Prevalence of Atrial Fibrillation and Associated Mortality Among Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis

Li, Zuwei; Shao, Wang; Zhang, Jing; Ma, Jianyong; Huang, Shanshan; Yu, Peng; Zhu, Wenzhen

doi:10.3389/fcvm.2021.720129

Cited by 40 publications

(56 citation statements)

References 61 publications

(130 reference statements)

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“…Similarly, in hospitalized patients with COVID, arrhythmic events are not uncommon among the COVID-19 related cardiovascular complications. As we previously reported, atrial fibrillation is the most prevalent arrhythmia in hospitalized patients (6). Regarding ventricular arrhythmia, evidence from earliest cohorts from Wuhan, China, showed that ventricular arrhythmia occurred in 7% of patients (13/187) and that the rate of ventricular arrhythmia was almost doubled in patients with elevated troponin T levels on ICU admission (18), which is consistent with our results (Figure 3).…”

Section: Discussionsupporting

confidence: 92%

“…An early report study on 138 patients from Wuhan, China, showed that 17% of the hospitalized patients suffered from total arrhythmia (5). Our recent metaanalysis also showed that the atrial fibrillation reached 10% and was associated with increased death in COVID-19 (6). Ventricular arrhythmia is still the major leading cause of death from the cardiovascular diseases (7).…”

Section: Introductionmentioning

confidence: 84%

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The Prevalence and Associated Death of Ventricular Arrhythmia and Sudden Cardiac Death in Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis

Tan

Huang

Mei

et al. 2022

Front. Cardiovasc. Med.

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BackgroundArrhythmia is a very common complication of coronavirus disease 2019 (COVID-19); however, the prevalence of ventricular arrhythmia and associated outcomes are not well-explored. Here, we conducted a systematic review and meta-analysis to determine the prevalence and associated death of ventricular arrhythmia and sudden cardiac death (SCD) in patients with COVID-19.MethodsDatabases of PubMed, Cochrane Library, Embase, and MdeRxiv were searched. Studies that could calculate the prevalence of ventricular arrhythmia/SCD during hospital admission or associated death in patients with COVID-19 were included. The study was registered with the PROSPERO (CRD42021271328).ResultsA total of 21 studies with 13,790 patients were included. The pooled prevalence of ventricular arrhythmia was 5% (95% CI: 4–6%), with a relatively high-SCD prevalence (1.8% in hospitalized COVID-19 and 10% in deceased cases of COVID-19). Subgroup analysis showed that ventricular arrhythmia was more common in patients with elevated cardiac troponin T [ES (effect size): 10%, 95% CI: −0.2 to 22%] and in European (ES: 20%, 95% CI: 11–29%) populations. Besides, ventricular arrhythmia was independently associated with an increased risk of death in patients with COVID-19 [odds ratio (OR) = 2.83; 95% CI: 1.78–4.51].ConclusionVentricular arrhythmia and SCD resulted as a common occurrence with a high prevalence in patients with COVID-19 admitted to the hospital. Furthermore, ventricular arrhythmia significantly contributed to an increased risk of death in hospitalized patients with COVID-19. Clinicians might be vigilant of ventricular arrhythmias for patients with COVID-19, especially for severe cases.Systematic Review Registrationwww.york.ac.uk/inst/crd, identifier: CRD42021271328.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 84%

The Prevalence and Associated Death of Ventricular Arrhythmia and Sudden Cardiac Death in Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis

Tan

Huang

Mei

et al. 2022

Front. Cardiovasc. Med.

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“…showed that the most common tachyarrhythmia associated with COVID 19 is atrial fibrillation, while the most common bradyarrhythmia were severe sinus bradycardia and complete atrio-ventricular block. Ventricular tachycardia or ventricular fibrillation was found in 4.8% of respondents, amiodarone being the most commonly used medication for these situations [9]. This global survey of more than 1,100 respondents once again demonstrated the presence of arrhythmic manifestations, from benign to life-threatening, as side effects often associated with hydroxychloroquine and azithromycin therapy, which led to QT prolongation.…”

Section: Conduction System Disease Effects Mecanismsmentioning

confidence: 77%

Management of arrythmia in the COVID 19 era

et al. 2021

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There is currently well-documented evidence that SARS CoV2 infection is frequently associated with secondary cardiac damage. Although lung damage is a priority, the evolution over time of COVID 19 infection frequently includes cardiovascular complications, the most common being: myocarditis, heart failure and acute coronary syndrome resulting from coronary artery thrombosis or plaque ruptures associated with SARS-CoV-2. Therefore, for the judicious use of resources, both human and material, and for the protection of medical staff, it is necessary to establish standard procedures to limit the contact of medical staff with the infected patient COVID 19.

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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 of Atrial Fibrillation and Associated Mortality Among Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis

Cited by 40 publications

References 61 publications

The Prevalence and Associated Death of Ventricular Arrhythmia and Sudden Cardiac Death in Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis

The Prevalence and Associated Death of Ventricular Arrhythmia and Sudden Cardiac Death in Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis

Management of arrythmia in the COVID 19 era

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

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