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. 2023 Sep;23(5):478-484.
doi: 10.7861/clinmed.2023-0188.

Higher incidence of new atrial fibrillation in hospitalised COVID-19 patients compared to lower respiratory tract infection, however, less patients prescribed anticoagulants at discharge

Isuru Induruwa  1 , Elizabeth Cattermole  2 , Christopher Paisey  2 , Colver Ken Howe Ne  2 , Kayvan Khadjooi  2
Affiliations

Higher incidence of new atrial fibrillation in hospitalised COVID-19 patients compared to lower respiratory tract infection, however, less patients prescribed anticoagulants at discharge

Isuru Induruwa et al. Clin Med (Lond). 2023 Sep.

Abstract

Infection contributes to developing cardiac arrhythmias, such as atrial fibrillation (AF), which causes over 25% of ischaemic stroke. We analysed a hospital coding database of patients hospitalised with Coronavirus 2019 (COVID-19) ± AF or a lower respiratory tract infection (LRTI) ± AF, to compare the incidence of first-diagnosed or 'new' AF (nAF) between COVID-19 and LRTI, as well as risk factors associated with developing nAF during COVID-19. In total, 2,243 patients with LRTI and 488 patients with COVID-19 were included. nAF was diagnosed in significantly more patients with COVID-19 compared with those with LRTI (7.0% vs 3.6%, p=0.003); however, significantly fewer patients with COVID-19 were discharged on anticoagulation medication (26.3% vs 56.4%, p=0.02). Patients who developed nAF during COVID-19 were older (p<0.001), had congestive cardiac failure (p=0.004), ischaemic heart disease (IHD) or peripheral vascular disease (PVD) (p<0.001) and a higher CHA2DS2-VASc score (p=0.02), compared with patients with COVID-19 patients who did not develop nAF. Older age (Odds ratio (OR) 1.03, p=0.007) and IHD/PVD (OR 2.87, p=0.01) increased the odds of developing nAF with COVID-19.

Keywords: COVID-19; anticoagulation; atrial fibrillation; ischaemic stroke; lower respiratory tract infection.

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Conflict of interest statement

KK has received travel grants from Bayer, Boehringer Ingelheim, Daiichi-Sankyo and Pfizer. The other authors declare no conflicts of interest.

Figures

Fig 1.
Fig 1.
Flow diagram showing the number of cases included or excluded at each stage of the study and the final numbers analysed within each cohort. AF = atrial fibrillation; COVID-19 = Coronavirus 2019; LRTI = lower respiratory tract infection.
See this image and copyright information in PMC

Comment in

References

    1. Royal College of Physicians Sentinel Stroke National Audit Programme . National clinical audit annual results portfolio April 2020–March 2021. RCP, 2022. www.strokeaudit.org/results/Clinical-audit/National-Results.aspx [Accessed 18 August 2023].
    1. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007;146:857–67. - PubMed
    1. Walkey AJ, Wiener RS, Ghobrial JM, et al. Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis. JAMA 2011;306:2248–55. - PMC - PubMed
    1. Søgaard M, Skjøth F, Nielsen PB, et al. Thromboembolic risk in patients with pneumonia and new-onset atrial fibrillation not receiving anticoagulation therapy. JAMA Netw Open 2022;5:E2213945. - PMC - PubMed
    1. Pellicori P, Doolub G, Wong CM, et al. COVID-19 and its cardiovascular effects: a systematic review of prevalence studies. Cochrane Database Syst Rev 2021;3:CD013879. - PMC - PubMed