Author: Peltzer, Bradley; Manocha, Kevin K.; Ying, Xiaohan; Kirzner, Jared; Ip, James E.; Thomas, George; Liu, Christopher F.; Markowitz, Steven M.; Lerman, Bruce B.; Safford, Monika M.; Goyal, Parag; Cheung, Jim W.
Title: Outcomes and mortality associated with atrial arrhythmias among patients hospitalized with COVIDâ€19 Cord-id: tkdzt5ol Document date: 2020_10_14
ID: tkdzt5ol
Snippet: INTRODUCTION: The impact of atrial arrhythmias on coronavirus disease 2019 (COVIDâ€19)â€associated outcomes are unclear. We sought to identify prevalence, risk factors and outcomes associated with atrial arrhythmias among patients hospitalized with COVIDâ€19. METHODS: An observational cohort study of 1053 patients with severe acute respiratory syndrome coronavirus 2 infection admitted to a quaternary care hospital and a community hospital was conducted. Data from electrocardiographic and tele
Document: INTRODUCTION: The impact of atrial arrhythmias on coronavirus disease 2019 (COVIDâ€19)â€associated outcomes are unclear. We sought to identify prevalence, risk factors and outcomes associated with atrial arrhythmias among patients hospitalized with COVIDâ€19. METHODS: An observational cohort study of 1053 patients with severe acute respiratory syndrome coronavirus 2 infection admitted to a quaternary care hospital and a community hospital was conducted. Data from electrocardiographic and telemetry were collected to identify atrial fibrillation (AF) or atrial flutter/tachycardia (AFL). The association between atrial arrhythmias and 30â€day mortality was assessed with multivariable analysis. RESULTS: Mean age of patients was 62 ± 17 years and 62% were men. Atrial arrhythmias were identified in 166 (15.8%) patients, with AF in 154 (14.6%) patients and AFL in 40 (3.8%) patients. Newly detected atrial arrhythmias occurred in 101 (9.6%) patients. Age, male sex, prior AF, renal disease, and hypoxia on presentation were independently associated with AF/AFL occurrence. Compared with patients without AF/AFL, patients with AF/AFL had significantly higher levels of troponin, Bâ€type natriuretic peptide, Câ€reactive protein, ferritin and dâ€dimer. Mortality was significantly higher among patients with AF/AFL (39.2%) compared to patients without (13.4%; p < .001). After adjustment for age and coâ€morbidities, AF/AFL (adjusted odds ratio [OR]: 1.93; p = .007) and newly detected AF/AFL (adjusted OR: 2.87; p < .001) were independently associated with 30â€day mortality. CONCLUSION: Atrial arrhythmias are common among patients hospitalized with COVIDâ€19. The presence of AF/AFL tracked with markers of inflammation and cardiac injury. Atrial arrhythmias were independently associated with increased mortality.
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