Sara Paris1, Riccardo M Inciardi1, Carlo Mario Lombardi1, Daniela Tomasoni1, Pietro Ameri2, Valentina Carubelli1, Piergiuseppe Agostoni3, Claudia Canale2, Stefano Carugo4, Giambattista Danzi5, Mattia Di Pasquale1, Filippo Sarullo6, Maria Teresa La Rovere7, Andrea Mortara8, Massimo Piepoli9,10, Italo Porto2, Gianfranco Sinagra11, Maurizio Volterrani12, Massimiliano Gnecchi13, Sergio Leonardi13, Marco Merlo11, Annamaria Iorio14, Stefano Giovinazzo2, Antonio Bellasi15, Gregorio Zaccone1, Rita Camporotondo13, Francesco Catagnano8,13, Laura Dalla Vecchia16, Gloria Maccagni5, Massimo Mapelli3, Davide Margonato8,16, Luca Monzo17, Vincenzo Nuzzi1, Andrea Pozzi14, Giovanni Provenzale4, Claudia Specchia1, Chiara Tedino1, Marco Guazzi18, Michele Senni14, Marco Metra1. 1. Cardiology; ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili, 125123 Brescia, Italy. 2. Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino-IRCCS Italian Cardiovascular Network, University of Genova, Genova, Italy. 3. Division of Cardiology, Department of Clinical Sciences and Community Health, Centro Cardiologico Monzino, University of Milan, Milan, Italy. 4. Division of Cardiology, Ospedale San Paolo, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy. 5. Division of Cardiology, Ospedale Maggiore di Cremona, Cremona, Italy. 6. Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, Italy. 7. Istituti Clinici Scientifici Maugeri, IRCCS, Dipartimento di Cardiologia, Istituto Scientifico di Pavia, Pavia, Italy. 8. Cardiology Department, Policlinico di Monza, Monza, Italy. 9. Heart Failure Unit, G da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy. 10. Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy. 11. Department of Cardiology, Cardiovascular Department, Azienda Sanitaria Universitaria Integrata, Trieste, Italy. 12. Department of Medical Sciences, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Pisana Rome, Rome, Italy. 13. Division of Cardiology, Dipartimento Scienze mediche e malattie infettive, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy. 14. Cardiovascular Department, Cardiology Unit, Papa Giovanni XXIII Hospital-Bergamo, Piazza OMS, 1, 24127 Bergamo, Italy. 15. Innovation and Brand Reputation Unit, Papa Giovanni XXIII Hospital, Bergamo Research, Bergamo, Italy. 16. Istituti Clinici Scientifici Maugeri, IRCCS, Dipartimento di Cardiologia, Istituto Scientifico di Milan, Milan, Italy. 17. Department of Cardiology, Istituto Clinico Casal Palocco, Policlinico Casilino, Rome, Italy. 18. Heart Failure Unit, Cardiology Department, University of Milan, IRCCS San Donato Hospital, Milan, Italy.
Abstract
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. Published on behalf of the European Society of Cardiology. All rights reserved.
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. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Vincenzo Nuzzi; Eva Del Mestre; Alessia Degrassi; Daniel I Bromage; Paolo Manca; Susan Piper; Jessica Artico; Piero Gentile; Paul A Scott; Mario Chiatto; Marco Merlo; Nilesh Pareek; Mauro Giacca; Gianfranco Sinagra; Theresa A McDonagh; Antonio Cannata Journal: Curr Cardiol Rep Date: 2022-06-25 Impact factor: 3.955
Authors: Zaki Akhtar; Sumeet Sharma; Ahmed I Elbatran; Lisa W M Leung; Christos Kontogiannis; Michael Spartalis; Alice Roberts; Abhay Bajpai; Zia Zuberi; Mark M Gallagher Journal: J Clin Med Date: 2022-04-05 Impact factor: 4.241
Authors: Michael J Cutler; Heidi T May; Tami L Bair; Brian G Crandall; Jeffrey S Osborn; Jared D Miller; Charles D Mallender; Joseph B Muhlestein; Jeffrey L Anderson; Kirk U Knowlton; Stacey Knight Journal: Int J Cardiol Heart Vasc Date: 2022-09-27