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Background: Studies have suggested that myocardial damage due to severe acute respiratory syndrome-2 (SARS-CoV-2), commonly referred to as COVID-19, may increase the risk of arrhythmias. Objective(s): To compare the one-year incidence of atrial fibrillation (AF) among patients with COVID-19 as compared to patients with non-COVID-19 acute upper respiratory infection (AURI). Method(s): The Optum Clinformatics database, an administrative claims databaseof commercially insured beneficiaries in the United States (US), was used for study purposes. Three cohorts of patients were identified: patients with COVID-19 diagnosis in any setting (April 2020-June 2021);patients with AURI in the pandemic period (April 2020-June 2021);and patients with AURI in the pre-pandemic period (January 2018-December 2018). Patients with prior AF diagnosis were excluded from each cohort. Three sets of analysis comparing AF incidence were performed: COVID-19 cohort vs AURI pandemic cohort;COVID-19 cohort vs AURI pre-pandemic cohort;and AURI pandemic cohort vs AURI pre-pandemic cohort. For each of the three comparisons, a matching weight method was used to help ensure balance among groups on baseline socio-demographic and clinical comorbidities. Logistic regression was used to assess the odds of 1-year incident AF among matched patients. Result(s): When comparing the matched COVID-19 (n=102,227) and AURI pandemic (n=102,101) cohorts, one-year incidence of AF was significantly higher in the COVID-19 cohort (2.2% vs 1.2%;p<0.001), who were 83% more likely to develop AF (odds ratio [OR] 1.83;95% confidence interval [CI] 1.72-1.95) as compared to the AURI group. COVID-19 patients were also observed to have significantly higher risk of incident AF as compared to AURI pre-pandemic cohort (2.7% vs 1.6%;p<0.001;OR 1.70, 95% CI 1.63-1.78). No significant difference was observed in AF incidence among the AURI pandemic versus AURI pre-pandemic cohort (1.1% vs 1.2%;p=0.133;OR 0.95, 95% CI 0.90-1.01). Figure 1 depicts differences in AF incidence across the comparator cohorts. Conclusion(s): Patients with COVID-19 were observed to have a higher incidence of AF as compared to those with upper respiratory infections. Awareness amongst clinicians of an increased AF incidence in COVID-19 affected patients appears warranted. [Formula presented] French language not detected for EMBFRA articles source xmlCopyright © 2023
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Introduction: Coronavirus disease 2019 (COVID-19) remains a worldwide pandemic with some patients requiring escalation to venovenous extracorporeal membrane oxygenation (VV-ECMO). Our ECMO Program placed 30 adult COVID-19 patients on VV ECMO within six weeks. This surge required immediate assessment of our program's current structure and resources and rapid execution of an emergency response plan. Methods: Additional hardware and disposable supplies were acquired through capital purchases, rental agreements, collaboration with neighboring institutions, and repurposing of existing equipment. All patients were ultimately cohorted to one location. Our Perfusion team implemented a new staffing schedule to increase ECMO coverage. A condensed COVID ECMO course was created to increase the number of ECMO-trained nurses. Existing bedside cannulation carts and an exchange process with Central Supply allowed for multiple cannulations in various locations. A daily report was distributed to ECMO and hospital leadership to promote effective communication and ensure transparency of ECMO capacity. Results: As of August 20th, 27 patients survived to ECMO decannulation and 23 patients survived to hospital discharge. Five patients remain hospitalized. During the surge, we averaged 13 patients on ECMO per day, which was an increase over our baseline of 3.5 patients per day for the six months preceding COVID-19. Conclusion: We conclude that it is possible to safely expand ECMO capacity during a pandemic. This requires proper planning and reallocation of resources as necessary. Our navigation of the surge was aided by our existing program processes and the generosity of neighboring ECMO programs and our industry partners.