Bernal Torres Wikler, Arango-Ibanez Juan Pablo, Montero Echeverri Juan Manuel, Posso Marín Santiago, Alvarado Armando, Ulate Andrés, Oliver Paola, Criollo Ivan, Yabar Galindo Wilbert German, Sandoval Sylvia, Millán Orozco William, Verdugo Thomas Fernando, Appiani Florit Franco, Buitrago Andrés, Christen Alejandra Ines, Morr Igor, Passos Luiz Carlos Santana, Aguirre Marlon, Correa Roger Martín, León-Giraldo Hoover O, Arteaga-Tobar Andrea Alejandra, Gómez-Mesa Juan Esteban
Fundación Valle del Lili, Departamento de Cardiología, Cali 760032, Colombia.
Facultad de Ciencias de la Salud, Universidad Icesi, Cali 760032, Colombia.
J Cardiovasc Dev Dis. 2024 Jul 4;11(7):210. doi: 10.3390/jcdd11070210.
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.
既往（慢性）心房颤动（AF）已被确定为新型冠状病毒肺炎（COVID-19）患者发生心血管并发症和死亡的危险因素；然而，拉丁美洲（LATAM）的相关证据却很匮乏。这项来自CARDIO COVID 19 - 20数据库的前瞻性多中心研究纳入了拉丁美洲14个国家因COVID-19住院的成年人。在模拟病例对照研究中，使用简约逻辑回归模型来确定与死亡率相关的主要因素，比较有AF病史的患者和无AF病史的患者。总共纳入了3260例患者，其中115例有AF。AF组患者年龄更大，合并症患病率更高，心血管药物使用更多。在该模型中，AF、慢性肾脏病以及入院时呼吸频率>25次/分钟与住院死亡率较高相关。使用糖皮质激素未达到统计学意义；然而，通过置信区间可以看出存在一定影响。因此，无论其他伴随因素如何，既往AF都会增加死亡风险。慢性肾脏病和入院时呼吸频率高也是住院死亡的关键因素。这些发现凸显了合并症和区域特征在COVID-19预后中的重要性，在此例中，为来自拉丁美洲的患者提供了更多证据。
