Atrial fibrillation and COVID-19 in older patients: how disability contributes to shape the risk profile. An analysis of the GeroCovid registry.
Atrial fibrillation
COVID-19
Disability
Older patients
Oral anticoagulants
Prognosis
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
22
08
2021
accepted:
16
10
2021
pubmed:
31
10
2021
medline:
1
2
2022
entrez:
30
10
2021
Statut:
ppublish
Résumé
Atrial fibrillation (AF) is often complicated by disabling conditions in the elderly. COVID-19 has high mortality in older people. This study aimed at evaluating the relationship of pre-infection AF with characteristics and survival of older COVID-19 patients. We retrospectively analyzed inpatients aged ≥ 60 years enrolled in GeroCovid Observational, a multicenter registry endorsed by the Italian and the Norwegian Societies of Gerontology and Geriatrics. Pre-COVID-19 sociodemographic, functional, and medical data were systematically collected, as well as in-hospital mortality. Between March and June 2020, 808 COVID-19 subjects were enrolled (age 79 ± 9 years; men 51.7%). The prevalence of AF was 21.8%. AF patients were older (82 ± 8 vs. 77 ± 9 years, p < 0.001), had a higher CHA AF is frequent in older patients with COVID-19, in whom it associates with clinical complexity and high mortality. Pre-infection disability shapes the prognosis of this extremely vulnerable segment of hospitalized subjects. GeroCovid Observational was registered at www.clinicaltrials.gov (NCT04379440).
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Atrial fibrillation (AF) is often complicated by disabling conditions in the elderly. COVID-19 has high mortality in older people. This study aimed at evaluating the relationship of pre-infection AF with characteristics and survival of older COVID-19 patients.
METHODS
METHODS
We retrospectively analyzed inpatients aged ≥ 60 years enrolled in GeroCovid Observational, a multicenter registry endorsed by the Italian and the Norwegian Societies of Gerontology and Geriatrics. Pre-COVID-19 sociodemographic, functional, and medical data were systematically collected, as well as in-hospital mortality.
RESULTS
RESULTS
Between March and June 2020, 808 COVID-19 subjects were enrolled (age 79 ± 9 years; men 51.7%). The prevalence of AF was 21.8%. AF patients were older (82 ± 8 vs. 77 ± 9 years, p < 0.001), had a higher CHA
CONCLUSIONS
CONCLUSIONS
AF is frequent in older patients with COVID-19, in whom it associates with clinical complexity and high mortality. Pre-infection disability shapes the prognosis of this extremely vulnerable segment of hospitalized subjects.
CLINICAL TRIAL REGISTRATION
BACKGROUND
GeroCovid Observational was registered at www.clinicaltrials.gov (NCT04379440).
Identifiants
pubmed: 34716570
doi: 10.1007/s40520-021-02008-5
pii: 10.1007/s40520-021-02008-5
pmc: PMC8556143
doi:
Substances chimiques
Anticoagulants
0
Banques de données
ClinicalTrials.gov
['NCT04379440']
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
249-256Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Magnussen C, Niiranen TJ, Ojeda FM et al (2017) Sex Differences and similarities in atrial fibrillation epidemiology, risk factors, and mortality in community cohorts: results from the BiomarCaRE consortium (biomarker for cardiovascular risk assessment in Europe). Circulation 136:1588–1597. https://doi.org/10.1161/CIRCULATIONAHA.117.028981
doi: 10.1161/CIRCULATIONAHA.117.028981
pubmed: 29038167
pmcid: 5657474
Fumagalli C, Rozzini R, Vannini M et al (2020) Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study. BMJ Open 10:e040729. https://doi.org/10.1136/bmjopen-2020-040729
doi: 10.1136/bmjopen-2020-040729
pubmed: 32978207
O’Shea CJ, Middeldorp ME, Thomas G et al (2021) Atrial fibrillation burden during the coronavirus disease 2019 pandemic. Europace. https://doi.org/10.1093/europace/euab099
doi: 10.1093/europace/euab099
pubmed: 34077513
pmcid: 8184223
Lip GYH, Genaidy A, Tran G et al (2021) Incident atrial fibrillation and its risk prediction in patients developing COVID-19: a machine learning based algorithm approach. Eur J Intern Med. https://doi.org/10.1016/j.ejim.2021.04.023
doi: 10.1016/j.ejim.2021.04.023
pubmed: 34952769
pmcid: 8118660
García-Granja PE, Veras C, Aparisi Á et al (2021) Atrial fibrillation in patients with SARS-CoV-2 infection. Med Clin (Engl Ed) 157:58–63. https://doi.org/10.1016/j.medcle.2021.01.010
doi: 10.1016/j.medcle.2021.01.010
Zuin M, Rigatelli G, Bilato C et al (2021) Pre-existing atrial fibrillation is associated with increased mortality in COVID-19 patients. J Interv Card Electrophysiol 62:231–238. https://doi.org/10.1007/s10840-021-00992-2
doi: 10.1007/s10840-021-00992-2
pubmed: 33855639
Peltzer B, Manocha KK, Ying X et al (2020) Outcomes and mortality associated with atrial arrhythmias among patients hospitalized with COVID-19. J Cardiovasc Electrophysiol 31:3077–3085. https://doi.org/10.1111/jce.14770
doi: 10.1111/jce.14770
pubmed: 33017083
Paris S, Inciardi RM, Lombardi CM et al (2021) Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: results of the Cardio-COVID-Italy multicentre study. Europace 23:1603–1611. https://doi.org/10.1093/europace/euab146
doi: 10.1093/europace/euab146
pubmed: 34297833
Spinoni EG, Mennuni M, Rognoni A et al (2021) Contribution of atrial fibrillation to in-hospital mortality in patients with COVID-19. Circ Arrhythm Electrophysiol 14:e009375. https://doi.org/10.1161/circep.120.009375
doi: 10.1161/circep.120.009375
pubmed: 33591815
pmcid: 7892203
Fumagalli S, Trevisan C, Del Signore S et al (2021) COVID-19 and atrial fibrillation in older patients: does oral anticoagulant therapy provide a survival benefit?-An insight from the GeroCovid registry. Thromb Haemost. https://doi.org/10.1055/a-1503-3875
doi: 10.1055/a-1503-3875
pubmed: 33962480
Trevisan C, Del Signore S, Fumagalli S et al (2021) Assessing the impact of COVID-19 on the health of geriatric patients: the European GeroCovid observational study. Eur J Intern Med 87:29–35. https://doi.org/10.1016/j.ejim.2021.01.017
doi: 10.1016/j.ejim.2021.01.017
pubmed: 33573885
pmcid: 7847394
Chamberlain AM, Alonso A, Gersh BJ et al (2017) Multimorbidity and the risk of hospitalization and death in atrial fibrillation: a population-based study. Am Heart J 185:74–84. https://doi.org/10.1016/j.ahj.2016.11.008
doi: 10.1016/j.ahj.2016.11.008
pubmed: 28267478
Fumagalli S, Chen J, Dobreanu D et al (2016) The role of the arrhythmia team, an integrated, multidisciplinary approach to treatment of patients with cardiac arrhythmias: results of the European heart rhythm association survey. Europace 18:623–627. https://doi.org/10.1093/europace/euw090
doi: 10.1093/europace/euw090
pubmed: 27174994
Fumagalli S, Pelagalli G, Montorzi RF et al (2020) The CHA2DS2-VASc score and geriatric multidimensional assessment tools in elderly patients with persistent atrial fibrillation undergoing electrical cardioversion. A link with arrhythmia relapse? Eur J Intern Med 82:56–61. https://doi.org/10.1016/j.ejim.2020.07.010
doi: 10.1016/j.ejim.2020.07.010
pubmed: 32709545
Rienstra M, Sun JX, Magnani JW et al (2012) White blood cell count and risk of incident atrial fibrillation (from the Framingham Heart Study). Am J Cardiol 109:533–537. https://doi.org/10.1016/j.amjcard.2011.09.049
doi: 10.1016/j.amjcard.2011.09.049
pubmed: 22100030
Misialek JR, Bekwelem W, Chen LY et al (2015) Association of white blood cell count and differential with the incidence of atrial fibrillation: the atherosclerosis risk in communities (ARIC) study. PLoS ONE 10:e0136219. https://doi.org/10.1371/journal.pone.0136219
doi: 10.1371/journal.pone.0136219
pubmed: 26313365
pmcid: 4551739
Goerlich E, Minhas A, Gilotra N et al (2021) Left atrial function in patients with COVID-19 and its association with incident atrial fibrillation/flutter. J Am Soc Echocardiogr. https://doi.org/10.1016/j.echo.2021.05.015
doi: 10.1016/j.echo.2021.05.015
pubmed: 34082022
pmcid: 8165042
Sanchis-Gomar F, Perez-Quilis C, Lavie CJ (2020) Should atrial fibrillation be considered a cardiovascular risk factor for a worse prognosis in COVID-19 patients? Eur Heart J 41:3092–3093. https://doi.org/10.1093/eurheartj/ehaa509
doi: 10.1093/eurheartj/ehaa509
pubmed: 32688380
Inciardi RM, Adamo M, Lupi L et al (2020) Atrial fibrillation in the COVID-19 era: simple bystander or marker of increased risk? Eur Heart J 41:3094. https://doi.org/10.1093/eurheartj/ehaa576
doi: 10.1093/eurheartj/ehaa576
pubmed: 32699894
Inciardi RM, Adamo M, Lupi L et al (2020) Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy. Eur Heart J 41:1821–1829. https://doi.org/10.1093/eurheartj/ehaa388
doi: 10.1093/eurheartj/ehaa388
pubmed: 32383763
Roth GA, Mensah GA, Johnson CO et al (2020) Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol 76:2982–3021. doi: https://doi.org/10.1016/j.jacc.2020.11.010
doi: 10.1016/j.jacc.2020.11.010
pubmed: 33309175
pmcid: 7755038
Fumagalli S, Pelagalli G, Franci Montorzi R et al (2021) Atrial fibrillation in older patients and artificial intelligence: a quantitative demonstration of a link with some of the geriatric multidimensional assessment tools-a preliminary report. Aging Clin Exp Res 33:451–455. https://doi.org/10.1007/s40520-020-01723-9
doi: 10.1007/s40520-020-01723-9
pubmed: 33095428
Landi F, Liperoti R, Russo A et al (2010) Disability, more than multimorbidity, was predictive of mortality among older persons aged 80 years and older. J Clin Epidemiol 63:752–759. https://doi.org/10.1016/j.jclinepi.2009.09.007
doi: 10.1016/j.jclinepi.2009.09.007
pubmed: 20056387
Plotnikov G, Waizman E, Tzur I et al (2021) The prognostic role of functional dependency in older inpatients with COVID-19. BMC Geriatr 21:219. https://doi.org/10.1186/s12877-021-02158-1
doi: 10.1186/s12877-021-02158-1
pubmed: 33789578
pmcid: 8011046
Fumagalli C, Ungar A, Rozzini R et al (2021) Predicting mortality risk in older hospitalized persons With COVID-19: a comparison of the COVID-19 mortality risk score with frailty and disability. J Am Med Dir Assoc 22:1588–1592 e1581. https://doi.org/10.1016/j.jamda.2021.05.028
doi: 10.1016/j.jamda.2021.05.028
pubmed: 34334160
pmcid: 8249822
Biolè C, Bianco M, Núñez-Gil IJ et al (2021) Gender differences in the presentation and outcomes of hospitalized patients with COVID-19. J Hosp Med 16:349–352. https://doi.org/10.12788/jhm.3594
doi: 10.12788/jhm.3594
pubmed: 34129486