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. 2024 Jul 4;11(7):210.
doi: 10.3390/jcdd11070210.

Pre-Existing Atrial Fibrillation in Hospitalized Patients with COVID-19: Insights from the CARDIO COVID 19-20 Registry

Wikler Bernal Torres  1   2 , Juan Pablo Arango-Ibanez  3 , Juan Manuel Montero Echeverri  3 , Santiago Posso Marín  2 , Armando Alvarado  4 , Andrés Ulate  5 , Paola Oliver  6 , Ivan Criollo  7 , Wilbert German Yabar Galindo  8 , Sylvia Sandoval  9 , William Millán Orozco  10 , Fernando Verdugo Thomas  11 , Franco Appiani Florit  12 , Andrés Buitrago  13 , Alejandra Ines Christen  14 , Igor Morr  15 , Luiz Carlos Santana Passos  16 , Marlon Aguirre  17 , Roger Martín Correa  18 , Hoover O León-Giraldo  2 , Andrea Alejandra Arteaga-Tobar  2 , Juan Esteban Gómez-Mesa  1   2   3
Affiliations

Pre-Existing Atrial Fibrillation in Hospitalized Patients with COVID-19: Insights from the CARDIO COVID 19-20 Registry

Wikler Bernal Torres et al. J Cardiovasc Dev Dis. .

Abstract

Pre-existing (chronic) atrial fibrillation (AF) has been identified as a risk factor for cardiovascular complications and mortality in patients with COVID-19; however, evidence in Latin America (LATAM) is scarce. This prospective and multicenter study from the CARDIO COVID 19-20 database includes hospitalized adults with COVID-19 from 14 countries in LATAM. A parsimonious logistic regression model was used to identify the main factors associated with mortality in a simulated case-control setting comparing patients with a history of AF to those without. In total, 3260 patients were included, of which 115 had AF. The AF group was older, had a higher prevalence of comorbidities, and had greater use of cardiovascular medications. In the model, AF, chronic kidney disease, and a respiratory rate > 25 at admission were associated with higher in-hospital mortality. The use of corticosteroids did not reach statistical significance; however, an effect was seen through the confidence interval. Thus, pre-existing AF increases mortality risk irrespective of other concomitant factors. Chronic kidney disease and a high respiratory rate at admission are also key factors for in-hospital mortality. These findings highlight the importance of comorbidities and regional characteristics in COVID-19 outcomes, in this instance, enhancing the evidence for patients from LATAM.

Keywords: COVID-19; arrhythmia; atrial fibrillation; mortality; risk factors.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the case-control study simulation for logistic regression modeling.
Figure 2
Figure 2
Forrest plot of clinical variables associated with in-hospital mortality. This graph displays a Forest plot of factors associated with in-hospital mortality from COVID-19, obtained through a regression model. The adjusted odds ratios (OR) for each factor are shown above the corresponding lines, with confidence intervals presented within brackets. Bpm: breaths per minute.
See this image and copyright information in PMC

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