Cardiology Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli"-Monaldi Hospital, 80131 Naples, Italy.
Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy.
Medicina (Kaunas). 2022 Mar 7;58(3):399. doi: 10.3390/medicina58030399.
Background and objectives: Pre-existing atrial fibrillation (AF) is a frequent comorbidity in hospitalized patients with COVID-19; however, little is still known about its prognostic role in infected patients. The aim of our study was to evaluate whether the pre-existing AF as comorbidity would contribute to increase the risk for severe forms of COVID-19, worse prognosis, or even higher mortality. Materials and Methods: We retrospectively evaluated all consecutive COVID-19 patients admitted to the emergency department of nine Italian Hospitals from 1 March to 30 April 2020.The prevalence and the type of pre-existing AF have been collected. The correlation between the history and type of AF and the development of severe ARDS and in-hospital mortality has been evaluated. Results: In total, 467 patients (66.88 ± 14.55 years; 63% males) with COVID-19 were included in the present study. The history of AF was noticed in 122 cases (26.1%), of which 12 (2.6%) with paroxysmal, 57 (12.2%) with persistent and 53 (11.3%) with permanent AF. Among our study population, COVID-19 patients with AF history were older compared to those without AF history (71.25 ± 12.39 vs. 65.34 ± 14.95 years; p < 0.001); however, they did not show a statistically significant difference in cardiovascular comorbidities or treatments. Pre-existing AF resulted in being independently associated with an increased risk of developing severe ARDS during the hospitalization; in contrast, it did not increase the risk of in-hospital mortality. Among patients with AF history, no significant differences were detected in severe ARDS and in-hospital mortality between patients with permanent and non-permanent AF history. Conclusions: Pre-existing AF is a frequent among COVID-19 patients admitted to hospital, accounting up to 25% of cases. It is independently associated with an increased risk of severe ARDS in hospitalized COVID-19 patients; in contrast, it did not affect the risk of death. The type of pre-existing AF (permanent or non-permanent) did not impact the clinical outcome.
在患有 COVID-19 的住院患者中，预先存在的心房颤动（AF）是一种常见的合并症；然而，对于感染患者，其预后作用仍知之甚少。我们的研究目的是评估预先存在的 AF 作为合并症是否会增加 COVID-19 患者出现严重疾病、预后较差甚至更高死亡率的风险。材料与方法：我们回顾性评估了 2020 年 3 月 1 日至 4 月 30 日期间，来自意大利 9 家医院急诊科收治的所有连续 COVID-19 患者。收集预先存在的 AF 的患病率和类型。评估 AF 病史和类型与严重急性呼吸窘迫综合征（ARDS）和院内死亡率之间的相关性。结果：本研究共纳入 467 例 COVID-19 患者（66.88 ± 14.55 岁；63%为男性）。122 例（26.1%）患者有 AF 病史，其中 12 例（2.6%）为阵发性，57 例（12.2%）为持续性，53 例（11.3%）为永久性。在我们的研究人群中，有 AF 病史的 COVID-19 患者比没有 AF 病史的患者年龄更大（71.25 ± 12.39 岁 vs. 65.34 ± 14.95 岁；p < 0.001）；然而，他们在心血管合并症或治疗方面没有统计学上的显著差异。预先存在的 AF 与住院期间发生严重 ARDS 的风险增加独立相关；相反，它并未增加院内死亡率的风险。在有 AF 病史的患者中，永久性和非永久性 AF 病史的患者在严重 ARDS 和院内死亡率方面没有差异。结论：预先存在的 AF 在住院 COVID-19 患者中很常见，占病例的 25%。它与住院 COVID-19 患者发生严重 ARDS 的风险增加独立相关；相反，它不会影响死亡风险。预先存在的 AF 的类型（永久性或非永久性）不会影响临床结局。
