Impact of New Onset Atrial Fibrillation in Hospitalized Patients with COVID-19. Results of the “ACO-VID” Registry

• Published in: Clinical and applied thrombosis/hemostasis Vol. 29; p. 10760296231208440
• Main Authors: Cerezo Manchado, Juan José, Iturbe Hernández, Teodoro, Martínez Pacheco, María del Carmen, Gil Ortega, Ignacio, Campoy, Desirée, Canals Pernas, Tania, Martinez Serra, Laia, Flores Aparco, Katia Jessica, Velasquez Escandon, Cesar Andres, García de Guadiana-Romualdo, Luis, Martinez Frances, Antonio, Olivera, Pavel
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2023; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Anticoagulants; Anticoagulants - adverse effects; Atrial Fibrillation - complications; Atrial Fibrillation - drug therapy; Cardiac arrhythmia; Coronaviruses; COVID-19; COVID-19 - complications; Hemorrhage - chemically induced; Hospitalization; Humans; Original Manuscript; Registries; Retrospective Studies; Risk Factors; Stroke - drug therapy; COVID-19; low molecular weight heparin; atrial fibrillation; direct oral anticoagulant; anticoagulation
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/10760296231208440

Objective To assess the impact of new-onset atrial fibrillation (AF) on patients hospitalized with coronavirus disease 2019 (COVID-19). Methods Multicenter and retrospective study that included subjects >55 years hospitalized with COVID-19 from March to October 2020 in Spanish hospitals. Patients were divided into 3 groups (no AF, new-onset AF, and preexisting AF) and followed-up to 90 days. Results A total of 668 patients were included, of whom 162 (24.3%) had no AF, 107 (16.0%) new-onset AF and 399 (59.7%) preexisting AF. Compared to patients without AF, those patients with new-onset AF were older and had more comorbidities, but without differences with preexisting AF. During hospitalization, in the univariate analysis, compared to patients without AF, major bleeding and cardiovascular mortality were more frequent in patients with new-onset AF (10.3% vs 0.6%; P < .001; 2.8% vs 0.6%; P = .025, respectively), with a trend toward more stroke (1.9% vs 0%; P = .085). Outcomes were similar between AF groups, but the length of stay was greater in preexisting AF patients. Among patients with new-onset AF taking reduced doses of anticoagulant treatment was associated with higher risks of stroke and major bleeding. Conclusions In COVID-19 hospitalized patients, new-onset AF may be associated with worse outcomes, but influenced by the dose of anticoagulants.