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Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: results of the Cardio-COVID-Italy multicentre study.


ABSTRACT:

Aims

To assess the clinical relevance of a history of atrial fibrillation (AF) in hospitalized patients with coronavirus disease 2019 (COVID-19).

Methods and results

We enrolled 696 consecutive patients (mean age 67.4 ± 13.2 years, 69.7% males) admitted for COVID-19 in 13 Italian cardiology centres between 1 March and 9 April 2020. One hundred and six patients (15%) had a history of AF and the median hospitalization length was 14 days (interquartile range 9-24). Patients with a history of AF were older and with a higher burden of cardiovascular risk factors. Compared to patients without AF, they showed a higher rate of in-hospital death (38.7% vs. 20.8%; P < 0.001). History of AF was associated with an increased risk of death after adjustment for clinical confounders related to COVID-19 severity and cardiovascular comorbidities, including history of heart failure (HF) and increased plasma troponin [adjusted hazard ratio (HR): 1.73; 95% confidence interval (CI) 1.06-2.84; P = 0.029]. Patients with a history of AF also had more in-hospital clinical events including new-onset AF (36.8% vs. 7.9%; P < 0.001), acute HF (25.3% vs. 6.3%; P < 0.001), and multiorgan failure (13.9% vs. 5.8%; P = 0.010). The association between AF and worse outcome was not modified by previous or concomitant use of anticoagulants or steroid therapy (P for interaction >0.05 for both) and was not related to stroke or bleeding events.

Conclusion

Among hospitalized patients with COVID-19, a history of AF contributes to worse clinical course with a higher mortality and in-hospital events including new-onset AF, acute HF, and multiorgan failure. The mortality risk remains significant after adjustment for variables associated with COVID-19 severity and comorbidities.

SUBMITTER: Paris S 

PROVIDER: S-EPMC8344555 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: results of the Cardio-COVID-Italy multicentre study.

Paris Sara S   Inciardi Riccardo M RM   Lombardi Carlo Mario CM   Tomasoni Daniela D   Ameri Pietro P   Carubelli Valentina V   Agostoni Piergiuseppe P   Canale Claudia C   Carugo Stefano S   Danzi Giambattista G   Di Pasquale Mattia M   Sarullo Filippo F   La Rovere Maria Teresa MT   Mortara Andrea A   Piepoli Massimo M   Porto Italo I   Sinagra Gianfranco G   Volterrani Maurizio M   Gnecchi Massimiliano M   Leonardi Sergio S   Merlo Marco M   Iorio Annamaria A   Giovinazzo Stefano S   Bellasi Antonio A   Zaccone Gregorio G   Camporotondo Rita R   Catagnano Francesco F   Dalla Vecchia Laura L   Maccagni Gloria G   Mapelli Massimo M   Margonato Davide D   Monzo Luca L   Nuzzi Vincenzo V   Pozzi Andrea A   Provenzale Giovanni G   Specchia Claudia C   Tedino Chiara C   Guazzi Marco M   Senni Michele M   Metra Marco M  

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 20211001 10


<h4>Aims</h4>To assess the clinical relevance of a history of atrial fibrillation (AF) in hospitalized patients with coronavirus disease 2019 (COVID-19).<h4>Methods and results</h4>We enrolled 696 consecutive patients (mean age 67.4 ± 13.2 years, 69.7% males) admitted for COVID-19 in 13 Italian cardiology centres between 1 March and 9 April 2020. One hundred and six patients (15%) had a history of AF and the median hospitalization length was 14 days (interquartile range 9-24). Patients with a hi  ...[more]

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