B-po02-071 new onset atrial fibrillation in patients hospitalized with covid-19: results from the american heart association covid-19 cardiovascular disease registry

New onset atrial fibrillation (AF) in patients hospitalized with COVID-19 has been reported and associated with poor clinical outcomes. To understand the prevalence of and outcomes associated with new onset AF in a diverse and representative U.S. cohort of patients hospitalized with COVID-19. We used data from the American Heart Association COVID-19 Cardiovascular Disease Registry. Patients were stratified by the presence versus absence of new onset AF. Of the first 14,899 patients from 88 institutions across the U.S hospitalized with COVID-19, 1,299 were excluded for a prior history of AF. 678 (5%) developed new onset AF during their index hospitalization. New onset AF associated with higher rates of death (49% vs. 14%) and MACE (death, myocardial infarction, stroke, and heart failure) (56% vs. 15%). The unadjusted hazard ratio (HR) for mortality was 2.13 (95% confidence interval [CI] 1.86-2.44) and for MACE was 2.26 (95% CI 1.88-2.71) for patients with versus without new onset AF. After adjusting for demographics, clinical comorbidities, and severity of disease, the associations with death HR 1.00 (95% CI 0.85-1.18) and MACE HR 1.00 (95% CI 0.78-1.28) were fully attenuated and no longer statistically significant. New onset AF was common (5%) among patients hospitalized with COVID-19. Almost half of patients with new AF died during their index hospitalization. After multivariable adjustment for comorbidities and disease severity, new onset AF was not associated with death or MACE, suggesting that new AF in these patients is primarily a marker of other adverse clinical factors rather than an independent driver of mortality.