New-onset atrial fibrillation: incidence, characteristics, and related events following a national COVID-19 lockdown of 5.6 million people

Abstract

Aim To determine the incidence, patient characteristics, and related events associated with new-onset atrial fibrillation (AF) during a national COVID-19 lockdown. Methods and results Using nationwide Danish registries, we included all patients, aged 18–90 years, receiving a new-onset AF diagnosis during the first 3 months of 2019 and 2020. The main comparison was between patients diagnosed during lockdown (12 March 12–1 April 2020) and patients diagnosed in the corresponding period 1 year previously. We found a lower incidence of new-onset AF during the 3 weeks of lockdown compared with the corresponding weeks in 2019 [incidence rate ratios with 95% confidence intervals (CIs) for the 3 weeks: 0.66 (0.56–0.78), 0.53 (0.45–0.64), and 0.41 (0.34–0.50)]. There was a 47% drop in total numbers (562 vs. 1053). Patients diagnosed during lockdown were younger and with a lower CHA2DS2-VASc score, while history of cancer, heart failure, and vascular disease were more prevalent. During lockdown, 30 (5.3%) patients with new-onset AF suffered an ischaemic stroke and 15 (2.7%) died, compared with 45 (4.3%) and 14 (1.3%) patients during the corresponding 2019 period, respectively. The adjusted odds ratio of a related event (ischaemic stroke or all-cause death) during lock-down compared with the corresponding weeks was 1.41 (95% CI 0.93–2.12). Conclusions Following a national lockdown in Denmark, a 47% drop in registered new-onset AF cases was observed. In the event of prolonged or subsequent lockdowns, the risk of undiagnosed AF patients developing complications could potentially translate into poorer outcomes in patients with AF during the COVID-19 pandemic.

Arrhythmia in COVID-19

“…According to a Danish study, following a national lockdown in Denmark, a 47% drop in registered new-onset atrial fibrillation cases was observed. The authors conclude that the risk of undiagnosed atrial fibrillation patients with complications could lead to worse outcomes in patients with atrial fibrillation in the COVID-19 pandemic [26].…”

Complications and mortality of cardiovascular emergency admissions during COVID-19 associated restrictive measures

“…Finally, a 47% drop in registered new-onset cases of atrial fibrillation was observed during the national lockdown in Denmark. In the event of prolonged or subsequent lockdowns, the risk of undiagnosed atrial fibrillation may also result in increased complications such as stroke, potentially translating into poorer outcomes in patients with atrial fibrillation during the COVID-19 pandemic [25]. Thus, to avoid unintended secondary effects of measures aiming at limiting the spread of SARS-CoV-2 on cardiovascular mortality, cardiologists and other health care practitioners should be alerted to develop complementary personalized approaches of patient care (e.g.…”

The Increased Risk of Complicated Ureteral Stones in the Era of COVID-19 Pandemic

“…2 While the major focus of the health care system is on COVID-19, the number of reports on the decreasing rate of non-COVID-19-related conditions is increasing. 3,4 Renal colic with ureter stone is a common case in a daily urology practice. Although the ureteral stone disease gener-ally is an uneventful condition, it might be life-threatening if infection and/or renal impairment accompany.…”