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Atrial Fibrillation in Patients Hospitalized With COVID-19: Incidence, Predictors, Outcomes, and Comparison to Influenza.
Musikantow, Daniel R; Turagam, Mohit K; Sartori, Samantha; Chu, Edward; Kawamura, Iwanari; Shivamurthy, Poojita; Bokhari, Mahmoud; Oates, Connor; Zhang, Chi; Pumill, Christopher; Malick, Waqas; Hashemi, Helen; Ruiz-Maya, Tania; Hadley, Michael B; Gandhi, Jonathan; Sperling, Dylan; Whang, William; Koruth, Jacob S; Langan, Marie-Noelle; Sofi, Aamir; Gomes, Anthony; Harcum, Stephanie; Cammack, Sam; Ellsworth, Betsy; Dukkipati, Srinivas R; Bassily-Marcus, Adel; Kohli-Seth, Roopa; Goldman, Martin E; Halperin, Jonathan L; Fuster, Valentin; Reddy, Vivek Y.
  • Musikantow DR; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Turagam MK; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Sartori S; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Chu E; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Kawamura I; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Shivamurthy P; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Bokhari M; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Oates C; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Zhang C; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Pumill C; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Malick W; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Hashemi H; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Ruiz-Maya T; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Hadley MB; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Gandhi J; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Sperling D; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Whang W; Department of Cardiovascular Medicine, Helmsley Electrophysiology Center, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Koruth JS; Department of Cardiovascular Medicine, Helmsley Electrophysiology Center, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Langan MN; Department of Cardiovascular Medicine, Helmsley Electrophysiology Center, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Sofi A; Department of Cardiovascular Medicine, Helmsley Electrophysiology Center, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Gomes A; Department of Cardiovascular Medicine, Helmsley Electrophysiology Center, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Harcum S; Department of Cardiovascular Medicine, Helmsley Electrophysiology Center, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Cammack S; Department of Cardiovascular Medicine, Helmsley Electrophysiology Center, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Ellsworth B; Department of Cardiovascular Medicine, Helmsley Electrophysiology Center, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Dukkipati SR; Department of Cardiovascular Medicine, Helmsley Electrophysiology Center, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Bassily-Marcus A; Department of Critical Care Medicine, Institute for Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Kohli-Seth R; Department of Critical Care Medicine, Institute for Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Goldman ME; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Halperin JL; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Fuster V; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Reddy VY; Department of Cardiovascular Medicine, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Helmsley Electrophysiology Center, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New
JACC Clin Electrophysiol ; 7(9): 1120-1130, 2021 09.
Article in English | MEDLINE | ID: covidwho-1198841
ABSTRACT

OBJECTIVES:

The goal of this study is to determine the incidence, predictors, and outcomes of atrial fibrillation (AF) or atrial flutter (AFL) in patients hospitalized with coronavirus disease-2019 (COVID-19).

BACKGROUND:

COVID-19 results in increased inflammatory markers previously associated with atrial arrhythmias. However, little is known about their incidence or specificity in COVID-19 or their association with outcomes.

METHODS:

This is a retrospective analysis of 3,970 patients admitted with polymerase chain reaction-positive COVID-19 between February 4 and April 22, 2020, with manual review performed of 1,110. The comparator arm included 1,420 patients with influenza hospitalized between January 1, 2017, and January 1, 2020.

RESULTS:

Among 3,970 inpatients with COVID-19, the incidence of AF/AFL was 10% (n = 375) and in patients without a history of atrial arrhythmias it was 4% (n = 146). Patients with new-onset AF/AFL were older with increased inflammatory markers including interleukin 6 (93 vs. 68 pg/ml; p < 0.01), and more myocardial injury (troponin-I 0.2 vs. 0.06 ng/ml; p < 0.01). AF and AFL were associated with increased mortality (46% vs. 26%; p < 0.01). Manual review captured a somewhat higher incidence of AF/AFL (13%, n = 140). Compared to inpatients with COVID-19, patients with influenza (n = 1,420) had similar rates of AF/AFL (12%, n = 163) but lower mortality. The presence of AF/AFL correlated with similarly increased mortality in both COVID-19 (relative risk 1.77) and influenza (relative risk 1.78).

CONCLUSIONS:

AF/AFL occurs in a subset of patients hospitalized with either COVID-19 or influenza and is associated with inflammation and disease severity in both infections. The incidence and associated increase in mortality in both cohorts suggests that AF/AFL is not specific to COVID-19, but is rather a generalized response to the systemic inflammation of severe viral illnesses.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Atrial Fibrillation / Influenza, Human / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Language: English Journal: JACC Clin Electrophysiol Year: 2021 Document Type: Article Affiliation country: J.jacep.2021.02.009

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Atrial Fibrillation / Influenza, Human / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Language: English Journal: JACC Clin Electrophysiol Year: 2021 Document Type: Article Affiliation country: J.jacep.2021.02.009