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Published on: February 26, 2013
Pre-Existing Atrial Fibrillation in Hospitalized Patients with COVID-19: Insights from the CARDIO COVID 19-20
Wikler Bernal Torres1,2, Juan Pablo Arango-Ibanez3, Juan Manuel Montero Echeverri3
1Fundación Valle del Lili, Departamento de Cardiología, Cali 760032, Colombia.
Insights
Pre-existing atrial fibrillation (AF) increases COVID-19 mortality risk in Latin America. Chronic kidney disease and high respiratory rate also significantly elevate mortality risk for hospitalized patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Pre-existing atrial fibrillation (AF) is a known risk factor for cardiovascular complications and mortality in COVID-19 patients.
- Evidence regarding AF's impact on COVID-19 outcomes in Latin America (LATAM) is limited.
Purpose of the Study:
- To investigate the association between pre-existing AF and in-hospital mortality among COVID-19 patients in LATAM.
- To identify other key factors contributing to mortality in this population.
Main Methods:
- Prospective, multicenter study utilizing the CARDIO COVID 19-20 database.
- Inclusion of hospitalized adult COVID-19 patients from 14 LATAM countries.
- Logistic regression analysis in a case-control setting comparing patients with and without AF.
Main Results:
- 115 out of 3260 patients had a history of AF. The AF group was older, had more comorbidities, and used more cardiovascular medications.
- Atrial fibrillation, chronic kidney disease, and respiratory rate > 25 at admission were independently associated with increased in-hospital mortality.
- Corticosteroid use showed a trend towards significance but did not reach statistical significance.
Conclusions:
- Pre-existing atrial fibrillation is a significant independent risk factor for in-hospital mortality in COVID-19 patients in LATAM.
- Chronic kidney disease and elevated respiratory rate at admission are critical factors influencing COVID-19 mortality.
- Findings underscore the importance of comorbidities and regional factors in COVID-19 outcomes, particularly for the LATAM population.
Abstract:
Pre-existing (chronic) atrial fibrillation (AF) has been identified as a risk factor for cardiovascular complications and mortality in patients with COVID-19; however, evidence in Latin America (LATAM) is scarce. This prospective and multicenter study from the CARDIO COVID 19-20 database includes hospitalized adults with COVID-19 from 14 countries in LATAM. A parsimonious logistic regression model was used to identify the main factors associated with mortality in a simulated case-control setting comparing patients with a history of AF to those without. In total, 3260 patients were included, of which 115 had AF. The AF group was older, had a higher prevalence of comorbidities, and had greater use of cardiovascular medications. In the model, AF, chronic kidney disease, and a respiratory rate > 25 at admission were associated with higher in-hospital mortality. The use of corticosteroids did not reach statistical significance; however, an effect was seen through the confidence interval. Thus, pre-existing AF increases mortality risk irrespective of other concomitant factors. Chronic kidney disease and a high respiratory rate at admission are also key factors for in-hospital mortality. These findings highlight the importance of comorbidities and regional characteristics in COVID-19 outcomes, in this instance, enhancing the evidence for patients from LATAM.
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