The incidence and impact of atrial fibrillation on hospitalized Coronavirus disease‐2019 patients

Abstract

AbstractBackgroundSince 2019, Coronavirus disease‐2019 (COVID‐19) has raised unprecedented global health crisis. The incidence and impact of atrial fibrillation (AF) on patients with COVID‐19 remain unclearly defined.MethodsWe conducted a retrospective cohort study using ICD‐10 codes to identify patients with a primary diagnosis of COVID‐19 with or without AF in National Inpatient Sample Database 2020. We compared the outcome of COVID‐19 patients with a concurrent diagnosis of AF with those without.HypothesisAF will adversely affect the prognosis of hospitalized COVID‐19 patients.ResultsA total of 211 619 patients with a primary diagnosis of COVID‐19 were identified. Among these patients, 31 923 (15.08%) had a secondary diagnosis of AF. Before propensity score matching, COVID‐AF cohort was older (75.8 vs. 62.2‐year‐old, p < .001) and had more men (57.5% vs. 52.0%, p < .001). It is associated with more comorbidities, mainly including diabetes mellitus (43.7% vs. 39.9%, p < .001), hyperlipidemia (54.6% vs. 39.8%, p < .001), chronic kidney disease (34.5% vs. 17.0%, p < .001), coronary artery disease (35.3% vs. 14.4%, p < .001), anemia (27.8% vs. 18.6%, p < .001), and cancer (4.8% vs. 3.4%, p < .001). After performing propensity score match, a total of 31 862 patients were matched within each group. COVID‐AF cohort had higher inpatient mortality (22.2% vs. 15.3%, p < .001) and more complications, mainly including cardiac arrest (3.9% vs. 2.3%, p < .001), cardiogenic shock (0.9% vs. 0.3%, p < .001), hemorrhagic stroke (0.4% vs. 0.3%, p = .025), and ischemic stroke (1.3% vs. 0.7%, p < .001). COVID‐AF cohort was more costly, with a longer length of stay, and a higher total charge.ConclusionAF is common in patients hospitalized for COVID‐19, and is associated with poorer in‐hospital mortality, immediate complications and increased healthcare resource utilization.