COVID-19 improves the danger of producing atrial fibrillation in hospitalized patients

We discovered 116,529 patients who satisfied the study’s assortment conditions. COVID 3090 clients soon after exclusion (pre-pandemic and spandemic hospitalization, no valid SARS-CoV-2 PCR examination outcomes in the course of the pandemic era, or absence of affected person data relating to gender or race) Matched with a positive exam in 19-11,004 clients with a destructive COVID-19 examination, and 5005 pre-pandemic patients on sensitivity examination (Determine 1).

Figure 1

Flowchart of affected person collection and review.

Demographics

In the demographics of unmatched sufferers, there had been 27,447 girls in the COVID-19 unfavorable cohort (out of 47,519 57.8%), in comparison with 2281 females in the COVID-19 beneficial team (out of 4838 47.1%). did(P <0.001 Standardized difference-0.2137 see Table 1). In the pre-pandemic cohort, 14,887 patients (out of 26,368 56.5%) were female (56.5%).P <0.001 Standardized difference-0.187 vs. COVID-19 positive). Patients suffering from COVID-19 were older than those suffering from COVID-19 (mean ± standard deviation). [SD] 63 ± 19 vs. 58 ± 21 Standardized difference 0.182 P <0.001) and pre-pandemic patients (59 ± 20 standardized difference 0.257 P<0.001).

Table 1 Unmatched patient characteristics.

Both groups in the comparison showed different proportions of racial groups (P<0.001 Standardized differences are 0.492 and 0.533, respectively). COVID-19-positive patients are predominantly black (776/4838, 16%), hispanic (243/4838, 5%), and others (859/4838, 17.8%), white. Was low (2737 of 4838 56.6%), and both COVID-19-negative and pre-pandemic patients were white (37,147 of 47,519). [78.2%] 21,142 out of 26,368 [80.2%] Respectively).

Among the known risk factors for AF, COVID-19 is unmatched for existing chronic renal failure, mitral valve disease, obesity, diabetes, hypertension, peripheral vascular disease, hyperlipidemia, smoking, and history of attacks. There was a difference between the cohort and the negative cohort. AF / AF1. Comparing the pre-pandemic and COVID-19-positive cohorts, mitral valve disease, congestive heart failure, COPD, history of myocardial infarction, obesity, diabetes mellitus, hypertension, peripheral vascular disease, hyperlipidemia, smoking, and AF / AF1 (See Table 1).

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result

In unmatched patients, AF was found in 552 (11.4%) of 4838 COVID-19-positive patients, 4718 (9.9%) of 47,519 COVID-19-negative patients, and 26,368 pre-pandemic patients. It occurred in 2451 (9.3%) of them. After matching, 192 of 5005 (3.8%) pre-pandemic patients developed AF / AF1 during hospitalization, whereas 145 of 2,283 COVID-19-positive patients (6.4%) had a crude odds ratio of 1.7. It became (95% CI 1.36). , 2.12 PCrude hazard ratios <0.001) and 1.35 (95% CI 1.08, 1.68 P= 0.007 see Table 2). Comparing matched COVID-19 negative and positive patients, 626 (5.7%) of 11,004 COVID-19 negatives developed AF / AF1, whereas those in the COVID-19 positive group. 249 out of 3090 (8.1%) had a crude oil odds ratio of 1.45 (95% CI 1.25, 1.69 PCrude hazard ratios <0.001) and 1.24 (95% CI 1.07, 1.44 P= 0.0038).

Table 2 Matched patient outcomes.

Deaths during hospitalization were 544 (2.1%) of 26,368 unparalleled pre-pandemic patients, 1139 (2.4%) of 47,519 COVID-19-negative patients, and 4838 COVID-19-positive patients. It occurred in 496 (10.3%) of them. After matching, 76 of the 5005 pre-pandemic patients died during hospitalization (1.5%) and 163 (7.1%) of the 2283 COVID-19-positive patients had a crude odds ratio of 4.99 (95% CI). 3.78, 6.58 PCrude hazard ratios of <0.001) and 2.08 (95% CI 1.51, 2.86 P<0.001). 228 (2.1%) of the 11,004 COVID-19-negative patients died during hospitalization after matching 253 (8.2%) of the 3090 COVID-19-positive patients, with a crude odds ratio of 4.22. It was (95% CI 3.51, 5.07 P <0.001). ) And a crude hazard ratio of 2.23 (95% CI 1.82, 2.74 P<0.001). Median (quartile 1) [Q1]– Quartile 3 [Q3]The length of stay for pre-pandemic patients was 3 days (2–6), 4 days (2–7) for COVID-negative patients, and 6 days (4–12) for COVID-positive patients. The median difference is 3 (95% CI 3, 3 P<0.001) Comparing unmatched COVID-19-positive patients with pre-pandemic patients, 2 (95% CI 2, 2 P<0.001) For COVID-19 positive and negative patients (“Supplementary Information”).

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Multivariable regression model

After adjusting patient demographics and comorbidity, COVID-19 was associated with a 1.19 (95% CI 1.00, 1.41) times higher probability of developing AF (95% CI 1.00, 1.41).P= 0.0495 see Figure 2) Comparison of matched COVID-19 positive and negative patients. Comparing COVID-19 positivity with pre-pandemic patients, the OR was 1.57 (95% CI 1.23, 2 P= 0.0003) In sensitivity analysis.

Figure 2
Figure 2

Multivariable logistic regression model and forest plot to determine the risk of post-matching atrial fibrillation (variable Hispanic vs. White and blank lines due to insufficient data to analyze history of myocardial infarction. “Race: Other” “vs White” includes COVID Hispanic-19 Positive vs. Prepandemic Model. ofAtrial fibrillation, AFlAtrial flutter, COPDChronic obstructive pulmonary disease).

History of paroxysmal AF or AF1 is associated with an OR of 8.25 (95% CI 5.57, 12.23 P> .001) to create AF / AF1 throughout hospitalization evaluating COVID-19-optimistic clients with pre-pandemic people. Nevertheless, the comparison of COVID-19 was favourable for COVID-19 adverse people, OR 5.01 (95% CI 3.92, 6.4 P<0.001).Age is two matching comparison groups for developing AF (both) P= 0.001), gender resulted in an OR of 1.7 (95% CI 1.32, 2.18) and 1.81 (95% CI 1.55, 2.12), respectively (both). P= 0.001). Asian and black races have an OR of 0.46 (95% CI 0.21, 0.99 P= 0.0462) Asian and Caucasian races and 0.63 OR (95% CI 0.44, 0.88 P= 0.00769) For black vs. white. In addition, we discovered differences in known risk factors: chronic renal failure, mitral valve disease, congestive heart failure, history of myocardial infarction, obesity, and hypertension (see Figure 2).

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