Increased interleukin-6 levels are associated with atrioventricular conduction delay in severe COVID-19 patients

被引：3

作者：

Accioli, Riccardo ^{[1
,2
]}

Lazzerini, Pietro Enea ^{[1
,2
]}

Salvini, Viola ^{[1
,2
]}

Cartocci, Alessandra ^{[3
]}

Verrengia, Decoroso ^{[1
,2
]}

Marzotti, Tommaso ^{[1
,2
]}

Salvadori, Fabio ^{[1
,2
]}

Bisogno, Stefania ^{[1
,2
]}

Cevenini, Gabriele ^{[3
]}

Voglino, Michele ^{[1
,2
]}

Gallo, Severino ^{[1
,2
]}

Pacini, Sabrina ^{[1
,2
]}

Pazzaglia, Martina ^{[1
,2
]}

Tansini, Angelica ^{[1
,2
]}

Otranto, Ambra ^{[1
,2
]}

Laghi-Pasini, Franco ^{[1
,2
]}

Acampa, Maurizio ^{[4
]}

Boutjdir, Mohamed ^{[5
,6
]}

Capecchi, Pier Leopoldo ^{[1
,2
]}

机构：

[1] Univ Siena, Dept Med Sci Surg & Neurosci, Siena, Italy

[2] Univ Siena, Div Internal Med & Geriatr, Electroimmunol Unit, Siena, Italy

[3] Univ Siena, Dept Med Biotechnol, Siena, Italy

[4] Univ Hosp Siena, Stroke Unit, Siena, Italy

[5] SUNY Downstate Hlth Sci Univ, VA New York Harbor Healthcare Syst, New York, NY USA

[6] NYU, Grossman Sch Med, New York, NY USA

来源：

JOURNAL OF ARRHYTHMIA | 2024年 / 40卷 / 05期

关键词：

atrioventricular block; COVID-19; interleukin-6; PR-interval; PR-segment; INFLUENZA-A VIRUS; PROLONGED PR INTERVAL; HEART-RATE; BLOCK; SYSTEM; COMPLICATION; DURATION; BEHAVIOR; OUTCOMES; DISEASE;

D O I：

10.1002/joa3.13114

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundSeverely ill patients with coronavirus disease 2019 (COVID-19) show an increased risk of new-onset atrioventricular blocks (AVBs), associated with high rates of short-term mortality. Recent data suggest that the uncontrolled inflammatory activation observed in these patients, specifically interleukin (IL)-6 elevation, may play an important pathogenic role by directly affecting cardiac electrophysiology. The aim of our study was to assess the acute impact of IL-6 changes on electrocardiographic indices of atrioventricular conduction in severe COVID-19. MethodsWe investigated (1) the behavior of PR-interval and PR-segment in patients with severe COVID-19 during active phase and recovery, and (2) their association with circulating IL-6 levels over time. ResultsDuring active disease, COVID-19 patients showed a significant increase of PR-interval and PR-segment. Such atrioventricular delay was transient as these parameters rapidly normalized during recovery. PR-indices significantly correlated with circulating IL-6 levels over time. All these changes and correlations persisted also in the absence of laboratory signs of cardiac strain/injury or concomitant treatment with PR-prolonging drugs, repurposed or not. ConclusionsOur study provides evidence that in patients with severe COVID-19 and high-grade systemic inflammation, IL-6 elevation is associated with a significant delay of atrioventricular conduction, independent of concomitant confounding factors. While transient, such alterations may enhance the risk of severe AVB and associated short-term mortality. Our data provide further support to current anti-inflammatory strategies for severe COVID-19, including IL-6 antagonists.

引用

页码：1137 / 1148

页数：12

共 58 条

[1] Influenza associated with circulatory collapse and atrioventricular block in an unvaccinated child with repaired CHD [J].