Abstract 15403: New-onset Atrial Fibrillation is Infrequent in Acute COVID-19 but Maybe Associated With Worse Outcomes

Abstract

Introduction: The COVID-19 has reached pandemic status with significant morbidity and mortality including cardiovascular complications. Systemic inflammation caused by the COVID-19 infection has been associated with an intense release of multiple cytokines which directly cause myocardial injury. New-onset atrial fibrillation (noAF) is a common consequence of systemic inflammation in bacterial pneumonia as well as influenza and has been shown to have independently poorer outcomes. Hypothesis: We sought to determine the incidence and significance of noAF in patients with confirmed COVID-19 infection. Methods: We prospectively studied patients with acute COVID-19 infection admitted to our referral center between March and May 2020. Data of demographics, clinical features, comorbidities and complications were collected. Cardiac rhythms were observed using 12-lead electrocardiogram and continuous telemetry. Results: Total 62 patients were followed. The end-point included incidence of any episode of AF, cardiovascular death and total mortality. Mean age was 66 ±17 years, 56% were males, 37 patients without history of cardiac disease, 25 patients with documented cardiac disease including 31% of coronary artery disease (CAD), 28% of congestive heart failure (CHF), 11% of history of prior atrial fibrillation (hoAF). Four (6.5%) patients manifested noAF during hospitalization (95% CI, 1.8, 16). There was a significant difference in mortality between patients with and without cardiac diseases (P = 0.02) (Table). All patients with noAF required ventilation support and had significantly higher mortality compared to patients without cardiac disease (P < 0.05) (Figure). Conclusions: New-onset AF was infrequently observed, however was associated with a poorer prognosis for hospitalized patients with acute COVID-19 infection. Larger studies are needed to confirm these findings as well as identify measures of AF prevention in this population. Download figure