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New-onset atrial fibrillation during COVID-19 infection predicts poor prognosis
Affiliations- Ramon y Cajal hospital, Carretera de colmenar km 9,100, 28034 Madrid, Spain
open access
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has led to
a paradigm shift in healthcare worldwide. Little is known about the impact on the cardiovascular
system, and the incidence and consequences of new onset of atrial fibrillation (AF) in infected patients
remain unclear. The aim of this study was to analyze the cardiovascular outcomes of patients with newonset AF and coronavirus disease 2019 (COVID-19) infection.
Methods: This observational study analyzed a sample of 160 consecutive patients hospitalized due to
COVID-19. A group with new-onset AF (n = 12) was compared with a control group (total: n = 148,
sinus rhythm: n = 118, previous AF: n = 30). New-onset AF patients were significantly older and
hypertensive, as well as presenting more frequently with a history of acute coronary syndrome and
renal dysfunction. This group showed a higher incidence of thromboembolic events (41.7% vs. 4.1%;
p < 0.001), bleeding (33.3% vs. 4.7%, p = 0.005), a combined endpoint of thrombosis and death
(58.3% vs. 19.6%, p = 0.006) and longer hospital stays (16.4 vs. 8.6 days, p < 0.001), with no differences in all-cause mortality.
Results: In multivariate analysis, adjusted by potential confounding factors, new-onset AF demonstrated
a 14.26 odds ratio for thromboembolism (95% confidence interval 2.86–71.10, p < 0.001).
Conclusions: New-onset AF in COVID-19 patients presumably has a notable impact on prognosis.
The appearance of new-onset AF is related to worse cardiovascular outcomes, considering it as an independent predictor of embolic events. Further studies are needed to identify patients with COVID-19
at high risk of developing “de novo” AF, provide early anticoagulation and minimize the embolic risk of
both entities.
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has led to
a paradigm shift in healthcare worldwide. Little is known about the impact on the cardiovascular
system, and the incidence and consequences of new onset of atrial fibrillation (AF) in infected patients
remain unclear. The aim of this study was to analyze the cardiovascular outcomes of patients with newonset AF and coronavirus disease 2019 (COVID-19) infection.
Methods: This observational study analyzed a sample of 160 consecutive patients hospitalized due to
COVID-19. A group with new-onset AF (n = 12) was compared with a control group (total: n = 148,
sinus rhythm: n = 118, previous AF: n = 30). New-onset AF patients were significantly older and
hypertensive, as well as presenting more frequently with a history of acute coronary syndrome and
renal dysfunction. This group showed a higher incidence of thromboembolic events (41.7% vs. 4.1%;
p < 0.001), bleeding (33.3% vs. 4.7%, p = 0.005), a combined endpoint of thrombosis and death
(58.3% vs. 19.6%, p = 0.006) and longer hospital stays (16.4 vs. 8.6 days, p < 0.001), with no differences in all-cause mortality.
Results: In multivariate analysis, adjusted by potential confounding factors, new-onset AF demonstrated
a 14.26 odds ratio for thromboembolism (95% confidence interval 2.86–71.10, p < 0.001).
Conclusions: New-onset AF in COVID-19 patients presumably has a notable impact on prognosis.
The appearance of new-onset AF is related to worse cardiovascular outcomes, considering it as an independent predictor of embolic events. Further studies are needed to identify patients with COVID-19
at high risk of developing “de novo” AF, provide early anticoagulation and minimize the embolic risk of
both entities.
Keywords
new-onset atrial fibrillation, COVID-19 prognostic, SARS-CoV-2, embolism
About this articleTitle
New-onset atrial fibrillation during COVID-19 infection predicts poor prognosis
Journal
Issue
Article type
Original Article
Pages
34-40
Published online
2020-10-30
Page views
2588
Article views/downloads
2069
DOI
Pubmed
Bibliographic record
Cardiol J 2021;28(1):34-40.
Keywords
new-onset atrial fibrillation
COVID-19 prognostic
SARS-CoV-2
embolism
Authors
Ana Pardo Sanz
Luisa Salido Tahoces
Rodrigo Ortega Pérez
Eduardo González Ferrer
Ángel Sánchez Recalde
José Luis Zamorano Gómez
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