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Medicina (Kaunas) . Clinical Outcome of Hospitalized COVID-19 Patients with History of Atrial Fibrillation

tetano

Editor, Senior Moderator
Medicina (Kaunas)


. 2022 Mar 7;58(3):399.
doi: 10.3390/medicina58030399.
Clinical Outcome of Hospitalized COVID-19 Patients with History of Atrial Fibrillation


Vincenzo Russo[SUP] 1 [/SUP], Angelo Silverio[SUP] 2 [/SUP], Fernando Scudiero[SUP] 3 [/SUP], Antonello D'Andrea[SUP] 4 [/SUP], Emilio Attena[SUP] 5 [/SUP], Gisella Di Palma[SUP] 6 [/SUP], Guido Parodi[SUP] 7 [/SUP], Valentina Caso[SUP] 1 [/SUP], Stefano Albani[SUP] 8 [/SUP], Gennaro Galasso[SUP] 2 [/SUP], Egidio Imbalzano[SUP] 9 [/SUP], Paolo Golino[SUP] 1 [/SUP], Marco Di Maio[SUP] 2 [/SUP]



Affiliations
Free article

Abstract

Background and objectives: Pre-existing atrial fibrillation (AF) is a frequent comorbidity in hospitalized patients with COVID-19; however, little is still known about its prognostic role in infected patients. The aim of our study was to evaluate whether the pre-existing AF as comorbidity would contribute to increase the risk for severe forms of COVID-19, worse prognosis, or even higher mortality. Materials and Methods: We retrospectively evaluated all consecutive COVID-19 patients admitted to the emergency department of nine Italian Hospitals from 1 March to 30 April 2020.The prevalence and the type of pre-existing AF have been collected. The correlation between the history and type of AF and the development of severe ARDS and in-hospital mortality has been evaluated. Results: In total, 467 patients (66.88 ± 14.55 years; 63% males) with COVID-19 were included in the present study. The history of AF was noticed in 122 cases (26.1%), of which 12 (2.6%) with paroxysmal, 57 (12.2%) with persistent and 53 (11.3%) with permanent AF. Among our study population, COVID-19 patients with AF history were older compared to those without AF history (71.25 ± 12.39 vs. 65.34 ± 14.95 years; p < 0.001); however, they did not show a statistically significant difference in cardiovascular comorbidities or treatments. Pre-existing AF resulted in being independently associated with an increased risk of developing severe ARDS during the hospitalization; in contrast, it did not increase the risk of in-hospital mortality. Among patients with AF history, no significant differences were detected in severe ARDS and in-hospital mortality between patients with permanent and non-permanent AF history. Conclusions: Pre-existing AF is a frequent among COVID-19 patients admitted to hospital, accounting up to 25% of cases. It is independently associated with an increased risk of severe ARDS in hospitalized COVID-19 patients; in contrast, it did not affect the risk of death. The type of pre-existing AF (permanent or non-permanent) did not impact the clinical outcome.

Keywords: COVID-19; SARS-CoV-2; atrial fibrillation; mortality; novel coronavirus; outcome.
 
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