INCIDENCE AND PROGNOSTIC IMPACT OF NEW-ONSET ATRIAL FIBRILLATION IN
PATIENTS WITH SEVERE COVID-19: A RETROSPECTIVE COHORT STUDY
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.