# Anticoagulating New-Onset Atrial Fibrillation After COVID-19: A Single-Center Experience

## TL;DR

This study examines anticoagulation practices and outcomes for patients with new-onset atrial fibrillation after COVID-19.

## Contribution

The study provides insights into anticoagulation strategies and outcomes for atrial fibrillation following COVID-19, a novel clinical scenario.

## Key findings

- 86% of patients were discharged on anticoagulation, and 25% remained in atrial fibrillation at one-year follow-up.
- No major bleeding events were recorded during the study period.
- The risk of death was similar to that of COVID-19 itself rather than the atrial fibrillation.

## Abstract

Anticoagulation (AC) strategy in new-onset atrial fibrillation (NOAF) secondary to other illnesses has not been broadly studied, and society-level guidance does not provide a strong recommendation regarding outpatient continuation upon discharge. Our study focused specifically on patients experiencing NOAF secondary to COVID-19. It sought to understand whether our facility’s rounding prescribers were continuing patients on AC at discharge, the presence of arrhythmia at one-year follow-up, and to observe the risk of adverse outcomes in light of this unique precipitant.

A retrospective cohort analysis and chart review were conducted of 231 consecutive inpatients during the initial 19 months of the COVID-19 pandemic. Eighteen patients experiencing NOAF with an average calculated CHA2DS2-VASc score of four were included in the cohort. Four patients (22%) died during hospitalization and 14 patients were discharged. Twelve of fourteen patients (86%) were discharged on AC, and eight remained adherent at follow-up. Two discharged patients died of unknown causes prior to follow-up. At follow-up, which occurred at a median of 1.2 years, 25% of the surviving cohort remained in atrial fibrillation (AF). No major bleeding events were recorded during the studied period.

This retrospective analysis of a small sample of patients admitted to a single medical center for COVID-19 and experiencing NOAF demonstrates that local prescribers are continuing AC at discharge, that the rate of recurrence of AF is similar to onset in non-COVID illness at one year, and that risk of death approximated that of COVID-19 itself rather than NOAF.