{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T22:08:42Z","timestamp":1785017322191,"version":"3.55.0"},"reference-count":10,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2021,8,12]]},"abstract":"<jats:p>Background. Novel coronavirus-19 disease (COVID-19) is associated with significant cardiovascular morbidity and mortality. However, there have been very few reports on complete heart block (CHB) associated with COVID-19. This case series describes clinical characteristics, potential mechanisms, and short-term outcomes of critically ill COVID-19 patients complicated by CHB. Case Summary. We present three cases of new-onset CHB in critically ill COVID-19 patients. Patient 1 is a 41-year-old male with well-documented history of Familial Mediterranean Fever (FMF) who required mechanical ventilator support for acute hypoxic respiratory failure from severe COVID-19 pneumonia. He developed new-onset CHB without a hemodynamic derangement but subsequently had acute coronary syndrome complicated by cardiogenic shock. Patient 2 is a 77-year-old male with no past medical history who required intubation for severe COVID-19 pneumonia acute hypoxic respiratory failure. He developed CHB with sinus pause requiring temporary pacing but subsequently developed multiorgan failure. Patient 3 is 36-year-old lady 38\u2009+\u20092 weeks pregnant, gravida 2 para 1 with no other medical history, who had an emergency Lower Section Caesarean Section (LSCS) as she required intubation for acute hypoxic respiratory failure. She exhibited new-onset CHB without hemodynamic compromise. The CHB resolved spontaneously after 24 hours. Discussion. COVID-19-associated CHB is a very rare clinical manifestation. The potential mechanisms for CHB in patients with COVID-19 include myocardial inflammation or direct viral infiltration as well as other causes such as metabolic derangements or use of sedatives. Patients diagnosed with COVID-19 should be monitored closely for the development of bradyarrhythmia and hemodynamic instability.<\/jats:p>","DOI":"10.1155\/2021\/9955466","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T20:20:09Z","timestamp":1628799609000},"page":"1-6","source":"Crossref","is-referenced-by-count":5,"title":["Complete Heart Block as a Clinical Feature in Critically Ill Coronavirus Disease 2019 (COVID-19) Patients: A Case Series of Three Cases"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7216-6040","authenticated-orcid":true,"given":"Farook","family":"Ahmad","sequence":"first","affiliation":[{"name":"Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK"},{"name":"Cardiology Unit, Medical Department of Universiti Teknologi MARA (UiTM) Sungai Buloh, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priti","family":"Gandre","sequence":"additional","affiliation":[{"name":"Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Nguekam","sequence":"additional","affiliation":[{"name":"Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6129-8320","authenticated-orcid":true,"given":"Alanna","family":"Wall","sequence":"additional","affiliation":[{"name":"Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ShiYu","family":"Ong","sequence":"additional","affiliation":[{"name":"Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul N.","family":"Karuppamakkantakath","sequence":"additional","affiliation":[{"name":"Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Tasopoulos","sequence":"additional","affiliation":[{"name":"Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Athar","family":"Sadiq","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Department of Medicine, Sultan Qaboos University, Muscat 123, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sazzli","family":"Kasim","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Medical Department of Universiti Teknologi MARA (UiTM) Sungai Buloh, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeronimo M.","family":"Cuesta","sequence":"additional","affiliation":[{"name":"Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30076-X"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1585"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"4","first-page":"253","article-title":"Myocardial injury and COVID-19: possible mechanisms","volume":"1","author":"S. Babapoor-Farrokhran","year":"2020","journal-title":"Life Sciences"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrcr.2020.06.014"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-020-00789-9"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5366.1149"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(64)90022-1"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1189\/jlb.0705416"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1378\/chest.81.5.592"}],"container-title":["Case Reports in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2021\/9955466.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2021\/9955466.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2021\/9955466.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T15:58:03Z","timestamp":1632153483000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/cricc\/2021\/9955466\/"}},"subtitle":[],"editor":[{"given":"Mehmet","family":"Doganay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,8,12]]},"references-count":10,"alternative-id":["9955466","9955466"],"URL":"https:\/\/doi.org\/10.1155\/2021\/9955466","relation":{},"ISSN":["2090-6439","2090-6420"],"issn-type":[{"value":"2090-6439","type":"electronic"},{"value":"2090-6420","type":"print"}],"subject":[],"published":{"date-parts":[[2021,8,12]]}}}