Key result
Newly-detected atrial arrhythmias were independently associated with higher in-hospital mortality (RR 2.02) compared to normal sinus rhythm in hospitalized COVID-19 patients.
Why the study?
Atrial arrhythmias are common in hospitalized COVID-19 patients, but data on their association with COVID-19 infection, clinical, and imaging outcomes were limited.
Does new-onset or a history of atrial arrhythmias increase in-hospital mortality in hospitalized COVID-19 patients?
Cohort (n=21,101)
Yes
Does new-onset or a history of atrial arrhythmias increase in-hospital mortality in hospitalized COVID-19 patients?
In hospitalized COVID-19 patients, both new-onset and a history of atrial arrhythmias are independently associated with significantly higher in-hospital mortality compared to normal sinus rhythm.
Answers are grounded in this paper and cite their sources.
May warrant closer monitoring for new atrial arrhythmias in COVID-19 inpatients; leaves open whether they are causal or markers of severity.
Atrial arrhythmias (AA) are common in hospitalized COVID-19 patients with limited data on their association with COVID-19 infection, clinical and imaging outcomes. In the related research article using retrospective research data from one quaternary care and five community hospitals, patients aged 18 years and above with positive SARS-CoV-2 polymerase chain reaction test were included. 6927 patients met the inclusion criteria. The data in this article provides demographics, home medications, in-hospital events and COVID-19 treatments, multivariable generalized linear regression regression models using a log link with a Poisson distribution (multi-parameter regression [MPR]) to determine predictors of new-onset AA and mortality in COVID-19 patients, computerized tomography chest scan findings, echocardiographic findings, and International Classification of Diseases–Tenth Revision codes. The clinical outcomes were compared to a propensity-matched cohort of influenza patients. For influenza, data is reported on baseline demographics, comorbid conditions, and in-hospital events. Generalized linear regression models were built for COVID-19 patients using demographic characteristics, comorbid conditions, and presenting labs which were significantly different between the groups, and hypoxia in the emergency room. Statistical analysis was performed using R programming language (version 4, ggplot2 package). Multivariable generalized linear regression model showed that, relative to normal sinus rhythm, history of AA (adjusted relative risk [RR]: 1.38; 95% CI: 1.11–1.71; p = 0.003) and newly-detected AA (adjusted RR: 2.02 95% CI: 1.68–2.43; p < 0.001) were independently associated with higher in-hospital mortality. Age in increments of 10 years, male sex, White race, prior history of coronary artery disease, congestive heart failure, end-stage renal disease, presenting leukocytosis, hypermagnesemia, and hypomagnesemia were found to be independent predictors of new-onset AA in the MPR model. The dataset reported is related to the research article entitled “Incidence, Mortality, and Imaging Outcomes of Atrial Arrhythmias in COVID-19” [Jehangir et al. Incidence, Mortality, and Imaging Outcomes of Atrial Arrhythmias in COVID-19, American Journal of Cardiology] [1].
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Jehangir et al. (2022) conducted a cohort in COVID-19 and Influenza (n=21,101). New-onset atrial arrhythmias vs. Normal sinus rhythm was evaluated on In-hospital mortality (RR 2.02, 95% CI 1.68-2.43, p=<0.001). Newly-detected atrial arrhythmias were independently associated with higher in-hospital mortality (RR 2.02) compared to normal sinus rhythm in hospitalized COVID-19 patients.
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