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?:abstract
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INTRODUCTION: The impact of atrial arrhythmias on COVID-19-associated outcomes are unclear We sought to identify prevalence, risk factors and outcomes associated with atrial arrhythmias among patients hospitalized with COVID-19 METHODS: An observational cohort study of 1053 patients with SARS-CoV2 infection admitted to a quaternary care hospital and a community hospital was conducted Data from electrocardiographic and telemetry were collected to identify atrial fibrillation (AF) or atrial flutter/tachycardia (AFL) The association between atrial arrhythmias and 30-day mortality was assessed with multivariable analysis RESULTS: Mean age of patients was 62 ± 17 years and 62% were men Atrial arrhythmias were identified in 166 (15 8%) patients, with AF in 154 (14 6%) patients and AFL in 40 (3 8%) patients Newly detected atrial arrhythmias occurred in 101 (9 6%) patients Age, male sex, prior AF, renal disease, and hypoxia on presentation were independently associated with AF/AFL occurrence Compared to patients without AF/AFL, patients with AF/AFL had significantly higher levels of troponin, B-type natriuretic peptide, C-reactive protein, ferritin and D-dimer Mortality was significantly higher among patients with AF/AFL (39 2%) compared to patients without (13 4%;P<0 001) After adjustment for age and co-morbidities, AF/AFL (adjusted OR 1 93;P = 0 007) and newly detected AF/AFL (adjusted OR 2 87;P <0 001) were independently associated with 30-day mortality CONCLUSIONS: Atrial arrhythmias are common among patients hospitalized with COVID-19 The presence of AF/AFL tracked with markers of inflammation and cardiac injury Atrial arrhythmias were independently associated with increased mortality This article is protected by copyright All rights reserved
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