Prevalence and clinical implications of atrial fibrillation in patients hospitalized due to COVID-19: Data from a registry in Poland

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Maryla Kocowska-Trytko¹  Wiktoria Wojciechowska¹  Marek Klocek¹  Jan W. Pęksa¹  Michał Terlecki¹  Paweł Lis¹  Tomasz Drożdż¹  Christopher Pavlinec¹  Marek Rajzer¹  Reinhold Kreutz²  Andrzej Januszewicz³  Tomasz Grodzicki⁴  Michał Kania⁵  Maciej Małecki⁵  Zbigniew Siudak⁶ 

[1] 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland;Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Berlin, Germany;Department of Hypertension, National Institute of Cardiology, Warsaw, Poland;Department of Internal Diseases and Geriatrics, Jagiellonian University Medical College, Kraków, Poland;Department of Metabolic Diseases and Diabetology, Jagiellonian University Medical College, Kraków, Poland;Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland;

关键词: atrial fibrillation;    COVID-19;    prognosis;    anticoagulation;    NOAC drugs;    MACE;   

DOI  :  10.3389/fcvm.2023.1133373

 received in 2023-02-05, accepted in 2023-02-24,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundAtrial fibrillation (AF) is a common arrhythmia with increasing prevalence with respect to age and comorbidities. AF may influence the prognosis in patients hospitalized with Coronavirus disease 2019 (COVID-19). We aimed to assess the prevalence of AF among patients hospitalized due to COVID-19 and the association of AF and in-hospital anticoagulation treatment with prognosis.Methods and resultsWe assessed the prevalence of AF among patients hospitalized due to COVID-19 and the association of AF and in-hospital anticoagulation treatment with prognosis. Data of all COVID-19 patients hospitalized in the University Hospital in Krakow, Poland, between March 2020 and April 2021, were analyzed. The following outcomes: short-term (30-days since hospital admission) and long-term (180-days after hospital discharge) mortality, major cardiovascular events (MACEs), pulmonary embolism, and need for red blood cells (RBCs) transfusion, as a surrogate for major bleeding events during hospital stay were assessed. Out of 4,998 hospitalized patients, 609 had AF (535 pre-existing and 74 de novo). Compared to those without AF, patients with AF were older and had more cardiovascular disorders. In adjusted analysis, AF was independently associated with an increased risk of short-term {p = 0.019, Hazard Ratio [(HR)] 1.236; 95% CI: 1.035–1.476} and long-term mortality (Log-rank p < 0.001) as compared to patients without AF. The use of novel oral anticoagulants (NOAC) in AF patients was associated with reduced short-term mortality (HR 0.14; 95% CI: 0.06–0.33, p < 0.001). Moreover, in AF patients, NOAC use was associated with a lower probability of MACEs (Odds Ratio 0.3; 95% CI: 0.10–0.89, p = 0.030) without increase of RBCs transfusion.ConclusionsAF increases short- and long-term risk of death in patients hospitalized due to COVID-19. However, the use of NOACs in this group may profoundly improve prognosis.

【 授权许可】

Unknown   
© 2023 Terlecki, Wojciechowska, Klocek, Drożdż, Kocowska-Trytko, Lis, Pavlinec, Pęksa, Kania, Siudak, Januszewicz, Kreutz, Małecki, Grodzicki and Rajzer.