Novel coronavirus 19 (COVID-19) associated sinus node dysfunction: A case series

Graham Peigh, Marysa V. Leya, Jayson R. Baman, Eric P. Cantey, Bradley P. Knight, James D. Flaherty*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Novel coronavirus-19 disease (COVID-19) is associated with significant cardiovascular morbidity and mortality. To date, there have not been reports of sinus node dysfunction (SND) associated with COVID-19. This case series describes clinical characteristics, potential mechanisms, and short-term outcomes of COVID-19 patients who experience de novo SND. Case summary: We present two cases of new-onset SND in patients recently diagnosed with COVID-19. Patient 1 is a 70-year-old female with no major past medical history who was intubated for acute hypoxic respiratory failure secondary to COVID-19 pneumonia and developed new-onset sinus bradycardia without a compensatory increase in heart rate in response to relative hypotension. Patient 2 is an 81-year-old male with a past medical history of an ascending aortic aneurysm, hypertension, and obstructive sleep apnoea who required intubation for COVID-19-induced acute hypoxic respiratory failure and exhibited new-onset sinus bradycardia followed by numerous episodes of haemodynamically significant accelerated idioventricular rhythm. Two weeks following the onset of SND, both patients remain in sinus bradycardia. Discussion: COVID-19-associated SND has not previously been described. The potential mechanisms for SND in patients with COVID-19 include myocardial inflammation or direct viral infiltration. Patients diagnosed with COVID-19 should be monitored closely for the development of bradyarrhythmia and haemodynamic instability.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalEuropean Heart Journal - Case Reports
Issue numberFI1
StatePublished - Oct 1 2020


  • Bradycardia
  • COVID-19
  • Case series
  • SARS-CoV-2
  • Sinus node dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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