RISK OF ATRIAL FIBRILLATION AND CARDIOVASCULAR HOSPITALISATION ONE YEAR AFTER DISCHARGE FOR COVID-19

Objective: To evaluate the incidence of atrial fibrillation and cardiovascular hospitalisation during one year after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19 with the necessity of in-hospital care.

Methods: Source of the data was the National Register of Reimbursed Health Services in the Czech Republic. The one-year incidence of newly developed atrial fibrillation and cardiovascular hospitalisation after COVID-19 hospitalisation from 1-Sep-2020 to 31-Dec-2020 was analysed in the Czech Republic (population 10.7 million). A control group was selected from the general population matched for sex and age in 1:5 ratio (case-control matching) without admission to the hospital for COVID-19 in the respective period. Patients who died within the first 30 days after COVID-19 admission were excluded.

Results: The study groups consisted of 27,975 patients and 139,875 controls, both without a history of atrial fibrillation or cardiovascular hospitalisation. The incidence of atrial fibrillation was 1.7% vs 0.7% (HR = 2.55 (95% CI: 2.27–2.86), p < 0.001) and incidence of cardiovascular hospitalisation was 3.2% vs 1.6% (HR 2.06 (95% CI: 1.91–2.22), p < 0.001). There is also several-fold higher risk of death in the patient group (11.3% vs 2.6%; HR = 4.65 (95% CI: 4.44–4.88), p < 0.001).

Conclusion: The incidence of newly developed atrial fibrillation is 2.6 times higher during one year after discharge for hospitalisation for COVID-19 comparing to matched general population. The risk of cardiovascular hospitalisation doubled over the same period. The risk of death is 4.7 times higher. Despite matching, there are many limitations to the analysis and the causality is unproven. The necessity of hospitalisation for COVID-19 is more likely a marker of the frailty than the independent risk factor.