Outcomes and mortality associated with atrial arrhythmias among patients hospitalized with COVID-19: A systematic review and meta-analysis

Szarpak, Łukasz; Filipiak‬, Krzysztof J.; Skwarek, Anna; Pruc, Michał; Rahnama, Mansur; Denegri, Andrea; Jachowicz, Marta; Dawidowska, Małgorzata; Jaguszewski, Miłosz; Iskrzycki, Łukasz; Rafique, Zubaid

doi:10.5603/cj.a2021.0167

Cited by 22 publications

(24 citation statements)

References 58 publications

(93 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cardiovascular diseases have been associated with worse prognosis in COVID-19 patients [ 11 , 12 ]. Recent evidence underlined whether arrhythmias may negatively affect outcome in this setting [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hypertension, diabetes, coronary artery disease and higher BMI have been also associated with higher risk of ARs development in COVID-19 patients [ 20 , 21 ]. Regardless the underlying mechanism, ARs have been associated with increased mortality in COVID-19 patients [ 12 ]. Baseline ECG abnormalities may be useful, in this setting, to predict the risk of cardiac arrest in COVID-19 patients [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Arrhythmias in COVID-19/SARS-CoV-2 Pneumonia Infection: Prevalence and Implication for Outcomes

Denegri

Sola

Morelli

et al. 2022

JCM

Self Cite

View full text Add to dashboard Cite

Arrhythmias (ARs) are potential cardiovascular complication of COVID-19 but may also have a prognostic role. The aim of this study was to explore the prevalence and impact of cardiac ARs in hospitalized COVID-19 patients. All-comer patients admitted to the emergency department of Modena University Hospital from 16 March to 31 December 2020 and diagnosed with COVID-19 pneumonia infection were included in the study. The primary endpoint was 30-day mortality. Out of 902 patients, 637 (70.6%) presented a baseline 12-lead ECG registration; of these, 122 (19.2%) were diagnosed with ARs. Atrial fibrillation (AF, 40.2%) was the most frequent AR detected. The primary endpoint (30-day mortality) occurred in 33.6% (p < 0.001). AR-patients presented an almost 3-fold risk of mortality compared to non-AR-patients at 30d (Adj. OR = 2.8, 95%CI: 1.8–4.3, p < 0.001). After adjustment for significant baseline characteristics selected by a stepwise backward selection, AR-patients remained at increased risk of mortality (Adj. HR = 2.0, 95%CI: 1.9–2.3, p < 0.001). Sub-group analysis revealed that among ARs patients, those with AF at admission presented the highest risk of 30-day mortality (Adj. HR = 3.1, 95%CI: 2.0–4.9, p < 0.001). In conclusion, ARs are a quite common manifestation in COVID-19 patients, who are burdened by even worse prognosis. AR patients with AF presented the highest risk of mortality; thus, these patients may benefit from a more aggressive secondary preventive therapy and a closer follow up.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Arrhythmias in COVID-19/SARS-CoV-2 Pneumonia Infection: Prevalence and Implication for Outcomes

Denegri

Sola

Morelli

et al. 2022

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…COVID-19 can cause myocardial injury and other cardiovascular complications, including acute myocarditis, pulmonary embolism, or acute heart failure [137][138][139][140][141]. The exact mechanism of heart damage in the course of SARS-CoV-2 infection is not fully understood, but it may occur directly or indirectly, or in both ways [137].…”

Section: Covid-19mentioning

confidence: 99%

Role of Epicardial Adipose Tissue in Cardiovascular Diseases: A Review

Konwerski

Opolski

Grabowski

et al. 2022

Biology

View full text Add to dashboard Cite

Cardiovascular diseases (CVDs) are the leading causes of death worldwide. Epicardial adipose tissue (EAT) is defined as a fat depot localized between the myocardial surface and the visceral layer of the pericardium and is a type of visceral fat. EAT is one of the most important risk factors for atherosclerosis and cardiovascular events and a promising new therapeutic target in CVDs. In health conditions, EAT has a protective function, including protection against hypothermia or mechanical stress, providing myocardial energy supply from free fatty acid and release of adiponectin. In patients with obesity, metabolic syndrome, or diabetes mellitus, EAT becomes a deleterious tissue promoting the development of CVDs. Previously, we showed an adverse modulation of gene expression in pericoronary adipose tissue in patients with coronary artery disease (CAD). Here, we summarize the currently available evidence regarding the role of EAT in the development of CVDs, including CAD, heart failure, and atrial fibrillation. Due to the rapid development of the COVID-19 pandemic, we also discuss data regarding the association between EAT and the course of COVID-19. Finally, we present the potential therapeutic possibilities aiming at modifying EAT’s function. The development of novel therapies specifically targeting EAT could revolutionize the prognosis in CVDs.

show abstract

“…52 Non-valvular atrial fibrillation (NVAF) seems to be the most common arrhythmia encountered in COVID-19 patients and COVID-19 is increasingly being postulated as an independent risk factor for stroke in patients with NVAF. 53,54 Of note, although the exact mechanistic pathways leading to arrhythmias remain unknown at large, plausible mechanisms, as discussed by Siripanthong et al, include direct injury to cardiomyocytes disrupting electrical conduction, pericardial edema affecting electrical conduction, ischemia disrupting electrical conduction, re-entrant arrhythmias due to myocardial fibrosis or scars, and arrhythmias caused by proinflammatory cytokines predisposing to arrhythmogenicity. 55 In a multicenter New York City cohort, of the 4,250 patients with COVID-19, 6% were noted to have a prolonged QTc (i.e., corrected QT; >500 ms) 5 and in a different cohort of 393 patients with COVID-19, atrial arrhythmias were more common among patients requiring mechanical ventilation than those who did not (17.7% versus 1.9%).…”

Section: Cardiovascular Manifestations Of Covid-19 and Underlying Pat...mentioning

confidence: 99%

COVID-19 and the cardiovascular system: an update

Salabei

Asnake

Ismail

et al. 2022

The American Journal of the Medical Sciences

View full text Add to dashboard Cite

Outcomes and mortality associated with atrial arrhythmias among patients hospitalized with COVID-19: A systematic review and meta-analysis

Abstract: This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Cardiology Journal" are listed in PubMed.

Cited by 22 publications

References 58 publications

Arrhythmias in COVID-19/SARS-CoV-2 Pneumonia Infection: Prevalence and Implication for Outcomes

Arrhythmias in COVID-19/SARS-CoV-2 Pneumonia Infection: Prevalence and Implication for Outcomes

Role of Epicardial Adipose Tissue in Cardiovascular Diseases: A Review

COVID-19 and the cardiovascular system: an update

Contact Info

Product

Resources

About