Servicio de Medicina Interna, Hospital Clínico San Carlos; Universidad Complutense de Madrid; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, España.
Servicio de Medicina Interna, Hospital Regional Universitario de Málaga; Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, España.
Med Clin (Barc). 2022 Nov 25;159(10):457-464. doi: 10.1016/j.medcli.2022.01.008. Epub 2022 Mar 10.
Atrial fibrillation and associated comorbidities pose a risk factor for mortality, morbidity and development of complications in patients admitted for COVID-19.
To describe the clinical, epidemiological, radiological and analytical characteristics of patients with atrial fibrillation admitted for COVID-19 in Spain. Secondarily, we aim to identify those variables associated with mortality and poor prognosis of COVID-19 in patients with atrial fibrillation.
Retrospective, observational, multicenter, nationwide, retrospective study of patients hospitalized for COVID-19 from March 1 to October 1, 2020. Data were obtained from the SEMI-COVID-19 Registry of the Spanish Society of Internal Medicine (SEMI) in which 150 Spanish hospitals participate.
Between March 1 and October 1, 2020, data from a total of 16,461 patients were entered into the SEMI-COVID-19 registry. 1816 (11%) had a history of atrial fibrillation and the number of deaths among AF patients amounted to 738 (41%). Regarding clinical characteristics, deceased patients were admitted with a higher heart rate (88.38 vs. 84.95; P>0.01), with a higher percentage of respiratory failure (67.2 vs. 20.1%; P<0.01) and high tachypnea (58 vs. 30%; P<0.01). The comorbidities that presented statistically significant differences in the deceased group were: age, hypertension and diabetes with target organ involvement. There was also a higher prevalence of a history of cardiovascular disease in the deceased. On multivariate analysis, DOACs treatment had a protective role for mortality (OR: 0.597; CI: 0.402-0.888; P=0.011).
Previous treatment with DOACs and DOACs treatment during admission seem to have a protective role in patients with atrial fibrillation, although this fact should be verified in prospective studies.
心房颤动及相关合并症是导致 COVID-19 住院患者死亡、发病和并发症发生的危险因素。
描述西班牙因 COVID-19 住院的心房颤动患者的临床、流行病学、影像学和实验室特征。其次，我们旨在确定与心房颤动患者 COVID-19 死亡率和不良预后相关的变量。
这是一项回顾性、观察性、多中心、全国性的回顾性研究，纳入 2020 年 3 月 1 日至 10 月 1 日期间因 COVID-19 住院的患者。数据来自西班牙内科学会（SEM）的 SEMI-COVID-19 登记处，该登记处有 150 家西班牙医院参与。
2020 年 3 月 1 日至 10 月 1 日期间，共有 16461 例患者进入 SEMI-COVID-19 登记处。其中 1816 例（11%）有心房颤动病史，心房颤动患者死亡人数为 738 例（41%）。在临床特征方面，死亡患者的心率更高（88.38 比 84.95；P>0.01），呼吸衰竭的比例更高（67.2 比 20.1%；P<0.01）和高呼吸急促（58 比 30%；P<0.01）。死亡组中统计学上有显著差异的合并症包括：年龄、高血压和糖尿病伴靶器官受累。死亡组中也有更高的心血管疾病史。多变量分析显示，直接口服抗凝剂（DOAC）治疗对死亡率有保护作用（OR：0.597；95%CI：0.402-0.888；P=0.011）。
DOAC 治疗和住院期间 DOAC 治疗似乎对心房颤动患者具有保护作用，但这一事实应在前瞻性研究中得到验证。
