Prognostic impact of atrial fibrillation in patients with severe acute respiratory syndrome coronavirus 2 infection

Lee, Ji Hyun; Hwang, You Mi; Cho, Youngjin; Oh, Il-Young

The prognostic impact of atrial fibrillation (AF) in patients with severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection has not been well evaluated. We estimated the prognostic implications of AF in SARS-CoV-2 confirmed patients. The OpenData4Covid19 (https://hira-covid19.net) project is a global research collaboration on coronavirus disease (COVID-19), hosted by the Ministry of Health and Welfare of Korea and the Health Insurance Review and Assessment Service of Korea. This dataset comprises all COVID-19-tested patients and their individual histories of medical service use from January 1, 2017 to May 15, 2020. All patients >19 years with confirmed SARS-CoV-2 infection were included. The primary endpoint was a composite of death and intensive care unit admission. In total, 7162 adults with SARS-CoV-2 infection were included in this study. The prevalence of AF was 1.8% (n = 130). Patients with AF had unfavorable characteristics, such as older age and higher prevalence of comorbidities. The primary endpoint was more common in patients with AF than in those without (33.9% vs 12.9%, P < .001). In the multivariable model, age (odds ratio [OR]: 1.035, 95% confidence interval [CI]: 1.030–1.040), female sex (OR: 0.618, 95% CI: 0.535–0.713), diabetes (OR: 1.341, 95% CI: 1.093–1.580), and chronic kidney disease (OR: 2.714, 95% CI: 1.541–4.777) were associated with the primary endpoint. However, AF was not an independent predictor of the primary endpoint (OR: 1.402, 95% CI: 0.932–2.108). Patients with AF and concomitant SARS-CoV-2 infection had more comorbidities and a worse prognosis. However, an independent association between AF and adverse clinical outcomes was not evident.