COVID-19 in AF patients with HF: no higher mortality but longer hospital stay

The results of a retrospective study suggest that the presence of atrial fibrillation (AF) is associated with a longer stay in ICU and hospital in patients with heart failure (HF). However, it did not affect other clinical outcomes such as cardiogenic shock or death.

“Recent studies reported a high prevalence of comorbidities, especially cardiovascular disease, and their association with severity of COVID-19 and increased mortality,” said Prof. Bektaş Murat (Eskisehir Osmangazi University, Turkey) [1]. Patients with HF have shown to be a particularly vulnerable population regarding complications during a COVID-19 infection. In contrast, little is known about the effects of AF on clinical outcomes in HF patients with COVID-19. Thus, Prof. Murat and his team aimed to evaluate the effect of concomitant AF on clinical outcomes in patients with HF who were hospitalised for COVID-19. They identified 240 patients with HF hospitalised for a COVID-19 infection in electronic medical records. The patients’ clinical features, laboratory findings, and in-hospital outcomes were compared according to the presence or absence of AF.

“Important biomarkers that have shown to be predictors of severity of COVID-19 infections are C-reactive protein (CRP) and procalcitonin,” Prof. Murat explained. Both biomarkers were elevated in HF patients with AF compared with those without AF, whereas other lab findings such as D-dimer or fibrinogen concentrations were similar between groups. Patients with AF had longer stays in hospital (13.7 vs 11 days; P=0.024) and in ICU (7 vs 4.3 days; P=0.038) compared with those without AF. However, no difference between groups was seen in the percentage of patients that required mechanical ventilation. “Presence of cardiogenic shock and death was also similar between groups,” Prof. Murat said. Thus, the presence of AF seems to indicate prolonged hospital and ICU stay, although it does not affect other clinical outcomes.

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   1. Murat B. Presence of atrial fibrillation prolongs hospital stay in heart failure patients hospitalised with Covid-19. Heart Failure and World Congress on Acute Heart Failure 2021, 29 June–1 July.

 

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Posted on 19 August, 202120 August, 2021