Arrhythmias as Part of Long COVID Syndrome in Hospitalized Patients That Survived a Severe COVID-19 Infection and the Potential Protective Role of Metformin in These Patients

DOI record: { "DOI": "10.3390/life16020319", "ISSN": [ "2075-1729" ], "URL": "http://dx.doi.org/10.3390/life16020319", "abstract": "<jats:p>Background: Cardiac arrhythmias are a frequent complication of acute SARS-CoV-2 infection. However, their long-term prevalence and clinical determinants among patients with post-COVID-19 syndrome, especially those previously hospitalized, remain poorly defined. Objectives: To assess the prevalence and types of arrhythmias in long COVID patients following hospitalization and to identify associated clinical risk factors. Methods: In this cross-sectional study, 53 patients previously hospitalized with confirmed COVID-19 were evaluated ≥3 months post-infection. All participants underwent a standardized clinical assessment, 12-lead electrocardiography, and 24 h Holter monitoring. Logistic and Cox regression analyses were performed to identify predictors of arrhythmia. Results: Arrhythmias were identified in 41.5% (n = 22) of patients. Atrial fibrillation (32%) was the most frequent arrhythmia, followed by sinus bradycardia (27%) and sinus tachycardia (18%). Age (OR 1.06, 95% CI 1.01–1.10, p = 0.01) and length of hospital stay (OR 1.1, 95% CI 1.01–1.2, p = 0.04) were independently associated with arrhythmia. Biguanide (metformin) therapy was inversely associated with the occurrence of arrhythmia (Exp(B) = 0.017, p = 0.008). Dyspnea (82.4%) and palpitations (41.5%) were the most commonly reported symptoms. Conclusions: Arrhythmias are common in patients with long COVID following severe disease. Advanced age and prolonged hospitalization are significant risk factors, while biguanide use may offer a protective effect. These findings underscore the need for targeted cardiac surveillance in this population.</jats:p>", "alternative-id": [ "life16020319" ], "author": [ { "affiliation": [ { "name": "Unidad de Cardiología, Del Hospital Civil Fray Antonio Alcalde, Guadalajara 44200, Mexico" } ], "family": "Morales-Vazquez", "given": "Haydee Ninette", "sequence": "first" }, { "ORCID": "https://orcid.org/0000-0002-9470-2489", "affiliation": [ { "name": "Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de La Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico" } ], "authenticated-orcid": false, "family": "Cardona-Müller", "given": "David", "sequence": "additional" }, { "affiliation": [ { "name": "Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de La Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico" } ], "family": "Grover-Paez", "given": "Fernando", "sequence": "additional" }, { "affiliation": [ { "name": "Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de La Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico" } ], "family": "Ramos-Becerra", "given": "Carlos Gerardo", "sequence": "additional" }, { "affiliation": [ { "name": "Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de La Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico" } ], "family": "Cardona-Muñoz", "given": "Ernesto Germán", "sequence": "additional" }, { "affiliation": [ { "name": "Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de La Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico" } ], "family": "Ramos-Zavala", "given": "Maria Guadalupe", "sequence": "additional" }, { "affiliation": [ { "name": "Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de La Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico" } ], "family": "Carmona-Huerta", "given": "Jaime", "sequence": "additional" }, { "ORCID": "https://orcid.org/0009-0005-4438-5875", "affiliation": [ { "name": "Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de La Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico" } ], "authenticated-orcid": false, "family": "Hernandez-del-Rio", "given": "Jorge Eduardo", "sequence": "additional" }, { "affiliation": [ { "name": "Unidad de Cardiología, Del Hospital Civil Fray Antonio Alcalde, Guadalajara 44200, Mexico" } ], "family": "Miranda-Aquino", "given": "Tomas", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0001-7086-2966", "affiliation": [ { "name": "Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de La Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico" } ], "authenticated-orcid": false, "family": "Gonzalez-Padilla", "given": "Christian", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0003-0563-5294", "affiliation": [ { "name": "Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de La Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico" } ], "authenticated-orcid": false, "family": "Lopez-Gradilla", "given": "Christopher Josue", "sequence": "additional" } ], "container-title": "Life", "container-title-short": "Life", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2026, 2, 12 ] ], "date-time": "2026-02-12T09:48:34Z", "timestamp": 1770889714000 }, "deposited": { "date-parts": [ [ 2026, 2, 12 ] ], "date-time": "2026-02-12T10:16:48Z", "timestamp": 1770891408000 }, "indexed": { "date-parts": [ [ 2026, 2, 12 ] ], "date-time": "2026-02-12T11:14:43Z", "timestamp": 1770894883278, "version": "3.50.1" }, "is-referenced-by-count": 0, "issue": "2", "issued": { "date-parts": [ [ 2026, 2, 12 ] ] }, "journal-issue": { "issue": "2", "published-online": { "date-parts": [ [ 2026, 2 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2026, 2, 12 ] ], "date-time": "2026-02-12T00:00:00Z", "timestamp": 1770854400000 } } ], "link": [ { "URL": "https://www.mdpi.com/2075-1729/16/2/319/pdf", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1968", "original-title": [], "page": "319", "prefix": "10.3390", "published": { "date-parts": [ [ 2026, 2, 12 ] ] }, "published-online": { "date-parts": [ [ 2026, 2, 12 ] ] }, "publisher": "MDPI AG", "reference": [ { "DOI": "10.3390/ph16060844", "doi-asserted-by": "crossref", "key": "ref_1", "unstructured": "Kingma, J., Simard, C., and Drolet, B. 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