Selected article for: "increase incidence and inflammation response"
Author: Musikantow, Daniel R.; Turagam, Mohit K.; Sartori, Samantha; Chu, Edward; Kawamura, Iwanari; Shivamurthy, Poojita; Bokhari, Mahmoud; Oates, Connor; Zhang, Chi; Pumill, Christopher; Malick, Waqas; Hashemi, Helen; Ruiz-Maya, Tania; Hadley, Michael B.; Gandhi, Jonathan; Sperling, Dylan; Whang, William; Koruth, Jacob S.; Langan, Marie-Noelle; Sofi, Aamir; Gomes, Anthony; Harcum, Stephanie; Cammack, Sam; Ellsworth, Betsy; Dukkipati, Srinivas R.; Goldman, Martin E.; Halperin, Jonathan L.; Fuster, Valentin; Reddy, Vivek Y.
Title: Atrial Fibrillation in Patients Hospitalized with COVID-19: Incidence, Predictors, Outcomes and Comparison to Influenza
  • Cord-id: zttcvqul
  • Document date: 2021_2_24
    • ID: zttcvqul
    Snippet: Background Coronavirus Disease 2019 (COVID-19) results in increased inflammatory markers previously associated with atrial arrhythmias. However, little is known about their incidence or specificity in COVID-19, or their association with outcomes. We determined the incidence, predictors and outcomes of atrial fibrillation or flutter (AF/AFL) in patients hospitalized with COVID-19, or hospitalized with Influenza. Methods This is a retrospective analysis of 3,970 patients admitted with PCR-positive
    Document: Background Coronavirus Disease 2019 (COVID-19) results in increased inflammatory markers previously associated with atrial arrhythmias. However, little is known about their incidence or specificity in COVID-19, or their association with outcomes. We determined the incidence, predictors and outcomes of atrial fibrillation or flutter (AF/AFL) in patients hospitalized with COVID-19, or hospitalized with Influenza. Methods This is a retrospective analysis of 3,970 patients admitted with PCR-positive COVID-19 between 2/4/2020-4/22/2020 with manual review performed of 1,110. The comparator arm included 1,420 patients with influenza hospitalized between 1/1/2017-1/1/2020. Results Among 3970 inpatients with COVID-19, the incidence of AF/AFL was 10% (N=375) and in patients without a history of atrial arrhythmias, 4% (N=146). Patients with new-onset AF/AFL were older with increased inflammatory markers including Interleukin-6 (93 vs 68 pg/ml, P<0.01), and more myocardial injury (Troponin-I: 0.2 vs 0.06ng/ml, P<0.01). AF/AFL were associated with increased mortality (46% vs 26%, P<0.01). Manual review captured a somewhat higher incidence of AF/AFL (13%, N=140). Compared to inpatients with COVID-19, patients with Influenza (N=1420) had similar rates of AF/AFL (12%, n=163) but lower mortality. The presence of AF/AFL correlated with similarly increased mortality in both COVID-19 (RR 1.77) and Influenza (RR 1.78). Conclusions AF/AFL occurs in a subset of patients hospitalized with either COVID-19 or Influenza, and is associated with inflammation and disease severity in both infections. The incidence and associated increase in mortality in both cohorts suggests that AF/AFL in not specific to COVID-19, but is rather a generalized response to the systemic inflammation of severe viral illnesses.

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