Key result
Cardiorespiratory comorbidity of COPD and atrial fibrillation leads to mutual worsening of the clinical course due to shared pathogenetic links like hypoxia and systemic inflammation, which are further exacerbated during the COVID-19 pandemic.
Why the study?
Patients with comorbid COPD and cardiovascular disease face high risk of adverse outcomes, and shared pathophysiology with COVID-19 complicates diagnosis and rational treatment.
COPD and AF share pathophysiological mechanisms such as systemic inflammation and hypoxia that mutually exacerbate their clinical course and worsen prognosis, particularly during the COVID-19 pandemic.
Comorbid COPD-AF may worsen prognosis in COVID-19; leaves open need for prospective studies on shared pathogenesis and management.
Background: Atrial fibrillation (AF) is observed in arterial hypertension, heart failure, ischemic heart disease, and pulmonary pathology, particularly, chronic obstructive pulmonary disease (COPD). COPD in turn is a risk factor for developing these cardiovascular diseases and various arrhythmias. In the coronavirus disease (COVID) situation, such comorbid patients are the most vulnerable group with a high risk of adverse outcomes. The relevance of the relationship between COPD and coronavirus infection is explained by the similarity of clinical and pathophysiological manifestations, creating more difficulties in diagnosing and determining rational treatment. The aim of the current study is to explore the role COPD plays in the onset and progression of AF, especially in the situation of COVID-19. Methods: We searched PubMed databases and included studies with information on comorbid patients suffering from COPD and AF, as well as similar patients in the context of COVID-19. Results: A modern view on the problem of comorbidity of COPD and AF is presented. In the presence of cardiorespiratory comorbidity, symptoms of mutual worsening of the clinical course are observed, due to the commonality of some links of pathogenesis, including hypoxia, hemodynamic disturbances, activation of the sympathoadrenal system, systemic inflammation, and development of fibrosis, leading to myocardial remodeling, a decrease in the effectiveness of the therapy, and a worsening prognosis, especially in the context of COVID-19. Conclusions: The results of a study of the features of the pathogenesis and course of AF in COPD are presented, as well as the formation and progression of this comorbid pathology in the context of the COVID-19 pandemic.
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Hazarapetyan et al. (2023) conducted a review in Atrial Fibrillation and Chronic Obstructive Pulmonary Disease. Chronic Obstructive Pulmonary Disease and COVID-19 was evaluated. Cardiorespiratory comorbidity of COPD and atrial fibrillation leads to mutual worsening of the clinical course due to shared pathogenetic links like hypoxia and systemic inflammation, which are further exacerbated during the COVID-19 pandemic.
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