Admissions to the Emergency Department Due to Atrial Fibrillation/Atrial Flutter Incidents during the Third Wave of COVID-19 Pandemic

Abstract

(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increases the risk of atrial fibrillation/flutter (AF/AFL) incident. The study aimed to present the characteristics of admissions to the emergency department (ED) due to AF/AFL incidents during the third COVID-19 pandemic wave. (2) Methods: A retrospective analysis of the medical records of the ED patients: 8399 during 3 months of the second and 11,144 during the 3 months of the third pandemic wave. (3) Results: SARS-CoV-2 positive patients there were 295 (3.5%) during the second wave and 692 (6.2%) during the third wave (p < 0.001). Among patients with SARS-CoV-2 infection, there were 44 (14.9%) patients with known AF/AFL during the second wave and 75 (10.8%) during the third wave, respectively (0.07). There were 116 visits with a diagnosis of AF/AFL incident during the third wave (study group) and 76 visits during the second wave (control group). The SARS-CoV-2 test was positive in 11 (9.5%) visits in the study group and in 1 (1.3%) visit in the control group p = 0.047. During the third wave, the patients with AF/AFL incidents with positive tests were older and more often had new-onset AF/AFL than those with negative tests: 76.3 (13.2) years vs. 71.8 (12.6) years; and 4 (36.4%) patients vs. 7 (7.6%) patients, respectively. (5) Conclusions: During the third pandemic wave, the number of patients with SARS-CoV-2 infection increased in comparison to the second wave. Additionally, among patients with AF/AFL incidents, the percentage of SARS-CoV-2-positive patients increased. During the third wave, the patients with positive tests and AF/AFL incident were older and more often had new-onset AF/AFL than those with AF/AFL incident and negative test which indicate the arrhythmogenic effect at the onset of the disease, especially in the older population.

Impact of New Onset Atrial Fibrillation in Hospitalized Patients with COVID-19. Results of the “ACO-VID” Registry

“…This high risk of AF in patients admitted with COVID-19 has been related to different mechanisms, including hypoxia (particularly in case of diffuse lung infiltration), inflammatory state, direct myocardial injury (ischemia, inflammation, etc), abnormal host immune response, or some drugs, among others.. [21][22][23][24] In fact, AF, including new-onset AF, has been described as the most common cardiac event associated with hospitalization for COVID-19. [25][26][27] Although we included our patients during the first wave of COVID-19 pandemic, recent studies have shown that AF incidence is also increased in the subsequent waves of COVID-19 infection, 28 indicating that our data are current.…”