Background Mortality in critically ill patients with coronavirus disease 2019 (COVID‐19) is high, therefore, it is essential to evaluate the independent effect of new‐onset atrial fibrillation (NOAF) on mortality in patients with COVID‐19. We aimed to determine the incidence, risk factors, and outcomes of NOAF in a cohort of critically ill patients with COVID‐19. Methods We conducted a retrospective study on patients admitted to the intensive care unit (ICU) with a diagnosis of COVID‐19. NOAF was defined as atrial fibrillation that was detected after diagnosis of COVID‐19 without a prior history. The primary outcome of the study was the effect of NOAF on mortality in critically ill COVID‐19 patients. Results NOAF incidence was 14.9% (n = 37), and 78% of patients (n = 29) were men in NOAF positive group. Median age of the NOAF group was 79.0 (interquartile range, 71.5‐84.0). Hospital mortality was higher in the NOAF group (87% vs 67%, respectively, P = .019). However, in multivariate analysis, NOAF was not an independent risk factor for hospital mortality (OR 1.42, 95% CI 0.40‐5.09, P = .582). Conclusions The incidence of NOAF was 14.9% in critically ill COVID‐19 patients. Hospital mortality was higher in the NOAF group. However, NOAF was not an independent risk factor for hospital mortality in patients with COVID‐19.

Objectives: To determine the incidence, risk factors, and outcomes of new-onset atrial fibrillation (NOAF) in a cohort of critically ill patients with coronavirus disease 2019 (COVID-19). Methods: We conducted a retrospective study on patients admitted to the intensive care unit (ICU) with a diagnosis of COVID-19. NOAF was defined as atrial fibrillation that was detected after diagnosis of COVID-19 without a prior history. The primary outcome of the study was the effect of NOAF on mortality in critically ill COVID-19 patients. Results: We enrolled 248 eligible patients. NOAF incidence was 14.9% (n=37), and 78% of patients (n=29) were men in NOAF positive group. Median age of the NOAF group was 79.0 (interquartile range, 71.5-84.0). Hospital mortality was higher in the NOAF group (87% vs 67%, respectively, p=0.019). However, in multivariate analysis, NOAF was not an independent risk factor for hospital mortality (OR 1.42, 95% CI 0.40–5.09, p=0.582) Conclusions: The incidence of NOAF was 14.9% in critically ill COVID-19 patients. Hospital mortality was higher in the NOAF group. However, NOAF was not an independent risk factor for hospital mortality in patients with COVID-19. Keywords: Atrial fibrillation, critical care, intensive care unit, COVID-19, mortality, hospital mortality

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OBJECTIVE: The most appropriate ventilatory mode during fiberoptic bronchoscopy is still not yet known clearly for patients with acute respiratory distress syndrome. Airway pressure release ventilation is used as a recovery treatment for patients with severe acute respiratory distress syndrome. In this study, the aim was to evaluate the safety of the fiberoptic bronchoscopy process in patients with severe acute respiratory distress syndrome ventilated with airway pressure release ventilation mode and its effect on gas exchange and respiratory mechanics. MATERIAL AND METHODS: Single-center retrospective observational study was performed in the intensive care unit of a tertiary referral center from September 2018 to November 2019. Patients with severe ARDS ventilated with APRV mode and undergoing FB were included. Fiberoptic bronchoscopy was performed by an expert intensivist-pulmonologist. All ventilator parameters set by the clinician were kept stable, and no change was made other than O 2 concentration. The mechanical ventilation parameters and arterial blood gas values before and after the procedure and fiberoptic bronchoscopy-related complications were recorded for the first 24 hours. Results: A total of 14 acute respiratory distress syndrome patients who were ventilated with airway pressure release ventilation were enrolled. No significant deteriorations were detected in gas exchange, pulmonary compliance, and airway resistance values in our case series. It was observed that a small reduction in PaO 2 and an increase in PaCO 2 were present after the 1st hour; however, both were returned to baseline values in the 24th hour. Only 1 patient developed fiberoptic bronchoscopy-induced hypoxemia (7.1%). Complications, such as fiberoptic bronchoscopy-induced barotrauma, pneumothorax, hemodynamic deterioration, and bleeding, were not detected. Conclusion: According to our preliminary findings, performing fiberoptic bronchoscopy under airway pressure release ventilation mode by an experienced bronchoscopist does not bring additional complication risks in patients with severe acute respiratory distress syndrome.