New onset atrial fibrilation and risk faktors in COVID-19

Keleşoğlu, Şaban; Yılmaz, Yücel; Özkan, Eyüp; Çalapkorur, Bekir; Gök, Mustafa; Dursun, Zehra Beştepe; Kılıç, Ayşegül Ulu; Demirelli, Selami; Şimşek, Ziya; Elçik, Deniz

doi:10.1016/j.jelectrocard.2020.12.005

Cited by 30 publications

(49 citation statements)

References 27 publications

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“…Of the 783 studies identified from the literature search (216 on Pubmed and 567 on EMBASE), 31 studies were selected according to the inclusion and exclusion criteria and included in the analysis [ 3 , 10 , 11 , 12 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ] ( Figure S1 in Supplementary Materials ), with a total of 187,716 COVID-19 patients. Baseline characteristics of the studies included are reported in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies were held in Europe [ 10 , 11 , 25 , 29 , 31 , 33 , 37 , 39 , 42 , 43 , 44 , 47 , 50 ], nine in North America [ 3 , 28 , 30 , 32 , 41 , 45 , 46 , 49 , 51 ], four in Asia [ 26 , 34 , 35 , 48 ], and five in other geographical locations, including one multinational study [ 12 , 27 , 36 , 38 , 40 ]. Twenty-five studies were observational retrospective [ 3 , 10 , 12 , 26 , 28 , 30 , 31 , 32 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ], four were based on prospective observational analysis of single center cohorts [ 11 , …”

Section: Resultsmentioning

confidence: 99%

“…Of the studies, 14 were included in the analysis for all-cause mortality according to AF status (12 reported in-hospital death [ 3 , 10 , 12 , 25 , 29 , 30 , 37 , 40 , 41 , 42 , 43 , 45 ] and two described 30-day mortality [ 32 , 50 ]). Nine studies included patients with new onset AF [ 10 , 29 , 36 , 37 , 40 , 41 , 42 , 45 , 51 ]. To improve the reliability of our estimates, after careful evaluation of the definitions of AF used and of the data reported, for two studies [ 37 , 51 ], we decided to compute only new onset AF in the main analysis about prevalence.…”

Section: Resultsmentioning

confidence: 99%

“…We compared several baseline characteristics and conditions between patients presenting with and without AF. Eight studies reported data disaggregated by AF diagnosis on proportion of female sex, hypertension, and diabetes [ 10 , 29 , 30 , 37 , 40 , 41 , 43 , 45 ]; seven reported about mean age [ 10 , 29 , 30 , 37 , 40 , 43 , 45 ] and CHF [ 10 , 29 , 30 , 40 , 41 , 43 , 45 ], while six reported on CAD [ 10 , 29 , 30 , 41 , 43 , 45 ]; finally, 12 reported on proportion of critical patients [ 3 , 26 , 29 , 30 , 35 , 37 , 40 , 41 , 45 , 48 , 49 ] (specifically, six according to ICU admission [ 3 , 26 , 29 , 30 , 43 , 49 ], two according to “critically ill” definition [ 35 , 48 ], one according to ICU/intermediate care unit admission [ 37 ], and two according to patients receiving mechanical ventilation [ 41 , 45 ]).…”

Section: Resultsmentioning

confidence: 99%

“…Subgroup analyses according to the outcome definition are reported in Figure S4 . Twelve studies reported in-hospital death [ 3 , 10 , 12 , 25 , 29 , 30 , 37 , 40 , 41 , 42 , 43 , 45 ] and two reported 30-days mortality [ 32 , 50 ]. Patients with AF showed both higher risk of in-hospital mortality (OR 3.52, 95% CI 2.44–5.10) and 30-days mortality (OR 7.34, 95% CI: 3.11–17.34), with no statistically significant difference between subgroups ( p = 0.12; Figure S4 ).…”

Section: Resultsmentioning

confidence: 99%

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Prevalence and Impact of Atrial Fibrillation in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

Romiti

Corica

Lip

et al. 2021

JCM

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Background: In patients with COVID-19, cardiovascular complications are common and associated with poor prognosis. Among these, an association between atrial fibrillation (AF) and COVID-19 has been described; however, the extent of this relationship is unclear. The aim of this study is to investigate the epidemiology of AF in COVID-19 patients and its impact on all-cause mortality. Methods: A systematic review and meta-analysis were performed and reported according to PRISMA guidelines, and a protocol for this study was registered on PROSPERO (CRD42021227950). PubMed and EMBASE were systematically searched for relevant studies. A random-effects model was used to estimate pooled odds ratios (OR) and 95% confidence intervals (CI). Results: Overall, 31 studies were included in the analysis, with a total number of 187,716 COVID-19 patients. The prevalence of AF was found to be as high as 8% of patients with COVID-19 (95% CI: 6.3–10.2%, 95% prediction intervals (PI): 2.0–27.1%), with a high degree of heterogeneity between studies; a multiple meta-regression model including geographical location, age, hypertension, and diabetes showed that these factors accounted for more than a third of the heterogeneity. AF COVID-19 patients were less likely to be female but more likely older, hypertensive, and with a critical status than those without AF. Patients with AF showed a significant increase in the risk of all-cause mortality (OR: 3.97, 95% CI: 2.76–5.71), with a high degree of heterogeneity. A sensitivity analysis focusing on new-onset AF showed the consistency of these results. Conclusions: Among COVID-19 patients, AF is found in 8% of patients. AF COVID-19 patients are older, more hypertensive, and more likely to have a critical status. In COVID-19 patients, AF is associated with a 4-fold higher risk of death. Further studies are needed to define the best treatment strategies to improve the prognosis of AF COVID-19 patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence and Impact of Atrial Fibrillation in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

Romiti

Corica

Lip

et al. 2021

JCM

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Risk factors, thromboembolic events, and clinical course of New‐Onset Atrial Fibrillation among COVID‐19 hospitalized patients: A multicenter cross‐sectional analysis in Iran

Rahimi

Afaghi

Tarki

et al. 2022

Health Science Reports

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Background and Aims We focused on determining the risk factors, thromboembolic events, and clinical course of New‐Onset Atrial Fibrillation (NOAF) among hospitalized coronavirus disease (COVID‐19) patients. Methods This retrospective study was conducted in the major referral centers in Tehran, Iran. Of 1764 patients enrolled in the study from January 2020 until July 2021, 147 had NOAF, and 1617 had normal sinus rhythm. Univariate and multivariate Logistic regressions were employed accordingly to evaluate NOAF risk factors. The statistical assessments have been run utilizing SPSS 25.0 (SPSS) or R 3.6.3 software. Results For the NOAF patients, the age was significantly higher, and the more prevalent comorbidities were metabolic syndrome, heart failure (HF), peripheral vascular disease, coronary artery disease, and liver cirrhosis. The multivariate analysis showed the established independent risk factors were; Troponin‐I (hazard ratio [HR] = 3.86; 95% confidence interval [CI] = 1.89−7.87; p < 0.001), HF (HR = 2.54; 95% CI = 1.61−4.02; p < 0.001), bilateral grand‐glass opacification (HR = 2.26; 95% CI = 1.68−3.05; p = 0.002). For cases with thromboembolic events, NOAF was the most important prognostic factor (odds ratio [OR] = 2.97; 95% CI = 2.03−4.33; p < 0.001). While evaluating the diagnostic ability of prognostic factors in detecting NOAF, Troponin‐I (Area under the curve [AUC] = 0.85), C‐Reactive Protein (AUC = 0.72), and d ‐dimer (AUC = 0.65) had the most accurate sensitivity. Furthermore, the Kaplan‐Meier curves demonstrated that the survival rates diminished more steeply for patients with NOAF history. Conclusion In hospitalized COVID‐19 patients with NOAF, the risk of thromboembolic events, hospital stay, and fatality are significantly higher. The established risk factors showed that patients with older age, higher inflammation states, and more severe clinical conditions based on CHADS2VASC‐score potentially need subsequent preventive strategies. Appropriate prophylactic anticoagulants, Initial management of cytokine storm, sufficient oxygen support, and reducing viral shedding could be of assistance in such patients.

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Pre-existing atrial fibrillation is associated with increased mortality in COVID-19 Patients

Zuin

Rigatelli

Bilato

et al. 2021

J Interv Card Electrophysiol

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Purpose The impacts of pre-existing atrial fibrillation (AF) on COVID-19-associated outcomes are unclear. We conducted a systematic review and meta-analysis to investigate the pooled prevalence of pre-existing AF and its short-term mortality risk in COVID-19 patients. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE and Scopus to locate all the articles published up to January 31, 2021, reporting data on pre-existing AF among COVID-19 survivors and non-survivors. The pooled prevalence of pre-existing AF was calculated using a random effects model and presenting the related 95% confidence interval (CI), while the mortality risk was estimated using the Mantel-Haenszel random effects models with odds ratio (OR) and related 95% CI. Statistical heterogeneity was measured using the Higgins I 2 statistic. Results Twelve studies, enrolling 15.562 COVID-19 patients (mean age 71.6 years), met the inclusion criteria and were included in the final analysis. The pooled prevalence of pre-existing AF was 11.0% of cases (95% CI: 7.8–15.2%, p < 0.0001) with high heterogeneity ( I 2 = 95.2%). Pre-existing AF was associated with higher risk of short-term death (OR 2.22, 95% CI 1.47–3.36, p < 0.0001), with high heterogeneity ( I 2 = 79.1%). Conclusion Pre-existing AF is present in about 11% of COVID-19 cases but results associated with an increased risk of short-term mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s10840-021-00992-2.

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New onset atrial fibrilation and risk faktors in COVID-19

Cited by 30 publications

References 27 publications

Prevalence and Impact of Atrial Fibrillation in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

Prevalence and Impact of Atrial Fibrillation in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

Risk factors, thromboembolic events, and clinical course of New‐Onset Atrial Fibrillation among COVID‐19 hospitalized patients: A multicenter cross‐sectional analysis in Iran

Pre-existing atrial fibrillation is associated with increased mortality in COVID-19 Patients

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