Giulio Francesco Romiti1, Bernadette Corica1, Gregory Y H Lip2,3, Marco Proietti2,4,5. 1. Department of Translational and Precision Medicine, Sapienza-University of Rome, 00161 Rome, Italy. 2. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool 14 3PE, UK. 3. Department of Clinical Medicine, Aalborg University, DK-9100 Aalborg, Denmark. 4. Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy. 5. Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
Abstract
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.
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-19patients 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-19patients. 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-19patients 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-19patients, AF is found in 8% of patients. AF COVID-19patients are older, more hypertensive, and more likely to have a critical status. In COVID-19patients, 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-19patients.
Authors: Juan José Cerezo-Manchado; Olga Meca Birlanga; Luis García de Guadiana Romualdo; Ignacio Gil-Ortega; Antonio Martínez Francés; Teodoro Iturbe-Hernandez Journal: Drugs Context Date: 2022-01-24
Authors: Marcin Protasiewicz; Konrad Reszka; Wojciech Kosowski; Barbara Adamik; Wojciech Bombala; Adrian Doroszko; Damian Gajecki; Jakub Gawryś; Maciej Guziński; Maria Jedrzejczyk; Krzysztof Kaliszewski; Katarzyna Kilis-Pstrusinska; Bogusława Konopska; Agnieszka Kopec; Krzysztof Kujawa; Anna Langner; Anna Larysz; Weronika Lis; Lilla Pawlik-Sobecka; Joanna Gorka-Dynysiewicz; Marta Rosiek-Biegus; Agnieszka Matera-Witkiewicz; Tomasz Matys; Michał Pomorski; Mateusz Sokolski; Janusz Sokołowski; Anna Tomasiewicz-Zapolska; Katarzyna Madziarska; Ewa A Jankowska Journal: J Clin Med Date: 2022-01-12 Impact factor: 4.241