Clinical course of atrial fibrillation in patients who experienced coronavirus disease (COVID-19): results of a 6-month follow-up

Авторы

  • O.S. Sychov SI “National Scientific Center “M.D. Strazhesko Institute of cardiology, clinical and regenerative medicine of the National Academy of Medical Sciences of Ukraine”, Sviatoslava Khorobroho str., 5, Kyiv, 03151, Ukraine https://orcid.org/0000-0001-8432-7403
  • O.V. Stasyshena SI “National Scientific Center “M.D. Strazhesko Institute of cardiology, clinical and regenerative medicine of the National Academy of Medical Sciences of Ukraine”, Sviatoslava Khorobroho str., 5, Kyiv, 03151, Ukraine https://orcid.org/0000-0002-2992-4640

DOI:

https://doi.org/10.26641/2307-0404.2024.3.313515

Ключевые слова:

arterial fibrillation, coronavirus disease, arterial hypertension, systemic nflammation, thrombosis, bleeding, heart failure

Аннотация

Atrial fibrillation (AF) is the most common extrapulmonary complication of the past SARS-CoV-2 infection. According to experts, almost 20% of patients with past COVID-19 have a history of atrial fibrillation and the incidence of new paroxysms of this arrhythmia ranges from 10 to 18%. Referring to the studied patients who experienced COVID-19 more than 6 months ago, the subjective perception of cardiac arrhythmia is the most frequent complaint, reported by approximately two-thirds of patients. The aim of our study was to determine the course of atrial fibrillation in patients after past 2019 coronavirus disease (COVID-19) during a dynamic 6-month follow-up after the initial hospitalization for atrial fibrillation in the specialized department of cardiac arrhythmias of the SI “National Scientific Center” “M.D. Strazhesko Institute of cardiology, clinical and regenerative medicine of the National Academy of Medical Sciences of Ukraine” depending on the clinical and anamnestic, demo­graphic, anthropometric factors, the results of laboratory research methods and the received treatment. 36 patients were included in the study, 27 of them formed the first group, which included patients in whom the course of atrial fibrillation improved against the background of recommended antiarrhythmic treatment after initial hospitalization for AF and past COVID-19, who at the time of hospitalization had a negative PCR test, of which 17 were women and 10 were men, aged 62.38±1.83 years. The second group consisted of 9 patients including 4 women and 5 men, aged 69.88±2.60 years in whom the course of atrial fibrillation neither changed nor worsened. We determined that the number of patients in whom the course of atrial fibrillation improved during the 6-month follow-up was three times greater than those in whom the course of this arrhythmia neither changed nor worsened (75% and 25%, respectively). Patients with a more favorable course of atrial fibrillation were younger (on average by 7.5 years), three times less likely to suffer from diabetes and not often had arterial hypertension of the III stage, than those examined, in whom the course of this arrhythmia did not change or worsen. Systemic inflammation and severity of heart failure significantly worsen the course of AF within 6 months after the hospital stage of treatment. However signs of deterioration of lipid metabolism are characteristic of patients with an unfavorable course of atrial fibrillation during 6 months after hospitalization, which is probably caused by the activation of systemic inflammation in them. The improvement of the prognosis of the examined patients was probably influenced by the appointment of antiarrhythmic drugs, such as: amiodarone, flecainide, beta-blockers, statins – from the "up-stream" therapy drugs.

Библиографические ссылки

Gunawardene MA, Willems S. Atrial fibrillation progression and the importance of early treatment for improving clinical outcomes. Europace. 2022;24(2):1122-8. doi: http://doi.org/10.1093/europace/euab257

Donniacuo M, De Angelis A, Rafaniello C, Cianflone E, Paolisso P, Torella D, et al. COVID-19 and atrial fibrillation: Intercepting lines. Front Cardiovasc Med. 2023;10(1):1-8. doi: http://doi.org/10.3389/fcvm.2023.1093053

Gupta A, Madhavan M, Sehgal K, Nair N, Mahajan S, Sehrawat T, et al. Extrapulmonary manifestations of COVID-19. 2020;26(7):1017-32. doi: http://doi.org/10.1038/s41591-020-0968-3

Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, et. al. Attributes and predictors of long COVID. 2021;27(4):626-31. doi: http://doi.org/10.1038/s41591-021-01292-y

Barron E, Bakhai C, Kar P. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Lancet Diabetes Endocrinol. 2020;8(1):813-22. doi: http://doi.org/10.1016/S2213-8587(20)30272-2

Sychov OS, Stasyshena OV. [The influence of a transferred infection of COVID-19 on the development of atrial fibrillation and changes in its course depending on clinical and anamnestic data]. Ukrainskyi kardiolohichnyi zhurnal. 2023;30(5-6):31-9. Ukrainian. doi: https://doi.org/10.31928/2664-4479-2023.5-6.3139

Mohammad M, Emin M, Bhutta A, Gul EH, Voorhees E, Afzal MR. Cardiac arrhythmias associated with COVID-19 infection: state of the art review. Expert Rev Cardiovasc Ther. 2021;19(10):881-9. doi: https://doi.org/10.1080/14779072.2021.1997589

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retro-spective cohort study. Lancet. 2020;395(10229):1054-62. doi: https://doi.org/10.1016/S0140-6736(20)30566-3

Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guide-lines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373-498. doi: https://doi.org/10.1093/eurheartj/ehaa612

Ibdah R, Obeidat O, Khader Y, Al-Nusair J, Abusurrah O, Obeidat A, et al. Validation of CHA2DS2 VASc Score Predictability of Stroke and Systemic Embolization in a Middle Eastern Population with AF: The Jordan Atrial Fibrillation (JoFib) Study. Vasc Health Risk Manag. 2023;19(1):255-64. doi: https://doi.org/10.2147/VHRM.S404575

Abowali H, Pacifico A, Erdinc B, Elkholy K, Burkhanova U, Aroriode T, et al. Assessment of Bleeding Risk in Hospitalized COVID-19 Patients: A Tertiary Hospital Experience during the Pandemic in a Predominant Minority Population—Bleeding Risk Factors in COVID-19 Patients. J Clin Med. 2022;11(1):27-54. doi: https://doi.org/10.3390/jcm11102754

Sweatt K, Garvey WT, Martins C. Strengths and Limitations of BMI in the Diagnosis of Obesity: What is the Path Forward? Curr Obes Rep. 2024;13(3):584-95. doi: https://doi.org/10.1007/s13679-024-00580-1

McElroy E, Herrett E, Patel K, Piehlmaier DM, Gessa GD, et al. Living alone and mental health: parallel analyses in UK longitudinal population surveys and ele-ctronic health records prior to and during the COVID-19 pandemic. BMJ Ment Health. 2023;26(1):300842. doi: https://doi.org/10.1136/bmjment-2023-300842

Huseynov A, Akin I, Duerschmied D, Scharf RE. Cardiac Arrhythmias in Post-COVID Syndrome: Prevalence, Pathology, Diagnosis, and Treatment. Viruses. 2023;15(2):389. doi: https://doi.org/10.3390/v15020389

Yong SJ. Long COVID or post-COVID-19 synd-rome: putativepathophysiology, risk factors, and treatments. Infect Dis (Lond). 2021;53(10):737-54. doi: https://doi.org/10.1080/23744235.2021.1924397

Thompson EJ, Williams DM, Walker AJ, Mitchell RE, Niedzwiedz CL, Yang TC, et al. Long COVID burden and risk factors in 10 UK longitudinalstudies and electronichealthrecords. Nat Commun. 2022;13(1):3528. doi: https://doi.org/10.1038/s41467-022-30836-0

Al-Aly Z, Xie Y, Bowe B. Highdimensional characterization of post-acute sequelae of COVID-19. Nature. 2021;594(7862):259-64. doi: https://doi.org/10.1038/s41586-021-03553-9

Опубликован

2024-10-16

Как цитировать

1.
Sychov O, Stasyshena O. Clinical course of atrial fibrillation in patients who experienced coronavirus disease (COVID-19): results of a 6-month follow-up. Med. perspekt. [Интернет]. 16 октябрь 2024 г. [цитируется по 24 ноябрь 2024 г.];29(3):59-67. доступно на: https://journals.uran.ua/index.php/2307-0404/article/view/313515

Выпуск

Раздел

CLINICAL MEDICINE