Arrhythmic manifestations of COVID-19 include atrial arrhythmias such as atrial fibrillation or atrial flutter, sinus node dysfunction, atrioventricular conduction abnormalities, ventricular tachyarrhythmias, sudden cardiac arrest, and cardiovascular dysautonomias including the so-called long COVID syndrome. Various pathophysiological mechanisms have been implicated, such as direct viral invasion, hypoxemia, local and systemic inflammation, changes in ion channel physiology, immune activation, and autonomic dysregulation. The development of atrial or ventricular arrhythmias in hospitalized COVID-19 patients has been shown to portend a higher risk of in-hospital death. Management of these arrhythmias should be based on published evidence-based guidelines, with special consideration of the acuity of COVID-19 infection, concomitant use of antimicrobial and anti-inflammatory drugs, and the transient nature of some rhythm disorders. In view of new SARS-CoV‑2 variants that may evolve, the development and use of newer antiviral and immunomodulator drugs, and the increasing adoption of vaccination, clinicians must remain vigilant for other arrhythmic manifestations that may occur in association with this novel but potentially deadly disease.

COVID-19 的心律失常表现包括心房颤动或心房扑动等房性心律失常、窦房结功能障碍、房室传导异常、室性心动过速、心脏骤停和心血管自主神经异常，包括所谓的长 COVID 综合征。涉及多种病理生理机制，例如直接病毒入侵、低氧血症、局部和全身炎症、离子通道生理学变化、免疫激活和自主神经失调。已证明住院的 COVID-19 患者出现房性或室性心律失常预示着更高的院内死亡风险。这些心律失常的管理应基于已发布的循证指南，并特别考虑 COVID-19 感染的严重程度，同时使用抗菌药和抗炎药，以及一些节律紊乱的短暂性。鉴于可能进化的新 SARS-CoV-2 变体、更新的抗病毒和免疫调节剂药物的开发和使用以及疫苗接种的日益普及，临床医生必须对可能与这种新型病毒相关但可能发生的其他心律失常表现保持警惕致命的疾病。