Key result
Influenza infection and vaccination show no association with incident atrial fibrillation at 1 year.
Why the study?
Whether influenza increases the risk of newly diagnosed atrial fibrillation beyond the effect of acute illness was uncertain. The study therefore examined the associations of viral etiology and prior influenza vaccination with newly diagnosed atrial fibrillation and one-year mortality in hospitalized adults.
Does influenza infection or prior influenza vaccination increase or reduce the risk of newly diagnosed atrial fibrillation within one year in hospitalized adults undergoing respiratory-virus PCR testing?
Cohort (n=21,653)
Yes
Does influenza infection or prior influenza vaccination increase or reduce the risk of newly diagnosed atrial fibrillation within one year in hospitalized adults undergoing respiratory-virus PCR testing?
Answers are grounded in this paper and cite their sources.
In hospitalized adults tested for respiratory viruses, neither influenza infection nor prior influenza vaccination was associated with an increased risk of newly diagnosed atrial fibrillation compared with PCR-negative controls, though newly diagnosed atrial fibrillation predicted higher one-year mortality.
Background/Objectives: Whether influenza increases the risk of newly diagnosed atrial fibrillation (NDAF) beyond the effect of acute illness is uncertain. We examined whether viral etiology and prior influenza vaccination (exposures) were associated with NDAF within one year (primary outcome), and whether NDAF was associated with one-year all-cause mortality (secondary outcome), in hospitalized adults. Methods: This retrospective cohort study included 21,653 adults hospitalized in Clalit Health Services facilities (2012–2020) who underwent respiratory-virus PCR testing: influenza A (n = 2829), influenza B (n = 992), other respiratory viruses (n = 561), and PCR-negative concurrent controls (n = 17,271). NDAF within 365 days was analyzed with cause-specific Cox and Fine–Gray models, including time windows; mortality with time-dependent Cox models; and vaccination with propensity score matching. Results: NDAF was recorded in 1228 patients (5.7%), 56% of them on the day of admission. Compared with PCR-negative patients, no viral etiology was associated with a higher hazard of NDAF (influenza A: HR 0.87, 95% CI 0.73–1.04; influenza B: HR 0.73, 95% CI 0.53–1.00), including within 30 days and after excluding day-0 events. NDAF was associated with higher one-year mortality (HR 1.68, 95% CI 1.52–1.87), especially when recorded after discharge (HR 3.04). Influenza vaccination was not associated with NDAF (HR 0.97, 95% CI 0.85–1.10). Conclusions: Among hospitalized adults tested for respiratory viruses, neither influenza nor prior vaccination was associated with NDAF compared with PCR-negative inpatients, who were not necessarily of similar acute illness severity. NDAF marked a higher hazard of one-year mortality.
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Sonkin et al. (2026) conducted a cohort in Hospitalized adults undergoing respiratory-virus PCR testing (n=21,653). Influenza infection (A and B), other respiratory viruses, and prior influenza vaccination vs. PCR-negative concurrent controls and unvaccinated patients was evaluated on Newly diagnosed atrial fibrillation (NDAF) within one year (HR 0.87, 95% CI 0.73–1.04). Influenza infection and prior vaccination were not associated with 1-year newly diagnosed atrial fibrillation vs PCR-negative controls (Flu A HR 0.87, 95% CI 0.73–1.04; Flu B HR 0.73, CI 0.53–1.00).
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