A systematic review and meta-analysis of new-onset atrial fibrillation
in the context of COVID-19
Abstract
Background: New-onset atrial fibrillation (NOAF) in COVID-19
raises significant clinical and public health issues. This systematic
review and meta-analysis aims to compile and analyze the current
literature on NOAF in COVID-19 and give a more comprehensive
understanding of the prevalence and outcomes of NOAF in COVID-19.
Methods: A comprehensive literature search was carried out
using several databases. The random effect model using inverse variance
method and DerSimonian and Laird estimator of Tua2 was used to calculate
the pooled prevalence and associated 95% confidence interval (CI).
Results for outcome analysis were presented as odds ratios (ORs) with
95% CI and pooled using the Mantel-Haenszel random-effects model.
Results: The pooled prevalence of NOAF in COVID-19 was 7.8%
(95% CI, 6.54% to 9.32%), pooled estimate from 30 articles (81,929
COVID-19 patients). Furthermore, our analysis reported that COVID-19
patients with NOAF had a higher risk of developing severe disease
compared with COVID–19 patients without a history of atrial
fibrillation (OR= 4.78, 95% CI 3.75 to 6.09) and COVID-19 patients with
a history of pre-existing atrial fibrillation (OR= 2.75, 95% CI 2.10 to
3.59) . Similarly, our analysis also indicated that COVID–19 patients
with NOAF had a higher risk of all-cause mortality compared with,
COVID–19 patients without a history of atrial fibrillation (OOR= 3.83,
95% CI 2.99 to 4.92) and COVID-19 patients with a history of
pre-existing atrial fibrillation (OR= 2.32, 95% CI 1.35 to 3.96). The
meta-analysis did not reveal any significant publication bias.
Conclusion: The results of the current meta-analysis a high
prevalence rate of NOAF among COVID-19 patients. Further the study
reported higher disease severity with NOAF compared with COVID-19
patients without a history of atrial fibrillation and with a history of
atrial fibrillation.