Mortality risk factors in patients with SARS-CoV-2 infection and atrial fibrillation: Data from the SEMI-COVID-19

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Javier Azaña Gómez1, Luis M Pérez-Belmonte2, Manuel Rubio-Rivas3

  • 1Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain.

Medicina Clinica (English Ed.)
|October 24, 2022
PubMed

Insights

Patients with atrial fibrillation (AF) admitted for COVID-19 faced high mortality. Direct oral anticoagulants (DOACs) showed a protective effect against death in these patients, warranting further investigation.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Atrial fibrillation (AF) is a significant risk factor for mortality and complications in COVID-19 patients.
  • Understanding the characteristics and outcomes of COVID-19 patients with AF is crucial for improving patient care.

Purpose of the Study:

  • To characterize the clinical, epidemiological, radiological, and analytical features of hospitalized COVID-19 patients with AF in Spain.
  • To identify factors associated with mortality and poor prognosis in this patient group.

Main Methods:

  • A retrospective, observational, multicenter study was conducted using data from the SEMI-COVID-19 Registry.
  • Data from 1,816 patients with a history of AF, hospitalized between March 1 and October 1, 2020, were analyzed.

Main Results:

  • The mortality rate among COVID-19 patients with AF was 41% (738 deaths).
  • Deceased patients exhibited higher heart rates, increased respiratory failure, and tachypnea.
  • Comorbidities like age, hypertension, and diabetes with target organ involvement were more prevalent in non-survivors.
  • Multivariate analysis indicated that direct oral anticoagulant (DOAC) treatment had a protective role against mortality (OR: 0.597).

Conclusions:

  • Direct oral anticoagulants (DOACs), both prior to and during admission, may offer a protective effect for COVID-19 patients with AF.
  • Further prospective studies are needed to confirm the protective role of DOACs in this population.
Abstract

Keywords:
AnticoagulationAtrial fibrillationCOVID-2019HospitalizationMortalityRisk factor

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