tetano
Editor, Senior Moderator
Int J Cardiol Heart Vasc
. 2022 Feb 4;100970.
doi: 10.1016/j.ijcha.2022.100970. Online ahead of print.
Sex- and age specific association of new-onset atrial fibrillation with in-hospital mortality in hospitalised COVID-19 patients
Joost A Offerhaus[SUP] 1 [/SUP], Linda P T Joosten[SUP] 2 [/SUP], Maarten van Smeden[SUP] 2 [/SUP], Marijke Linschoten[SUP] 3 [/SUP], Hidde Bleijendaal[SUP] 1 4 [/SUP], Robert Tieleman[SUP] 5 [/SUP], Arthur A M Wilde[SUP] 1 [/SUP], Frans H Rutten[SUP] 2 [/SUP], Geert-Jan Geersing[SUP] 2 [/SUP], Carol Ann Remme[SUP] 1 [/SUP], CAPACITY-COVID collaborative consortium
Affiliations
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, 5,782 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.
Keywords: COVID-19; age; atrial fibrillation; mortality; prevalence; sex.
. 2022 Feb 4;100970.
doi: 10.1016/j.ijcha.2022.100970. Online ahead of print.
Sex- and age specific association of new-onset atrial fibrillation with in-hospital mortality in hospitalised COVID-19 patients
Joost A Offerhaus[SUP] 1 [/SUP], Linda P T Joosten[SUP] 2 [/SUP], Maarten van Smeden[SUP] 2 [/SUP], Marijke Linschoten[SUP] 3 [/SUP], Hidde Bleijendaal[SUP] 1 4 [/SUP], Robert Tieleman[SUP] 5 [/SUP], Arthur A M Wilde[SUP] 1 [/SUP], Frans H Rutten[SUP] 2 [/SUP], Geert-Jan Geersing[SUP] 2 [/SUP], Carol Ann Remme[SUP] 1 [/SUP], CAPACITY-COVID collaborative consortium
Affiliations
- PMID: 35136831
- PMCID: PMC8813563
- DOI: 10.1016/j.ijcha.2022.100970
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, 5,782 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.
Keywords: COVID-19; age; atrial fibrillation; mortality; prevalence; sex.