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Article ; Online: Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: results of the Cardio-COVID-Italy multicentre study.

Paris, Sara / Inciardi, Riccardo M / Lombardi, Carlo Mario / Tomasoni, Daniela / Ameri, Pietro / Carubelli, Valentina / Agostoni, Piergiuseppe / Canale, Claudia / Carugo, Stefano / Danzi, Giambattista / Di Pasquale, Mattia / Sarullo, Filippo / La Rovere, Maria Teresa / Mortara, Andrea / Piepoli, Massimo / Porto, Italo / Sinagra, Gianfranco / Volterrani, Maurizio / Gnecchi, Massimiliano /
Leonardi, Sergio / Merlo, Marco / Iorio, Annamaria / Giovinazzo, Stefano / Bellasi, Antonio / Zaccone, Gregorio / Camporotondo, Rita / Catagnano, Francesco / Dalla Vecchia, Laura / Maccagni, Gloria / Mapelli, Massimo / Margonato, Davide / Monzo, Luca / Nuzzi, Vincenzo / Pozzi, Andrea / Provenzale, Giovanni / Specchia, Claudia / Tedino, Chiara / Guazzi, Marco / Senni, Michele / Metra, Marco

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

2021  Volume 23, Issue 10, Page(s) 1603–1611

Abstract: ... patients with coronavirus disease 2019 (COVID-19).: Methods and results: We enrolled 696 consecutive ... after adjustment for clinical confounders related to COVID-19 severity and cardiovascular comorbidities ... not related to stroke or bleeding events.: Conclusion: Among hospitalized patients with COVID-19 ...

Abstract Aims: To assess the clinical relevance of a history of atrial fibrillation (AF) in hospitalized patients with coronavirus disease 2019 (COVID-19).
Methods and results: We enrolled 696 consecutive patients (mean age 67.4 ± 13.2 years, 69.7% males) admitted for COVID-19 in 13 Italian cardiology centres between 1 March and 9 April 2020. One hundred and six patients (15%) had a history of AF and the median hospitalization length was 14 days (interquartile range 9-24). Patients with a history of AF were older and with a higher burden of cardiovascular risk factors. Compared to patients without AF, they showed a higher rate of in-hospital death (38.7% vs. 20.8%; P < 0.001). History of AF was associated with an increased risk of death after adjustment for clinical confounders related to COVID-19 severity and cardiovascular comorbidities, including history of heart failure (HF) and increased plasma troponin [adjusted hazard ratio (HR): 1.73; 95% confidence interval (CI) 1.06-2.84; P = 0.029]. Patients with a history of AF also had more in-hospital clinical events including new-onset AF (36.8% vs. 7.9%; P < 0.001), acute HF (25.3% vs. 6.3%; P < 0.001), and multiorgan failure (13.9% vs. 5.8%; P = 0.010). The association between AF and worse outcome was not modified by previous or concomitant use of anticoagulants or steroid therapy (P for interaction >0.05 for both) and was not related to stroke or bleeding events.
Conclusion: Among hospitalized patients with COVID-19, a history of AF contributes to worse clinical course with a higher mortality and in-hospital events including new-onset AF, acute HF, and multiorgan failure. The mortality risk remains significant after adjustment for variables associated with COVID-19 severity and comorbidities.
MeSH term(s) Aged ; Aged, 80 and over ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; COVID-19 ; Female ; Heart Failure/diagnosis ; Heart Failure/epidemiology ; Hospital Mortality ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Risk Factors ; SARS-CoV-2
Language English
Publishing date 2021-07-23
Publishing country England
Document type Journal Article ; Multicenter Study
ZDB-ID 1449879-0
ISSN 1532-2092 ; 1099-5129
ISSN (online) 1532-2092
ISSN 1099-5129
DOI 10.1093/europace/euab146
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ab Jg. 2022: Lesesaal (EG)
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