Published 2021
| Version v1
Publication
Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: results of the Cardio-COVID-Italy multicentre study
Creators
- Paris, Sara
- Inciardi, Riccardo M
- Lombardi, Carlo Mario
- Tomasoni, Daniela
- Ameri, Pietro
- Carubelli, Valentina
- Agostoni, Piergiuseppe
- Canale, Claudia
- Carugo, Stefano
- Danzi, Giambattista
- Di Pasquale, Mattia
- Sarullo, Filippo
- La Rovere, Maria Teresa
- Mortara, Andrea
- Piepoli, Massimo
- Porto, Italo
- Sinagra, Gianfranco
- Volterrani, Maurizio
- Gnecchi, Massimiliano
- Leonardi, Sergio
- Merlo, Marco
- Iorio, Annamaria
- Giovinazzo, Stefano
- Bellasi, Antonio
- Zaccone, Gregorio
- Camporotondo, Rita
- Catagnano, Francesco
- Dalla Vecchia, Laura
- Maccagni, Gloria
- Mapelli, Massimo
- Margonato, Davide
- Monzo, Luca
- Nuzzi, Vincenzo
- Pozzi, Andrea
- Provenzale, Giovanni
- Specchia, Claudia
- Tedino, Chiara
- Guazzi, Marco
- Senni, Michele
- Metra, Marco
Contributors
Others:
- Paris, Sara
- Inciardi, Riccardo M
- Lombardi, Carlo Mario
- Tomasoni, Daniela
- Ameri, Pietro
- Carubelli, Valentina
- Agostoni, Piergiuseppe
- Canale, Claudia
- Carugo, Stefano
- Danzi, Giambattista
- Di Pasquale, Mattia
- Sarullo, Filippo
- La Rovere, Maria Teresa
- Mortara, Andrea
- Piepoli, Massimo
- Porto, Italo
- Sinagra, Gianfranco
- Volterrani, Maurizio
- Gnecchi, Massimiliano
- Leonardi, Sergio
- Merlo, Marco
- Iorio, Annamaria
- Giovinazzo, Stefano
- Bellasi, Antonio
- Zaccone, Gregorio
- Camporotondo, Rita
- Catagnano, Francesco
- Dalla Vecchia, Laura
- Maccagni, Gloria
- Mapelli, Massimo
- Margonato, Davide
- Monzo, Luca
- Nuzzi, Vincenzo
- Pozzi, Andrea
- Provenzale, Giovanni
- Specchia, Claudia
- Tedino, Chiara
- Guazzi, Marco
- Senni, Michele
- Metra, Marco
Description
Aims: To assess the clinical relevance of a history of atrial fibrillation (AF) in hospitalized patients with coronavirus disease 2019 (COVID-19).
Methods and results: We enrolled 696 consecutive patients (mean age 67.4 ± 13.2 years, 69.7% males) admitted for COVID-19 in 13 Italian cardiology centres between 1 March and 9 April 2020. One hundred and six patients (15%) had a history of AF and the median hospitalization length was 14 days (interquartile range 9-24). Patients with a history of AF were older and with a higher burden of cardiovascular risk factors. Compared to patients without AF, they showed a higher rate of in-hospital death (38.7% vs. 20.8%; P < 0.001). History of AF was associated with an increased risk of death after adjustment for clinical confounders related to COVID-19 severity and cardiovascular comorbidities, including history of heart failure (HF) and increased plasma troponin [adjusted hazard ratio (HR): 1.73; 95% confidence interval (CI) 1.06-2.84; P = 0.029]. Patients with a history of AF also had more in-hospital clinical events including new-onset AF (36.8% vs. 7.9%; P < 0.001), acute HF (25.3% vs. 6.3%; P < 0.001), and multiorgan failure (13.9% vs. 5.8%; P = 0.010). The association between AF and worse outcome was not modified by previous or concomitant use of anticoagulants or steroid therapy (P for interaction >0.05 for both) and was not related to stroke or bleeding events.
Conclusion: Among hospitalized patients with COVID-19, a history of AF contributes to worse clinical course with a higher mortality and in-hospital events including new-onset AF, acute HF, and multiorgan failure. The mortality risk remains significant after adjustment for variables associated with COVID-19 severity and comorbidities
Additional details
Identifiers
- URL
- http://hdl.handle.net/11567/1096408
- URN
- urn:oai:iris.unige.it:11567/1096408
Origin repository
- Origin repository
- UNIGE