Atrial Fibrillation Risks in Patients with COVID-19 Pneumonia

Recent evidence suggests that atrial fibrillation (AF) has an epidemiological association with coronavirus virus disease 2019 (COVID-19), but the outcomes of AF in patients with COVID-19 is unclear. Ming-Yue Chen, MD, from the Department of Geriatrics at the Second Affiliated Hospital of Nanjing Medical University in Nanjing, China, and colleagues aimed to describe the full impact of AF on the prognosis and risks of patients with COVID-19 pneumonia.

Researchers reviewed a total of 36 studies and calculated pooled odds ratios (ORs) and 95% confidence intervals (CIs) to define the associations between AF, both preexisting and newly presenting cases, and the primary endpoints of in–hospital mortality, post–discharge mortality, and ventilator use.

Patients with preexisting AF and COVID-19 had increased in–hospital mortality (pooled OR = 2.07; 95% CI, 1.60–2.67; p <0.001), post–discharge mortality (pooled OR = 2.69; 95% CI, 1.24–5.83; p <0.05), and ventilator utilization (pooled OR = 4.53; 95% CI, 1.33–15.38; p <0.05). Comparatively, new–onset AF during severe acute respiratory syndrome coronavirus 2 infection was significantly associated with increased mortality (pooled OR = 2.38; 95% CI, 2.04–2.77; p <0.001).

Dr. Chen and colleagues judged that the presence of AF, preexisting and new–onset, was correlated with adverse outcomes and higher mortality in patients with COVID-19 pneumonia, which they advised “deserves increased attention and should be managed appropriately to prevent adverse outcomes.”