Examining Impact of COVID-19 Diagnosis Timing on AF Progression | AHA 2024
“[O]ur data do not support the hypothesis that early COVID resulted in more significant structural or electrical cardiac remodeling that would increase the likelihood of atrial fibrillation progression,” the authors said.
There is no association between timing of COVID-19 diagnosis and progression of atrial fibrillation in patients with new onset atrial fibrillation, according to research data presented at the American Heart Association’s 2024 Scientific Sessions, held November 16 to 18 in Chicago, Illinois.1 The authors said the findings do not support the notion that early COVID-19 diagnosis increases the likelihood of atrial fibrillation progression.
Examining Impact of COVID-19 Diagnosis Timing on AF Progression / Dr_Microbe - stock.adobe.com
Research has shown that COVID-19 can lead to cardiovascular complications, including heart attack, stroke, and myocarditis.2 Patients with COVID-19 have also experienced increased rates of new onset atrial fibrillation, which has raised concerns of unfavorable outcomes. However, there has been a lack of data on atrial fibrillation progression in patients with new onset atrial fibrillation during a COVID-19 infection.
READ MORE: Medication Optimization Needed for Patients with Long COVID
Investigators from the Intermountain Medical Center in Salt Lake City, Utah conducted a study to compare atrial fibrillation progression in patients with new onset atrial fibrillation during early vs late COVID-19. The researchers hypothesized that early COVID-19 would be associated with increased atrial fibrillation progression compared to late COVID-19.
The study cohort included 11767 patients who received a SARS-COV-2 test from April 2020 to February 2024, had new onset atrial fibrillation, and had no prior history of atrial fibrillation. Patients were split into 2 groups based on whether they tested positive or negative for COVID-19. Of the patients, 3052 had an early COVID-19 diagnosis occurring between April 2020 and August 2021, and 8715 had a late diagnosis occurring between September 2021 and February 2024.
The study investigated atrial fibrillation endpoints at 3, 6 and 12 months, which included atrial fibrillation hospitalization, atrial fibrillation emergency department visit, cardioversion and atrial fibrillation ablation.
The study found that patients with a late COVID-19 diagnosis were more likely to be female, have hypertension, coronary artery disease and hyperlipidemia. There was no difference in atrial fibrillation progression between the early and late COVID-19 groups for any endpoint at 3 and 6 months. However, there was an increase of atrial fibrillation emergency department visits and a trend toward more atrial fibrillation hospitalizations among the late diagnosis group at 12 months.
Additionally, patients in the early COVID-19 diagnosis were less likely to undergo atrial fibrillation ablation and be hospitalized for atrial fibrillation at 12 months compared to patients with new onset atrial fibrillation during the same time without COVID-19. There was also no difference in atrial fibrillation progression between the positive and negative COVID-19 patients in the late diagnosis group.
“These findings demonstrate that there is no significant difference in atrial fibrillation progression in patients with new onset atrial fibrillation during COVID when stratified by timing of diagnosis,” the authors concluded. “As such, our data do not support the hypothesis that early COVID resulted in more significant structural or electrical cardiac remodeling that would increase the likelihood of atrial fibrillation progression.”
READ MORE: COVID-19 Resource Center
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