New-Onset Atrial Arrhythmias Predict Mortality in Black and White
Patients Hospitalized with COVID-19
Abstract
Background: Specific details about cardiovascular complications,
especially arrhythmias, related to COVID-19 are not well described.
Objective: We sought to evaluate the incidence and predictive factors of
cardiovascular complications and new-onset arrhythmias in Black and
White hospitalized COVID-19 patients and determine the impact of
new-onset arrhythmia on outcomes. Methods: We collected and analyzed
baseline demographic and clinical data from COVID-19 patients
hospitalized at the Tulane Medical Center in New Orleans, Louisiana,
between March 1st and May 1st, 2020. Results: Among 310 hospitalized
COVID-19 patients, the mean age was 61.4 ± 16.5 years, with 58,7%
females, and 67% Black patients. Black patients were more likely to be
younger, have diabetes and obesity . The incidence of cardiac
complications was 20%, with 9% of patients having new-onset
arrhythmia. There was no significant difference in cardiovascular
outcomes between Black and White patients. D-dimer levels positively
correlated with cardiac and new-onset arrhythmic event . New onset
atrial arrhythmias predicted in-hospital mortality (OR=2.99 95% CI
[1.35;6.63], p=0.007), a longer intensive care unit length of stay
(mean of 6.14 days, 95% CI [2.51;9.77], p=0.001) and mechanical
ventilation duration(mean of 9.08 days, 95% CI [3.75;14.40],
p=0.001). Conclusion: Our results indicate that new onset atrial
arrhythmias are commonly encountered in COVID-19 patients and can
predict in-hospital mortality. Early elevation in D-dimer in COVID-19
patients is a significant predictor of new onset arrhythmias. Our
finding suggest continuous rhythm monitoring should be adopted in this
patient population during hospitalization to better risk stratify
hospitalized patients and prompt earlier intervention.