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Abstract：
BACKGROUND: Since 2019, Coronavirus disease-2019 (COVID-19) has raised unprecedented global health crisis. The incidence and impact of atrial fibrillation (AF) on patients with COVID-19 remain unclearly defined.
METHODS: We conducted a retrospective cohort study using ICD-10 codes to identify patients with a primary diagnosis of COVID-19 with or without AF in National Inpatient Sample Database 2020. We compared the outcome of COVID-19 patients with a concurrent diagnosis of AF with those without.
OBJECTIVE: AF will adversely affect the prognosis of hospitalized COVID-19 patients.
RESULTS: A total of 211 619 patients with a primary diagnosis of COVID-19 were identified. Among these patients, 31 923 (15.08%) had a secondary diagnosis of AF. Before propensity score matching, COVID-AF cohort was older (75.8 vs. 62.2-year-old, p < .001) and had more men (57.5% vs. 52.0%, p < .001). It is associated with more comorbidities, mainly including diabetes mellitus (43.7% vs. 39.9%, p < .001), hyperlipidemia (54.6% vs. 39.8%, p < .001), chronic kidney disease (34.5% vs. 17.0%, p < .001), coronary artery disease (35.3% vs. 14.4%, p < .001), anemia (27.8% vs. 18.6%, p < .001), and cancer (4.8% vs. 3.4%, p < .001). After performing propensity score match, a total of 31 862 patients were matched within each group. COVID-AF cohort had higher inpatient mortality (22.2% vs. 15.3%, p < .001) and more complications, mainly including cardiac arrest (3.9% vs. 2.3%, p < .001), cardiogenic shock (0.9% vs. 0.3%, p < .001), hemorrhagic stroke (0.4% vs. 0.3%, p = .025), and ischemic stroke (1.3% vs. 0.7%, p < .001). COVID-AF cohort was more costly, with a longer length of stay, and a higher total charge.
CONCLUSIONS: AF is common in patients hospitalized for COVID-19, and is associated with poorer in-hospital mortality, immediate complications and increased healthcare resource utilization.
METHODS: We conducted a retrospective cohort study using ICD-10 codes to identify patients with a primary diagnosis of COVID-19 with or without AF in National Inpatient Sample Database 2020. We compared the outcome of COVID-19 patients with a concurrent diagnosis of AF with those without.
OBJECTIVE: AF will adversely affect the prognosis of hospitalized COVID-19 patients.
RESULTS: A total of 211 619 patients with a primary diagnosis of COVID-19 were identified. Among these patients, 31 923 (15.08%) had a secondary diagnosis of AF. Before propensity score matching, COVID-AF cohort was older (75.8 vs. 62.2-year-old, p < .001) and had more men (57.5% vs. 52.0%, p < .001). It is associated with more comorbidities, mainly including diabetes mellitus (43.7% vs. 39.9%, p < .001), hyperlipidemia (54.6% vs. 39.8%, p < .001), chronic kidney disease (34.5% vs. 17.0%, p < .001), coronary artery disease (35.3% vs. 14.4%, p < .001), anemia (27.8% vs. 18.6%, p < .001), and cancer (4.8% vs. 3.4%, p < .001). After performing propensity score match, a total of 31 862 patients were matched within each group. COVID-AF cohort had higher inpatient mortality (22.2% vs. 15.3%, p < .001) and more complications, mainly including cardiac arrest (3.9% vs. 2.3%, p < .001), cardiogenic shock (0.9% vs. 0.3%, p < .001), hemorrhagic stroke (0.4% vs. 0.3%, p = .025), and ischemic stroke (1.3% vs. 0.7%, p < .001). COVID-AF cohort was more costly, with a longer length of stay, and a higher total charge.
CONCLUSIONS: AF is common in patients hospitalized for COVID-19, and is associated with poorer in-hospital mortality, immediate complications and increased healthcare resource utilization.
摘要：
背景：自2019年以来，2019年冠状病毒病（COVID-19）引发了前所未有的全球健康危机。房颤（AF）对COVID-19患者的发生率和影响仍不清楚。
方法：我们使用ICD-10代码进行了一项回顾性队列研究，以在2020年国家住院患者样本数据库中识别出主要诊断为COVID-19伴或不伴AF的患者。我们比较了同时诊断为房颤的COVID-19患者与无房颤的患者的预后。
目的：AF会对住院COVID-19患者的预后产生不利影响。
结果：共确定了211619例初步诊断为COVID-19的患者。在这些患者中,31923（15.08%）有房颤的二次诊断。在倾向得分匹配之前，COVID-AF队列年龄较大（75.8vs.62.2岁，p<.001），男性人数更多（57.5%vs.52.0%,p<.001)。它与更多的合并症有关，主要包括糖尿病（43.7%vs.39.9%,p<.001),高脂血症（54.6%vs.39.8%,p<.001),慢性肾脏病（34.5%vs.17.0%,p<.001),冠状动脉疾病（35.3%vs.14.4%,p<.001),贫血（27.8%vs.18.6%,p<.001),和癌症（4.8%vs.3.4%,p<.001)。在进行倾向得分匹配后，每组共有31,862例患者进行匹配.COVID-AF队列的住院患者死亡率较高（22.2%与15.3%,p<.001)和更多的并发症，主要包括心脏骤停(3.9%vs.2.3%,p<.001),心源性休克（0.9%vs.0.3%,p<.001),出血性中风（0.4%vs.0.3%,p=.025)，和缺血性卒中（1.3%vs.0.7%，p<.001)。COVID-AF队列成本更高，停留时间较长，和更高的总收费。
结论：房颤在因COVID-19住院的患者中很常见，并且与较低的住院死亡率相关，立即并发症和增加医疗资源利用率。
方法：我们使用ICD-10代码进行了一项回顾性队列研究，以在2020年国家住院患者样本数据库中识别出主要诊断为COVID-19伴或不伴AF的患者。我们比较了同时诊断为房颤的COVID-19患者与无房颤的患者的预后。
目的：AF会对住院COVID-19患者的预后产生不利影响。
结果：共确定了211619例初步诊断为COVID-19的患者。在这些患者中,31923（15.08%）有房颤的二次诊断。在倾向得分匹配之前，COVID-AF队列年龄较大（75.8vs.62.2岁，p<.001），男性人数更多（57.5%vs.52.0%,p<.001)。它与更多的合并症有关，主要包括糖尿病（43.7%vs.39.9%,p<.001),高脂血症（54.6%vs.39.8%,p<.001),慢性肾脏病（34.5%vs.17.0%,p<.001),冠状动脉疾病（35.3%vs.14.4%,p<.001),贫血（27.8%vs.18.6%,p<.001),和癌症（4.8%vs.3.4%,p<.001)。在进行倾向得分匹配后，每组共有31,862例患者进行匹配.COVID-AF队列的住院患者死亡率较高（22.2%与15.3%,p<.001)和更多的并发症，主要包括心脏骤停(3.9%vs.2.3%,p<.001),心源性休克（0.9%vs.0.3%,p<.001),出血性中风（0.4%vs.0.3%,p=.025)，和缺血性卒中（1.3%vs.0.7%，p<.001)。COVID-AF队列成本更高，停留时间较长，和更高的总收费。
结论：房颤在因COVID-19住院的患者中很常见，并且与较低的住院死亡率相关，立即并发症和增加医疗资源利用率。
