ArticleMedical hypotheses2020
COVID-19: Electrophysiological mechanisms underlying sudden cardiac death during exercise with facemasks.
Article in Medical hypotheses, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Masks and respirators for prevention of respiratory infections: a state of the science review.Clinical microbiology reviews · 2024Pooled it
- Prolonged ventricular fibrillation treated with nifekalant in fulminant myocarditis following late-onset coronavirus disease 2019.BMJ case reports · 2026Article
- A new perspective of frozen shoulder pathology; the interplay between the brain and the immune system.Frontiers in physiology · 2024Review
- The plausible effects of wearing face masks on sports performance - A scoping review.Science & sports · 2023Review
- Effect of Face Masks on Physiological and Perceptual Responses during 30 Minutes of Self-Paced Exercise in Older Community Dwelling Adults.International journal of environmental research and public health · 2022Article
- Facemask wearing does not impact neuro-electrical brain activity.Scientific reports · 2022Article
- Physiological Effects of Surgical and N95 Masks During Exercise in the COVID-19 era.The American journal of the medical sciences · 2022Article
- Ventricular Tachycardia or Fibrillation Storm in Coronavirus Disease.Case reports in cardiology · 2022Article
- Hematologic adaptation to mask-wearing among pregnant women and obstetrical outcome during the coronavirus disease 2019 pandemic.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2021Article
- Effect of a Warm-Up Protocol with and without Facemask-Use against COVID-19 on Cognitive Function: A Pilot, Randomized Counterbalanced, Cross-Sectional Study.International journal of environmental research and public health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The mandatory use of facemasks is a public health measure implemented by various countries in response to the novel coronavirus disease 19 (COVID-19) pandemic. However, there have been case reports of sudden cardiac death (SCD) with the wearing of facemasks during exercise. In this paper, we hypothesize that exercise with facemasks may increase the risk of ventricular tachycardia/ventricular fibrillation (VT/VF) leading to SCD via the development of acute and/or intermittent hypoxia and hypercapnia. We discuss the potential underlying mechanisms including increases in adrenergic stimulation and oxidative stress leading to electrophysiological abnormalities that promote arrhythmias via non-reentrant and reentrant mechanisms. Given the interplay of multiple variables contributing to the increased arrhythmic risk, we advise avoidance of a facemask during high intensity exercise, or if wearing of a mask is mandatory, exercise intensity should remain low to avoid precipitation of lethal arrhythmias. However, we cannot exclude the possibility of an arrhythmic substrate even with low intensity exercise especially in those with established chronic cardiovascular disease in whom baseline electrophysiological abnormalities may be found.
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