Atrial fibrillation incidence in SARS-CoV-2 infected patients: Predictors and relationship with in-hospital mortality

Background: Among the different CardioVascular (CV) manifestation of the COronaVIrus-related Disease (COVID) particular attention has been paid to arrhythmia and particularly to Atrial fibrillation (AF). The aim of our study was to assess the incidence of AF episodes in patients hospitalized for COVID and to evaluate its predictors and its relationship with in-hospital all-cause mortality. Method(s): We enrolled 3435 cases of SARS-CoV2 infection admitted in four hospitals in Northern Italy. We collected data on clinical history, vital signs, Intensive Care Unit (ICU) admission, laboratory tests and pharmacological treatment. AF incident and all-cause in-hospital mortality were considered as outcomes. Result(s): 145 (4.2%) patients develop AF during hospitalization, with a median time of 3 days (IQR: 0, 11.5) from admission. Incident AF patients were older and had lower eGFR, lower platelet and lymphocytes count and higher C-Reactive Protein (CRP), were admitted more frequently to ICU and more frequently died compared to subjects that didn't present AF. At the Cox regression model significant determinants of incident AF were older age (HR 1.070;95% CI: 1.048, 1.092), history of AF (HR 2.800;95% CI: 1.465, 5.351), ischemic heart disease (HR 0.324;95% CI: 0.130, 0.811) and ICU admission (HR 8.030;95% CI: 4.511, 14.292). Incident AF was a predictor of all-cause mortality (HR 1.679;95% CI: 1.170, 2.410), together with age (HR 1.053;95% CI: 1.042, 1.065), dementia (HR 1.553;95% CI 1.151, 2.095), platelet count (HR 0.997;95% CI: 0.996, 0.999) higher CRP (HR 1.004;95% CI: 1.003, 1.005) and eGFR (HR: 0.991;95% CI: 0.986, 0.996) Conclusion(s): AF present as the main arrhythmia in COVID-19 patients and its development during the hospitalization strongly relates with in-hospital mortality.

Atrial Fibrillation Incidence in Sars-Cov-2 Infected Patients: Predictors and Relationship with in-Hospital Mortality

Background: Among the different CardioVascular (CV) manifestation of the COronaVIrus-related Disease (COVID) particular attention has been paid to arrhythmia and particularly to Atrial fibrillation (AF). The aim of our study was to assess the incidence of AF episodes in patients hospitalized for COVID and to evaluate its predictors and its relationship with in-hospital all-cause mortality. Method(s): We enrolled 3435 cases of SARS-CoV2 infection admitted in four hospitals in Northern Italy. We collected data on clinical history, vital signs, Intensive Care Unit (ICU) admission, laboratory tests and pharmacological treatment. AF incident and all-cause in-hospital mortality were considered as outcomes. Result(s): 145 (4.2%) patients develop AF during hospitalization, with a median time of 3 days (IQR: 0, 11.5) from admission. Incident AF patients were older and had lower eGFR, lower platelet and lymphocytes count and higher C-Reactive Protein (CRP), were admitted more frequently to ICU and more frequently died compared to subjects that didn't present AF. At the Cox regression model significant determinants of incident AF were older age (HR 1.070;95% CI: 1.048, 1.092), history of AF (HR 2.800;95% CI: 1.465, 5.351), ischemic heart disease (HR 0.324;95% CI: 0.130, 0.811) and ICU admission (HR 8.030;95% CI: 4.511, 14.292). Incident AF was a predictor of all-cause mortality (HR 1.679;95% CI: 1.170, 2.410), together with age (HR 1.053;95% CI: 1.042, 1.065), dementia (HR 1.553;95% CI 1.151, 2.095), platelet count (HR 0.997;95% CI: 0.996, 0.999) higher CRP (HR 1.004;95% CI: 1.003, 1.005) and eGFR (HR: 0.991;95% CI: 0.986, 0.996) Conclusion(s): AF present as the main arrhythmia in COVID-19 patients and its development during the hospitalization strongly relates with in-hospital mortality.

Atrial fibrillation incidence in SARS-CoV-2 infected patients: Predictors and relationship with in-hospital mortality

Background and Aims : Among the different CardioVascular (CV) manifestation of the CoronaVIrus-related Disease (COVID) particular attention has been paid to Atrial fibrillation (AF). The aim of our study was to assess the incidence of AF episodes in patients hospitalized for COVID and to evaluate its predictors and its relationship with in-hospital all-cause mortality. Method(s): We enrolled 3435 cases of SARS-CoV2 infection admitted in four hospitals in Northern Italy. We collected data on clinical history, vital signs, Intensive Care Unit (ICU) admission, laboratory tests and pharmacological treatment. AF incident and all-cause in-hospital mortality were considered as outcomes. Result(s): 145 (4.2%) patients develop AF during hospitalization, with a median time of 3 days (IQR:0,11.5) from admission. Incident AF patients were older and had lower eGFR, lower platelet and lymphocytes count and higher C-Reactive Protein (CRP), were admitted more frequently to ICU and more frequently died compared to subjects that didn't present AF. At the Cox regression model significant determinants of incident AF were older age (HR 1.070;95% CI: 1.048-1.092), history of AF (HR 2.800;95% CI:1.465-5.351), ischemic heart disease (HR 0.324;95% CI: 0.130-0.811) and ICU admission (HR 8.030;95% CI:4.511, 14.292). Incident AF was a predictor of all-cause mortality (HR 1.679;95% CI:1.170-2.410), together with age (HR 1.053;95% CI: 1.042-1.065), dementia (HR 1.553;95% CI:1.151-2.095), platelet count (HR 0.997;95% CI:0.996-0.999) higher CRP (HR 1.004;95% CI:1.003-1.005) and eGFR (HR: 0.991;95% CI:0.986-0.996) Conclusion(s): AF present as the main arrhythmia in COVID-19 patients and its development during the hospitalization strongly relates with in-hospital mortality. Copyright © 2022

ATRIAL FIBRILLATION INCIDENCE IN SARS-CoV-2 INFECTED PATIENTS: PREDICTORS AND RELATIONSHIP WITH IN-HOSPITAL MORTALITY

Introduction: Among the different CardioVascular (CV) manifestation of the COronaVIrus-related Disease (COVID) particular attention has been paid to arrhythmia and particularly to Atrial fibrillation (AF). Aim(s): To assess the incidence of AF episodes in patients hospitalized for COVID and to evaluate its predictors and its relationship with inhospital all-cause mortality. Method(s): We enrolled 3435 cases of SARS-CoV2 infection admitted in four hospitals in Northern Italy. We collected data on clinical history, vital signs, Intensive Care Unit (ICU) admission, laboratory tests and pharmacological treatment. AF incident and all-cause inhospital mortality were considered as outcomes. Result(s): 145 (4.2%) patients develop AF during hospitalization, with a median time of 3 days (IQR: 0, 11.5) from admission. Incident AF patients were older and had lower eGFR, lower platelet and lymphocytes count and higher C-Reactive Protein (CRP), were admitted more frequently to ICU and more frequently died compared to subjects that didn't present AF. At the Cox regression model significant determinants of incident AF were older age (HR 1.070;95% CI: 1.048, 1.092), history of AF (HR 2.800;95% CI: 1.465, 5.351), ischemic heart disease (HR 0.324;95% CI: 0.130, 0.811) and ICU admission (HR 8.030;95% CI: 4.511, 14.292). Incident AF was a predictor of all-cause mortality (HR 1.679;95% CI: 1.170, 2.410), together with age (HR 1.053;95% CI: 1.042, 1.065), dementia (HR 1.553;95% CI 1.151, 2.095), platelet count (HR 0.997;95% CI: 0.996, 0.999) higher CRP (HR 1.004;95% CI: 1.003, 1.005) and eGFR (HR: 0.991;95% CI: 0.986, 0.996) Conclusion(s): AF present as the main arrhythmia in COVID-19 patients and its development during the hospitalization strongly relates with in-hospital mortality.

COVID-19 AND CARDIOVASCULAR SYSTEM: NOT ONLY HEART BUT ALSO VASCULAR. THE EFFECTS OF THE INFECTION ON ARTERIAL STIFFNESS

OBJECTIVE: SARS-CoV-2 determines a framework of multi-organ dysfunction that can involve the cardiovascular system creating damages of different nature. Among these, endothelial damage could play a key role in increasing arterial stiffness and thus the cardiovascular risk of infected patients. The aim of this study is to evaluate the Pulse Wave Velocity (PWV) of a population of patients after recovery from infection and to compare them with those of a group affected by arterial hypertension. DESIGN AND METHOD: This prospective observational monocentric study involved 143 patients with previous diagnosis of Covid-19 who undergone PWV measurement during the follow-up at a median time of 3.8 months after the infection. These patients were compared to a population of 143 patients with hypertension matched by age, sex, Systolic Blood Pressure values and Body Mass Index. RESULTS: PWV values were higher in Covid-19 group comparing to hypertension group (10.5 ± 3.0 m/s VS 8.9 ± 2.5 m/s). Furthermore, there is a correlation between higher PWV values and lower values of SpO2% at time of admission at the Emergency Department. (R = -0.302;p < 0.001). CONCLUSIONS: SARS-CoV-2 infection seems related to increased PWV values. Moreover, higher arterial stiffness seems correlated to a worse oxygen saturation in Emergency Department. More studies with longer follow-up time are necessary to establish whether the vascular damage is reversible and whether it correlates with an increase of long-term cardiovascular risk. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

ATRIAL FIBRILLATION INCIDENCE IN SARS-COV-2 INFECTED PATIENTS: PREDICTORS AND RELATIONSHIP WITH IN-HOSPITAL MORTALITY

Objective: Among the different CardioVascular (CV) manifestation of the COronaVIrus- related Disease (COVID) particular attention has been paid to arrhythmia and particularly to Atrial fibrillation (AF). The aim of our study was to assess the incidence of AF episodes in patients ospitalisat for COVID and to evaluate its predictors and its relationship with in-hospital all-cause mortality. Design and method: We enrolled 3435 cases of SARS-CoV2 infection admitted in four hospitals in Northern Italy. We collected data on clinical history, vital signs, Intensive Care Unit (ICU) admission, laboratory tests and pharmacological treatment. AF incident and all-cause in-hospital mortality were considered as outcomes. Results: 145 (4.2%) patients develop AF during ospitalisation, with a median time of 3 days (IQR: 0, 11.5) from admission. Incident AF patients were older and had lower eGFR, lower platelet and lymphocytes count and higher C-Reactive Protein (CRP), were admitted more frequently to ICU and more frequently died compared to subjects that didn't present AF. At the Cox regression model significant determinants of incident AF were older age (HR 1.070;95% CI: 1.048, 1.092), history of AF (HR 2.800;95% CI: 1.465, 5.351), ischemic heart disease (HR 0.324;95% CI: 0.130, 0.811) and ICU admission (HR 8.030;95% CI: 4.511, 14.292). Incident AF was a predictor of all-cause mortality (HR 1.679;95% CI: 1.170, 2.410), together with age (HR 1.053;95% CI: 1.042, 1.065), dementia (HR 1.553;95% CI 1.151, 2.095), platelet count (HR 0.997;95% CI: 0.996, 0.999) higher CRP (HR 1.004;95% CI: 1.003, 1.005) and eGFR (HR: 0.991;95% CI: 0.986, 0.996) Conclusions: AF present as the main arrhythmia in COVID-19 patients and its development during the ospitalisation strongly relates with in-hospital mortality.

Stroke and pulmonary embolism in moderate CoViD-19

Background: Venous thromboembolism, arterial thrombosis and thrombotic microangiopathy substantially contribute to increased morbidity and mortality in CoViD-19. We report a case of 56-year old man that presented with stroke and was found to have CoViD- 19 pneumonia complicated by pulmonary embolism (PE). Description of the case: A 55-year-old man with history of hypertension presented to the emergency department after a transient loss of consciousness. He was found to have left lateral hemianopia and lower right quadrantanopsia and head CT confirmed bilateral stroke in the posterior cerebral artery territory. MR angiography excluded atherosclerosis/dissection of the vertebral and basilar artery and a positive nasopharingeal swab PCR test revealed SARS-CoV-2 infection. The patient was admitted and ASA 100 mg and enoxaparin 40 mg per day were started. He experienced dry cough and fever and 10 days after admission presented atypical chest pain. CT Angiography revealed multiple confined ground glass opacities with segmental bilateral PE. Therapeutic dose of enoxaparin was started and after 5 days switched to edoxaban 60 mg per day. The patient progressively recovered and a complete work up excluded patent foramen ovale and any other cause predisponing to combined presence of venous and arterial thrombosis Conclusions: CoViD-19 has presented many diagnostic challanges in patients with neurologic and respiratory findings: thromboembolic disease may even be the initial or unique presentation. The early recognition of these phenotipes of the disease play a dramatic role in the CoViD-19 management.