Causal associations between COVID-19 and atrial fibrillation: A bidirectional Mendelian randomization study

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Xiaoyu Zhang1, Biyan Wang2, Tao Geng3

  • 1Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.

Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
|January 28, 2022
PubMed

Insights

This study found no causal link between COVID-19 infection and atrial fibrillation (AF) risk. Mendelian randomization analysis confirmed no significant association in either direction, suggesting COVID-19 does not cause AF.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Genetics

Background:

  • Observational studies indicate COVID-19 disproportionately affects the elderly with cardiovascular disease (CVD).
  • The potential causal relationship between COVID-19 and atrial fibrillation (AF) susceptibility is not well understood.
  • Existing research highlights the vulnerability of elderly individuals with CVD to severe COVID-19 outcomes.

Purpose of the Study:

  • To investigate the bidirectional causal relationship between COVID-19 infection severity and the risk of developing atrial fibrillation (AF).
  • To determine if COVID-19 causally influences AF susceptibility or if AF increases the risk of severe COVID-19.
  • To utilize Mendelian randomization to explore genetic predispositions linking COVID-19 and AF.

Main Methods:

  • Employed a two-sample Mendelian randomization (MR) analysis to assess the causal effects.
  • Utilized genetic variants associated with COVID-19 and AF as instrumental variables.
  • Performed MR-Egger regression to test for directional pleiotropy and assess the robustness of findings.

Main Results:

  • Genetically predicted severe COVID-19 showed no significant association with the risk of AF (OR, 1.037; P=0.023).
  • Genetically predicted AF was not causally associated with severe COVID-19 (OR, 0.993; P=0.905).
  • No significant causal associations were found between general COVID-19 and AF, or hospitalized COVID-19 and AF.

Conclusions:

  • This Mendelian randomization study found no clear evidence supporting a causal association between COVID-19 and the risk of atrial fibrillation.
  • The findings suggest that COVID-19 infection is unlikely to be a direct cause of AF.
  • Further research may be needed to explore other potential indirect links or confounding factors.
Abstract

Keywords:
Atrial fibrillationBidirectional Mendelian randomizationCoronavirus disease 2019

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