis A.S., Manolis A.A., Manolis T.A. Apostolopoulos E.J., Papatheou D., Melita H. 2020. COVID-19 Infection and Cardiac Arrhythmias. Trends Cardiovasc Med. 30: 451–460. doi: 10.1016/j.tcm.2020.08.002

Naeije R., Richter M.J., Rubin L.J. 2022. The Physiological Basis of Pulmonary Arterial Hypertension. Eur Respir J. 59(6): 2102334. doi: 10.1183/13993003.02334-2021

Ning Q., Wu D., Wang X., Xi D., Chen T., Chen G., Wang H., Lu H., Wang M., Zhu L., Hu J., Liu T., Ma K., Han M., Luo X. 2022. The Mechanism Underlying Extrapulmonary Complications of the Coronavirus Disease 2019 and its Therapeutic Implication. Signal Transduct Target Ther. 7: 57. doi: 10.1038/s41392-022-00907-1

Nishiga M., Wang D.W., Han Y., Lewis D.B., Wu J.C. 2020. COVID-19 and Cardiovascular Disease: From Basic Mechanisms to Clinical Perspectives. Nat Rev Cardiol. 17: 543–558. doi: 10.1038/s41569-020-0413-9

Patone M., Mei X.W., Handunnetthi L., Dixon S., Zaccardi F., Shankar-Hari M., Watkinson P., Khunti K., Harnden A., Coupland C.A.C., Channon K.M., Mills N.L., Sheikh A., Hippisley-Cox J. 2022. Risks of Myocarditis, Pericarditis, and Cardiac Arrhythmias Associated with COVID-19 Vaccination or SARS-CoV-2 Infection. Nat Med. 28: 410–422. doi: 10.1038/s41591-021-01630-0

Peretto G., Sala S., Rizzo S., De Luca G., Campochiaro C., Sartorelli S., Benedetti G., Palmisano A., Esposito A., Tresoldi M., Thiene G., Basso C., Della Bella P. 2019. Arrhythmias in Myocarditis: State of the Art. Heart Rhythm. 16: 793–801. doi: 10.1016/j.hrthm.2018.11.024

Ruan Q., Yang K., Wang W., Jiang L., Song J. 2020. Clinical Predictors of Mortality Due to COVID-19 Based on an Analysis of Data of 150 Patients from Wuhan, China. Intensive Care Med. 46: 846–848. doi: 10.1007/s00134-020-05991-x

Shang J., Ye G., Shi K., Yu. Wan, Luo C., Aihara H., Geng Q., Auerbach A., Li F. 2020. Structural Basis of Receptor Recognition by SARS-CoV-2. Nature. 581: 221–4. doi: 10.1038/s41586-020-2179-y

Siripanthong B., Nazarian S., Muser D., Deo R., Santangeli P., Khanji M.Y., Cooper L.T. Jr, Chahal C.A.A. 2020. Recognizing COVID-19-Related Myocarditis: The Possible Pathophysiology and Proposed Guideline for Diagnosis and Management. Heart Rhythm. 17: 1463–1471. doi: 10.1016/j.hrthm.2020.05.001

Varney J.A., Dong V.S., Tsao T., Sabir M.S., Rivera A.T., Ghula S., Moriles K.E., Cherukuri M.L., Fazal R., Azevedo C.B., Mohamed R.M., Jackson G.R., Fleming S.E., Rochez D.E., Abbas K.S., Shah J.H., Minh L.H.N., Osman F., Rafla S.M., Huy N.T. 2022. COVID-19 and Arrhythmia: An Overview. J Cardiol. 79: 468–475. doi: 10.1016/j.jjcc.2021.11.019

Wang R.S., Loscalzo J. 2023. Repurposing Drugs for the Treatment of COVID-19 and Its Cardiovascular Manifestations. Circ Res. 132: 1374–1386. doi: 10.1161/CIRCRESAHA.122.321879

Wong L.R., Perlman S. 2022. Immune Dysregulation and Immunopathology Induced by SARS-CoV-2 and Related Coronaviruses - Are We Our Own Worst Enemy? Nat Rev Immunol. 22: 47–56. doi: 10.1038/s41577-021-00656-2

Yang L., Liu S., Liu J., Zhang Z., Wan X., Huang B., Chen Y., Zhang Y. 2020. COVID-19: Immunopathogenesis and Immunotherapeutics. Signal Transduct Target Ther. 5:128. doi: 10.1038/s41392-020-00243-2

Zequn Z., Yujia W., Dingding Q., Jiangfang L. 2021. Off-label Use of Chloroquine, Hydroxychloroquine, Azithromycin and Lopinavir/Ritonavir in COVID-19 Risks Prolonging the QT Interval by Targeting the hERG Channel. Eur J Pharmacol. 893:173813. doi: 10.1016/j.ejphar.2020.173813

Zhan Y., Yue H., Liang W., Wu Z. 2022. Effects of COVID-19 on Arrhythmia. J Cardiovasc Dev Dis. 9: 292. doi: 10.3390/jcdd9090292

Zheng Y.Y., Ma Y.T., Zhang J.Y., Xie X. 2020. COVID-19 and the Cardiovascular System. Nat Rev Cardiol. 17:259–260. doi: 10.1038/s41569-020-0360-5