Long-Term Clinical Implications of Atrial Fibrillation on Mortality in Patients Hospitalized with COVID-19: A Nationwide Cohort Study

Background: Atrial fibrillation (AF) increases the risk of long-term mortality in patients hospitalized with Coronavirus Disease 2019 (COVID-19), but the evidence is limited. Methods: This study used data from the Common Data Model of the Health Insurance Review and Assessment Service of Korea collected between 1 January 2020 and 30 April 2022. A total of 107,247 patients hospitalized with COVID-19 were included in this study. They were divided into two groups according to a history of AF. The primary outcome was all-cause mortality. Results: After propensity score stratification, 1919 patients with a history of AF and 105,328 patients without a history of AF who were hospitalized with COVID-19 were analyzed to determine long-term mortality. The primary outcome occurred in 99 of 1919 patients (5.2%) with a history of AF and in 1397 of 105,328 patients (1.3%) without a history of AF (hazard ratio, 1.49; 95% confidence interval 1.20–1.82; p < 0.01). A history of AF was also associated with an increased risk of within 30-day mortality. Conclusion: A history of AF was associated with an increased risk of long-term mortality in patients hospitalized with COVID-19. Our findings indicate the necessity for physicians to reevaluate the optimal management of patients with AF following discharge.