PMC:7796041 / 20921-22851 JSONTXT

Annnotations TAB JSON ListView MergeView

3.5. Subgroup Analysis of Patients with Atrial Fibrillation Atrial fibrillation constituted the most common incident arrhythmia during hospitalization for COVID-19. In the subgroup analysis of patients with incident AF, age, hypertension and cardiovascular disease were associated with incidence of the arrhythmia (Table 5). Both cardiac and inflammatory markers showed a stronger increase in patients with AF. Similar to the effects of incident arrhythmia in the overall cohort, AF itself was associated with longer overall hospitalization times and longer duration of ICU/IMC care. Additionally, an increased need for high-flow oxygen therapy or non-invasive ventilation, mechanical ventilation and pharmacological circulatory support could be seen in this subgroup. Information regarding initiation of anticoagulation therapy was available in 10 patients with AF during hospitalization for COVID-19. In six cases, low-molecular-weight heparin (LMWH) in therapeutic doses was applied, two other patients received NOACs. Two patients only received prophylactic doses of LMWH, in one case due to a low CHA2DS2-Vasc-Score of 1 and a self-limiting AF-episode, in one case due to delayed diagnosis of AF. Two patients in the AF-subgroup were diagnosed with myocardial infarction. In both cases, anticoagulation therapy had been initiated with LMWH. One patient underwent PCI and died in the later course of the hospitalization due to mesenteric ischemia. In this patient anticoagulation therapy had been paused for 22 days after coronary angiography due to severe bleeding complications requiring transfusion therapy. The other patient received medical treatment as a type-II myocardial infarction was suspected due to stable echocardiography und ECG-findings. All cases of death in patients with AF were attributed to non-cardiac causes: in addition to the patient described above three patients deceased due to respiratory failure.