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Published on: February 26, 2013
Atrial Fibrillation as a Predictor of Mortality in High Risk COVID-19 Patients: A Multicentre Study of 171 Patients
Randy J Ip1, Abbas Ali2, Zulfiqar Qutrio Baloch3
1Division of Cardiovascular Medicine, Ascension Macomb, Warren, MI, USA.
Insights
Critically ill COVID-19 patients have high mortality. Atrial fibrillation is linked to increased mortality in these patients, suggesting early treatment for those with this condition may improve outcomes.
Area of Science:
- Critical care medicine
- Infectious diseases
- Cardiology
Background:
- Predictors of survival in COVID-19 patients are being investigated.
- Understanding outcomes in critically ill COVID-19 patients remains a challenge.
Purpose of the Study:
- To identify predictors of mortality in critically ill patients with COVID-19.
- To explore the relationship between cardiovascular conditions and COVID-19 outcomes.
Main Methods:
- Multicenter analysis of 171 intensive care unit (ICU) patients with confirmed COVID-19.
- Data collected included demographics, medical history, laboratory values, and cardiac monitoring.
- Patient outcomes were tracked until hospital discharge or end of follow-up.
Main Results:
- The study cohort had a mean age of 66 years, with 57% males.
- Overall mortality in the ICU cohort was 46.2%.
- Atrial fibrillation was identified as a significant predictor of increased mortality (Odds Ratio 4.8, p=0.004).
Conclusions:
- Critically ill COVID-19 patients face a high risk of mortality.
- A significant association exists between atrial fibrillation and increased mortality in COVID-19.
- Aggressive early management for high-risk patients, including those with atrial fibrillation, may enhance clinical outcomes.
Purpose:
Certain patient demographics and biomarkers have been suggested to predict survival in patients infected with COVID-19. However, predictors of outcome in patients who are critically ill are unclear.
Materials And Methods:
We performed a multicentre analysis of 171 consecutive patients with confirmed COVID-19 who were admitted to the intensive care unit (ICU) between 1 March 2020 and 30 April 2020 and were followed until 23 May 2020. Demographic data, past medical history, laboratory values, echocardiographic and telemetry data were analysed. Patient status was classified as either alive or deceased at hospital discharge or the end of follow-up period.
Results:
Mean patient age was 66±13 and 57% were male. Mortality rate of this ICU cohort at the end of follow-up was 46.2%. A multivariable logistic regression analysis identified the presence or history of atrial fibrillation (Odds Ratio 4.8, p=0.004) as a significant cardiovascular attribute that contributed to increased mortality.
Conclusion:
Mortality of critically ill COVID-19 patients is high. This study suggests a relationship between atrial fibrillation and increased mortality from COVID-19. Early aggressive treatment patients with high risk characteristics, such as atrial fibrillation could improve clinical outcome.
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