Abstract
Background
Coronavirus disease 2019 (COVID-19) is a systemic disease with cardiovascular involvement, including cardiac arrhythmias. Notably, new-onset atrial fibrillation (AF) and atrial flutter (AFL) during hospitalisation in COVID-19 patients has been associated with increased mortality. However, how this risk is impacted by age and sex is still poorly understood.
Methods
For this multicentre cohort study, we extracted demographics, medical history, occurrence of electrical disorders and in-hospital mortality from the large international patient registry CAPACITY-COVID. For each electrical disorder, prevalence during hospitalisation was calculated. Subsequently, we analysed the incremental prognostic effect of developing AF/AFL on in-hospital mortality, using multivariable logistic regression analyses, stratified for sex and age.
Results
In total, 5782 patients (64% male; median age 67) were included. Of all patients 11.0% (95% CI 10.2–11.8) experienced AF and 1.6% (95% CI 1.3–1.9) experienced AFL during hospitalisation. Ventricular arrhythmias were rare (<0.8% (95% CI 0.6–1.0)) and a conduction disorder was observed in 6.3% (95% CI 5.7–7.0). An event of AF/AFL appeared to occur more often in patients with pre-existing heart failure. After multivariable adjustment for age and sex, new-onset AF/AFL was significantly associated with a poorer prognosis, exemplified by a two- to three-fold increased risk of in-hospital mortality in males aged 60–72 years, whereas this effect was largely attenuated in older male patients and not observed in female patients.
Conclusion
In this large COVID-19 cohort, new-onset AF/AFL was associated with increased in-hospital mortality, yet this increased risk was restricted to males aged 60–72 years.
【저자키워드】 COVID-19, Mortality, Sex, Prevalence, Atrial fibrillation, age, 【초록키워드】 Coronavirus disease 2019, Prognosis, risk, cohort study, heart failure, International, male, Patient, multicentre, hospitalisation, disease, ventricular arrhythmia, in-hospital mortality, COVID-19 patient, demographics, cardiac arrhythmias, Older, 95% CI, increased risk, median age, multivariable logistic regression, Female patients, increased mortality, prognostic effect, disorder, COVID-19 cohort, multivariable, Occurrence, Result, significantly, analysed, calculated, occur, electrical, analyses, age and sex, stratified, impacted, 【제목키워드】 in-hospital mortality, association, hospitalised COVID-19 patient,