Syncope and presyncope in patients with COVID‐19

Oates, Connor; Turagam, Mohit K.; Musikantow, Daniel; Chu, Edward; Shivamurthy, Poojita; Lampert, Joshua; Kawamura, Iwanari; Bokhari, Mahmoud; Whang, William; Miller, Marc A.; Choudry, Subbarao; Langan, Noelle; Sofi, Aamir; Dukkipati, Srinivas R.; Reddy, Vivek Y.; Koruth, Jacob S.

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