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INCIDENCE AND PROGNOSTIC IMPACT OF NEW-ONSET ATRIAL FIBRILLATION IN PATIENTS WITH SEVERE COVID-19: A RETROSPECTIVE COHORT STUDY
  • Vijayabharathy Kanthasamy,
  • Richard Schilling
Vijayabharathy Kanthasamy
St Bartholomew's Hospital
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Richard Schilling
Barts and The London NHS Trust

Corresponding Author:richard.schilling@nhs.net

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Abstract

Background Corona virus disease 2019 (COVID-19) contributes to cardiovascular complications including arrhythmias due to high inflammatory surge. Nevertheless, the common types of arrhythmia amongst severe COVID-19 is not well described. New onset atrial fibrillation (NOAF) is frequently seen in critically ill patients and therefore we aim to assess the incidence of NOAF in severe COVID -19 and its association with prognosis. Methods This is a retrospective multicentre study including 109 consecutive patients admitted to intensive care units (ICU) with confirmed COVID-19 pneumonia and definitive outcome (death or discharge). The study period was between 11th March and 5th May 2020. Results Median age of our population was 59 years (IQR 53-65) and 83% were men. Nearly three-fourth of the population had two or more comorbidities. 14.6% developed NOAF during ICU stay with increased risk amongst older age and with underlying chronic heart failure and chronic kidney disease. NOAF developed earlier during the course of severe COVID-19 infection amongst non-survivors than those survived the illness and strongly associated with increased in-hospital death (OR 5.4; 95% CI 1.7-17; p=0.004). Conclusion In our cohort with severe COVID-19, the incidence of new onset atrial fibrillation is comparatively lower than patients treated in ICU with severe sepsis in general. Presence of NOAF has shown to be a poor prognostic marker in this disease entity.