Clinical factors that influence the onset of atrial fibrillation or worsen its course after infection with Covid - 19

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: Public hospital(s). Main funding source(s): In. of cardiology INTRODUCTION: It is known that atrial fibrillation (AF) is not only one of the most common arrhythmias, but also a frequent rhythm disturbance in patients who have undergone SARS-CoV-2 infection. This arrhythmia often develops in the post-covid period. PURPOSE: to determine clinical factors associated with the onset or worsening of the course of atrial fibrillation in patients with coronavirus disease (COVID-19). MATERIALS AND METHODS: The study included 187 patients aged 62.5±0.9 years (47% men, 53% women). The vast majority of patients (89%) had arterial hypertension (II stage – 80%, III stage – 9%). Chronic forms of coronary heart disease were diagnosed in 53% of patients. The first three groups formed 116 patients who had AF and underwent coronavirus infection (CI). The first group (G1) consisted of 36 patients who did not have AF before CI. The second group (G2) was represented by 25 patients in whom the transition of the paroxysmal form of AF into persistent, or persistent AF into its permanent form occurred. The third group (G3) consisted of 55 patients in whom the form of AF did not change, but in 35 of them the frequency or duration of AF paroxysms increased (subgroup 3a), and in 20 people the frequency or duration of AF paroxysms did not change (subgroup 3b). Two control groups were also formed: K1 - 49 patients with AF who did not have a history of HF, and K2 - 22 patients with extrasystole who experienced HF, but who did not develop AF. The results. G1 patients were older than those in K2 (63.6±0.64 years vs. 50.7±1.1 years, respectively; p<0.001). At the same time, G2 patients at the time of inclusion in the study were older than those in G3 (66.5±1.04 years vs. 62.9±1.12 years, respectively; p<0.05). Women more often occurred in G1 than in K1 (51.7% vs. 30.6%, respectively; p<0.001), as well as in the combined group of G2-G3 compared to K1 (53.7% vs. 30.6% ,respectively; p<0.001). Concomitant hypertension was associated with an increase in the frequency and duration of AF paroxysms after COVID-19. Thus, group 2, compared to group 3, was characterized by more frequent detection of both stage II hypertension (72% vs. 65.5%; p<0.05) and its stage III (12% vs. 3.6%, p<0 ,05). Similarly, patients with chronic forms of CAD were more frequent in group 2, in contrast to group 3 (72.0% vs. 50%, p<0.001). In addition, the frequency of detection of patients with chronic forms of coronary heart disease was higher in subgroup 3a, compared to subgroup 3b (54.3% vs. 45.0%; p<0.005). CONCLUSION: Older age, female sex, hypertension, and coronary heart disease were clinical factors associated with the occurrence of AF or worsening of previously diagnosed AF in patients with COVID-19.