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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: Results of the Cardio-COVID-Italy multicentre study
Europace, Volume 23, No. 10, Year 2021
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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. © 2021 Published on behalf of the European Society of Cardiology. All rights reserved.
Authors & Co-Authors
Tomasoni, Daniela
Italy, Brescia
Spedali Civili Di Brescia
Ameri, Pietro
Italy, Genoa
Irccs San Martino Polyclinic Hospital
Agostoni, Piergiuseppe
Italy, Milan
Irccs Centro Cardiologico Monzino
Carugo, Stefano
Italy, Milan
Ospedale San Paolo
La Rovere, Maria Teresa
Italy, Pavia
Istituti Clinici Scientifici Maugeri Spa – sb
Mortara, Andrea
Unknown Affiliation
PIEPOLI, MASSIMO Francesco
Italy, Piacenza
Ospedale Guglielmo da Saliceto
Italy, Pisa
Sant'anna Scuola Universitaria Superiore Pisa
Porto, Italo
Italy, Genoa
Irccs San Martino Polyclinic Hospital
Volterrani, Maurizio
Italy, Rome
Irccs San Raffaele Pisana
Gnecchi, Massimiliano
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Leonardi, Sergio
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Iorio, Anna Maria Aria
Italy, Bergamo
Papa Giovanni Xxiii Hospital
Giovinazzo, Stefano
Italy, Genoa
Irccs San Martino Polyclinic Hospital
Camporotondo, Rita
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Mapelli, Massimo
Italy, Milan
Irccs Centro Cardiologico Monzino
Pozzi, Andrea
Italy, Bergamo
Papa Giovanni Xxiii Hospital
Specchia, Claudia
Italy, Brescia
Spedali Civili Di Brescia
Guazzi, Marco
Italy, San Donato Milanese
Gruppo Ospedaliero San Donato
Senni, Michele
Italy, Bergamo
Papa Giovanni Xxiii Hospital
Metra, Marco
Italy, Brescia
Spedali Civili Di Brescia
Statistics
Citations: 31
Authors: 20
Affiliations: 13
Identifiers
Doi:
10.1093/europace/euab146
ISSN:
10995129
Research Areas
Covid
Environmental
Health System And Policy
Noncommunicable Diseases