Atrial fibrillation in patients with SARS-CoV-2 infection.

Introduction And Objective: the SARS-CoV-2 infection ranges from asymptomatic to critical forms and several prognostic factors have been described. Atrial fibrillation (AF) is common in acute situations where it is linked with more complications and mortality. We aimed to evaluate the prognostic information of AF in this population.

Methods: retrospective analysis of a cohort of 517 patients consecutively admitted in a tertiary hospital due to SARS-CoV-2 infection. We divided the patients in two groups according the development of AF and compared the main features of both groups. An univariable and multivariable analysis of mortality were also performed.

Results: among 517 patients with SARS-CoV-2 infection admitted in a tertiary center, 54 (10.4%) developed AF. These patients are older (81.6 vs 66.5 years old,  < 0.001) and present more hypertension (74% vs 47%,  < 0.001), cardiomyopathy (9% vs 1%,  = 0.002), previous heart failure admission (9% vs 0.4%,  < 0.001), previous episodes of AF (83% vs 1%,  < 0.001) and bigger left atrium (47.8 vs 39.9 mm,  < 0.001). AF COVID-19 patients present more acute respiratory failure (72% vs 40%,  < 0.001) and higher in-hospital mortality (50% vs 22%,  < 0.001). Predictors of AF development are age and previous AF. AF is not an independent predictor of in-hospital mortality. Predictors are age, creatinine > 1.5 mg/dL at admission, LDH > 250 UI/L at admission and acute respiratory failure.

Conclusion: Atrial fibrillation appears in 10% of hospitalized patients with SARS-CoV-2 infection. These patients present more comorbidities and two-fold increase in hospital mortality. Atrial fibrillation is not an independent prognostic factor.