# Pre-Existing Atrial Fibrillation in Hospitalized Patients with COVID-19: Insights from the CARDIO COVID 19–20 Registry

## TL;DR

This study shows that pre-existing atrial fibrillation increases the risk of in-hospital mortality for hospitalized COVID-19 patients in Latin America.

## Contribution

The study provides novel evidence on the impact of pre-existing AF on mortality in hospitalized COVID-19 patients from Latin America.

## Key findings

- Pre-existing atrial fibrillation is associated with higher in-hospital mortality in hospitalized COVID-19 patients.
- Chronic kidney disease and a respiratory rate >25 at admission are also linked to increased mortality.
- Corticosteroid use showed a potential effect on mortality, though it was not statistically significant.

## Abstract

Pre-existing (chronic) atrial fibrillation (AF) has been identified as a risk factor for cardiovascular complications and mortality in patients with COVID-19; however, evidence in Latin America (LATAM) is scarce. This prospective and multicenter study from the CARDIO COVID 19–20 database includes hospitalized adults with COVID-19 from 14 countries in LATAM. A parsimonious logistic regression model was used to identify the main factors associated with mortality in a simulated case-control setting comparing patients with a history of AF to those without. In total, 3260 patients were included, of which 115 had AF. The AF group was older, had a higher prevalence of comorbidities, and had greater use of cardiovascular medications. In the model, AF, chronic kidney disease, and a respiratory rate > 25 at admission were associated with higher in-hospital mortality. The use of corticosteroids did not reach statistical significance; however, an effect was seen through the confidence interval. Thus, pre-existing AF increases mortality risk irrespective of other concomitant factors. Chronic kidney disease and a high respiratory rate at admission are also key factors for in-hospital mortality. These findings highlight the importance of comorbidities and regional characteristics in COVID-19 outcomes, in this instance, enhancing the evidence for patients from LATAM.