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

Romiti, Giulio Francesco; Corica, Bernadette; Lip, Gregory Y.H.; Proietti, Marco

doi:10.3390/jcm10112490

Cited by 64 publications

(51 citation statements)

References 74 publications

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“…AF is a common clinical manifestation in hospitalized patients with coronavirus disease 2019 (COVID-19) infection and is associated with a higher risk of mortality and/or requirement for intensive care. 187 188 189 190 The latter is perhaps unsurprising given the higher risk of adverse outcomes in COVID-19 with associated cardiovascular comorbidities. 190 …”

Section: Oac Use In Af Patients During the Covid-19 Pandemicmentioning

confidence: 99%

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2021 Focused Update Consensus Guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: Executive Summary

et al. 2021

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The consensus of the Asia Pacific Heart Rhythm Society (APHRS) on stroke prevention in atrial fibrillation (AF) has been published in 2017 which provided useful clinical guidance for cardiologists, neurologists, geriatricians, and general practitioners in the Asia-Pacific region. In these years, many important new data regarding stroke prevention in AF were reported. The practice guidelines subcommittee members comprehensively reviewed updated information on stroke prevention in AF, and summarized them in this 2021 focused update of the 2017 consensus guidelines of the APHRS on stroke prevention in AF. We highlighted and focused on several issues, including the importance of the AF Better Care pathway, the advantages of non-vitamin K antagonist oral anticoagulants (NOACs) for Asians, the considerations of use of NOACs for Asian AF patients with single one stroke risk factor beyond gender, the role of lifestyle factors on stroke risk, the use of oral anticoagulants during the “coronavirus disease 2019” pandemic, etc. We fully realize that there are gaps, unaddressed questions, and many areas of uncertainty and debate in the current knowledge of AF, and the physician's decision remains the most important factor in the management of AF.

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Section: Oac Use In Af Patients During the Covid-19 Pandemicmentioning

confidence: 99%

“… 187 188 189 190 The latter is perhaps unsurprising given the higher risk of adverse outcomes in COVID-19 with associated cardiovascular comorbidities. 190 …”

Section: Oac Use In Af Patients During the Covid-19 Pandemicmentioning

confidence: 99%

2021 Focused Update Consensus Guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: Executive Summary

et al. 2021

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“…For example, we could not know whether the result related to chronic heart disease is due to which of ischemic heart disease, valvular heart disease, and cardiomyopathy. In addition, our data did not include information on atrial fibrillation, which was known to be one of the poor prognostic factors associated with COVID-19 (30). There is no information about the stage of CKD, with the data only indicating whether a patient did or did not have CKD.…”

Section: Discussionmentioning

confidence: 99%

Association Between Cardiovascular Risk Factors and the Severity of Coronavirus Disease 2019: Nationwide Epidemiological Study in Korea

Kong

Jung

et al. 2021

Front. Cardiovasc. Med.

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Background: Acute respiratory viral infections can result in cardiovascular involvement, with such patients having a significantly higher mortality rate than those without cardiovascular involvement. Due to the ongoing coronavirus disease 2019 (COVID-19) pandemic, it is important to determine whether cardiovascular risk factors are associated with the severity of COVID-19.Methods: These nationwide data were provided by the Korea Disease Control and Prevention Agency. We defined a patient as having a “critical illness” if they required more than invasive mechanical ventilation and “fatal illness” if they died.Results: Among the total 5,307 patients, 2,136 (40.8%) were male. The critical illness rate was 5.1% (males: 6.7, females: 4.0%) and the fatality rate was 4.54%. The multivariable analysis showed that age ≥60 years, male sex, diabetes mellitus, hypertension, heart failure, chronic kidney disease, cancer, and dementia were independent risk factors for critical illness. The risk scoring model showed the significance of multiple risk factors. Patients with four risk factors; old age (≥60 years), male sex, hypertension, and diabetes mellitus had a more than a 100 times higher risk for severe COVID-19 than those without these risk factors (OR; 95% confidence interval, 104; 45.6–240.6 for critical, 136.2; 52.3–3547.9 for fatal illness).Conclusions: This study demonstrated that cardiovascular risk factors are also significant risk factors for severe COVID-19. In particular, patients who have multiple cardiovascular risk factors are more likely to progress to severe COVID-19. Therefore, early and appropriate treatment of these patients is crucial.

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“…Of note, the prevalence of these conditions was substantially lower in our population compared to what was reported by Gamst et al [ 24 ] in the intensive care setting and may justify the discrepancy between the results of these studies. Recently, two metanalysis [ 27 , 28 ] suggested that COVID-19 patients with new-onset AF showed a significantly increased risk of all-cause mortality compared to those without AF; however, no data about the prognostic value of pre-existing AF have been provided. Our results suggest that the clinical outcome of hospitalized COVID-19 patients was not influenced by the type of pre-existing AF (permanent or non-permanent).…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Hospitalized COVID-19 Patients with History of Atrial Fibrillation

Russo

Silverio

Scudiero³

et al. 2022

Medicina

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Background and objectives: Pre-existing atrial fibrillation (AF) is a frequent comorbidity in hospitalized patients with COVID-19; however, little is still known about its prognostic role in infected patients. The aim of our study was to evaluate whether the pre-existing AF as comorbidity would contribute to increase the risk for severe forms of COVID-19, worse prognosis, or even higher mortality. Materials and Methods: We retrospectively evaluated all consecutive COVID-19 patients admitted to the emergency department of nine Italian Hospitals from 1 March to 30 April 2020.The prevalence and the type of pre-existing AF have been collected. The correlation between the history and type of AF and the development of severe ARDS and in-hospital mortality has been evaluated. Results: In total, 467 patients (66.88 ± 14.55 years; 63% males) with COVID-19 were included in the present study. The history of AF was noticed in 122 cases (26.1%), of which 12 (2.6%) with paroxysmal, 57 (12.2%) with persistent and 53 (11.3%) with permanent AF. Among our study population, COVID-19 patients with AF history were older compared to those without AF history (71.25 ± 12.39 vs. 65.34 ± 14.95 years; p < 0.001); however, they did not show a statistically significant difference in cardiovascular comorbidities or treatments. Pre-existing AF resulted in being independently associated with an increased risk of developing severe ARDS during the hospitalization; in contrast, it did not increase the risk of in-hospital mortality. Among patients with AF history, no significant differences were detected in severe ARDS and in-hospital mortality between patients with permanent and non-permanent AF history. Conclusions: Pre-existing AF is a frequent among COVID-19 patients admitted to hospital, accounting up to 25% of cases. It is independently associated with an increased risk of severe ARDS in hospitalized COVID-19 patients; in contrast, it did not affect the risk of death. The type of pre-existing AF (permanent or non-permanent) did not impact the clinical outcome.

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

Cited by 64 publications

References 74 publications

2021 Focused Update Consensus Guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: Executive Summary

2021 Focused Update Consensus Guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: Executive Summary

Association Between Cardiovascular Risk Factors and the Severity of Coronavirus Disease 2019: Nationwide Epidemiological Study in Korea

Clinical Outcome of Hospitalized COVID-19 Patients with History of Atrial Fibrillation

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