Atrial fibrillation is a cardiovascular risk factor for worse prognosis in covid-19
Circulation
; 144(SUPPL 1), 2021.
Article
in English
| EMBASE | ID: covidwho-1631427
ABSTRACT
Background:
In the presence of comorbid conditions, COVID-19 infections are known to require more advanced treatment, poorer outcomes and have longer-term sequelae. New-onset atrial fibrillation (AF) during COVID-19 infection has been associated with worse cardiovascular outcomes but not mortality. However, it remains unclear whether a prior history (hx) of atrial fibrillation is a cardiovascular risk factor predicting a worse outcome in COVID-19 patients. As such, we examined, using propensity matching accounting for possible confounders, the need for advanced treatment and subsequent major cardiovascular events (MACE) in patients with a prior hx of AF with COVID19 infection.Methods:
From March 2020 to May 2021, patients testing positive for SARS-CoV-2 with a prior AF diagnosis (n=3119) were propensity matched for age, gender, race/ethnicity, prior coronary artery disease (CAD), prior heart failure (HF), prior stroke and hypertension to non-AF SARS-CoV-2 positive patients. Cox hazard regression analysis with multivariable adjustment was used to determine risk of subsequent MACE (all-cause death, myocardial infarction, HF and stroke).Results:
Baseline characteristics, treatments, and outcomes stratified by AF status are shown in the Table. While the groups had similar baseline characteristics, AF COVID-19 patients were more likely to require hospitalization, ICU care, and ventilator support. Consistent with our hypothesis, composite MACE event rates were higher in the AF patients (HR=1.60, p<0.0001) secondary to increases in heart failure and all-cause mortality rates.Conclusions:
These data support AF as a cardiovascular risk factor predicting worse outcomes in COVID-19 patients. Specifically, AF increases the need for advanced treatments such as hospitalization, ICU care and ventilator support resulting in an increase in subsequent heart failure and all-cause mortality.
adult; all, cause, mortality; artificial, ventilation; atrial, fibrillation; cardiovascular, risk, factor; cerebrovascular, accident; conference, abstract; confounding, variable; controlled, study; coronary, artery, disease; ethnicity; female; gender; heart, failure; heart, infarction; hospitalization; human; hypertension; major, clinical, study; male; nonhuman; prognosis; race; Severe, acute, respiratory, syndrome, coronavirus, 2; ventilator
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Circulation
Year:
2021
Document Type:
Article
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