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COVID-19 增加了住院患者发生心房颤动的风险。

COVID-19 increases the risk for the onset of atrial fibrillation in hospitalized patients.

机构信息

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.

出版信息

Sci Rep. 2022 Jul 14;12(1):12014. doi: 10.1038/s41598-022-16113-6.

Abstract

COVID-19 is associated with significant extrapulmonary symptoms. Myocardial involvement has been described for infections with SARS-CoV-2 which may lead to an increase in morbidity and mortality. The objective of our study was to investigate the association of COVID-19 and atrial fibrillation (AF) or atrial flutter (AFl) in hospitalized patients. This retrospective study used electronic medical records to detect patients with COVID-19 and their comorbidities within the Mass General Brigham hospital system. All patients ≥ 18 years who were hospitalized and received a PCR test for SARS-CoV-2 were screened for inclusion as well as patients from a pre-pandemic cohort. We matched on common risk factors for AF and then used multivariable logistic regression to estimate the odds for AF or AFl. Of 78,725 patients eligible for analysis, 11,004 COVID-19 negative patients were matched to 3,090 COVID-19 positive patients and 5005 pre-pandemic patients were matched to 2283 COVID-19 positive patients. After adjusting for demographics and comorbidities, COVID-19 positive patients had 1.19 times the odds (95% CI 1.00, 1.41) of developing AF compared to COVID-19 negative patients and 1.57 times the odds (95% CI 1.23, 2.00) of developing AF compared to pre-pandemic patients. Our study demonstrated an increased risk for AF, directing the attention for improved screening and treatment regimens for the sequelae of COVID-19. While COVID-19 continues to affect many people around the world, AF may be a significant cause for morbidity and mortality. Adequate detection and treatment of AF is essential to reduce the burden of disease.

摘要

COVID-19 与显著的肺外症状有关。已描述了 SARS-CoV-2 感染引起的心肌受累,这可能导致发病率和死亡率增加。我们的研究目的是调查 COVID-19 与住院患者心房颤动(AF)或心房扑动(AFl)的关联。这项回顾性研究使用电子病历在麻省总医院系统中检测 COVID-19 患者及其合并症。筛选了≥18 岁的住院患者,这些患者接受了 SARS-CoV-2 的 PCR 检测,并纳入了来自大流行前队列的患者。我们对 AF 的常见危险因素进行了匹配,然后使用多变量逻辑回归来估计 AF 或 AFl 的几率。在 78725 名符合条件的患者中,11004 名 COVID-19 阴性患者与 3090 名 COVID-19 阳性患者相匹配,5005 名大流行前患者与 2283 名 COVID-19 阳性患者相匹配。在调整了人口统计学和合并症后,COVID-19 阳性患者发生 AF 的几率是 COVID-19 阴性患者的 1.19 倍(95%CI 1.00,1.41),与大流行前患者相比,发生 AF 的几率是 1.57 倍(95%CI 1.23,2.00)。我们的研究表明,AF 的风险增加,这引起了对 COVID-19 后遗症进行改善筛查和治疗方案的关注。虽然 COVID-19 仍在影响着世界各地的许多人,但 AF 可能是发病率和死亡率的重要原因。充分检测和治疗 AF 对于减轻疾病负担至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a6/9283476/347ff1b9592d/41598_2022_16113_Fig1_HTML.jpg

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