Key result
COVID-19 with AF precipitates progressive heart failure, AKI, and severe pericardial tamponade.
Why the study?
Atrial fibrillation is common in elderly patients who are at high risk for COVID-19 morbidity and mortality, but its role as a risk factor for unfavorable outcomes in COVID-19 is unclear.
Does atrial fibrillation contribute to unfavourable outcomes in COVID-19 patients?
Case Report (n=1)
Does atrial fibrillation contribute to unfavourable outcomes in COVID-19 patients?
Atrial fibrillation exacerbation in COVID-19 can lead to severe haemodynamic deterioration and complex management challenges.
Alerts clinicians to monitor for fulminant cardiac events in elderly COVID-19 patients with AF; leaves open mechanistic insights and management strategies.
BACKGROUND: Fulminant cardiac involvement in COVID-19 patients has been reported; the underlying suspected mechanisms include myocarditis, arrhythmia, and cardiac tamponade. In parallel, atrial fibrillation is common in the elderly population which is at particularly high risk for COVID-19 morbidity and mortality. CASE SUMMARY: A 72-year-old male SARS-CoV2-positive patient was admitted to the intensive care unit due to delirium and acute respiratory failure. Atrial fibrillation known from history was exacerbated, and made complex rate and rhythm control necessary. Progressive heart failure with haemodynamic deterioration and acute kidney injury with the need for continuous renal replacement therapy were further aggravated by pericardial tamponade. DISCUSSION: Treatment of acute heart failure in COVID-19 patients with a cytokine storm complicated by tachycardic atrial fibrillation should include adequate rate or rhythm control, and potentially immunomodulation.
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Schnaubelt et al. (2020) conducted a case report in COVID-19 and Atrial Fibrillation (n=1). COVID-19 with atrial fibrillation was evaluated. A 72-year-old male with COVID-19 and atrial fibrillation developed severe complications including progressive heart failure, acute kidney injury, and pericardial tamponade.
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