![]() ![]() Patients hospitalized with COVID-19 infection between March and April 2020 were studied. A total of 160 consecutive patients were enrolled. The present observational single-center review consists of consecutive patients hospitalized with COVID-19-related infection in a tertiary hospital and prospective follow-up until discharge. The current study aims to evaluate the impact of new-onset AF compared with pre-existing AF and sinus rhythm on long-term mortality, stroke, and bleeding in COVID patients. The balance between embolic and bleeding risk in these patients is challenging. ![]() On the other hand, coagulopathy is a common abnormality in patients with COVID-19 disease and these patients seem to have a higher risk of developing thromboembolic events. The management of AF regarding the use of antithrombotic therapies in the setting of COVID-19 disease, in clinical practice, does not differ from the routine management. The outcomes in patients with new-onset AF, pre-existing AF, and sinus rhythm remain unclear in patients with COVID-19.Ītrial fibrillation is a common cause of stroke, hospitalization and death, whereas anticoagulation therapy for the prevention of stroke can trigger bleeding events. Several previous studies have demonstrated that new onset atrial arrhythmias are associated with increased morbidity and mortality. The onset of AF may be related to electrolyte abnormalities, dehydration and hypoxia. The prevalence of AF in COVID-19 patients is substantial when combining both pre-existing and newonset AF. The most common arrhythmia overall in patients with COVID-19 is sinus tachycardia, but the most frequent pathologic arrhythmias include AF, atrial flutter and monomorphic or polymorphic ventricular tachycardia. In 138 patients from Wuhan who were hospitalized with COVID-19-related infection, arrhythmias were reported in 17% of the general cohort and in 44% of the patients admitted to an intensive care unit. The presence of palpitations has been reported as one of the most common initial symptom of the disease (7.3%). AF is the most common pathologic of arrhythmia, and its incidence is increased in the presence of an infection. As with any infection, there can be an increase of stress on the body from which arrhythmias can arise. There is a lack of information about the incidence and the consequences of arrhythmias related to the virus. The disease can trigger exacerbated inflammatory responses that can be challenging for patients with heart conditions. Furthermore, patients with pre-existing health conditions such as obesity, pulmonary disease, hypertension and heart failure are at higher risk for a more severe infection by SARS-CoV-2. Affected patients have been reported to have an inflammatory state that may predispose patients to in-hospital cardiovascular complications, such as myocardial damage, atrial fibrillation (AF), and stroke. This study showed an unprecedented detrimental effect of COVID-19 vaccines on atrial fibrillation and warrants the need to take that into consideration when prescribing COVID-19 vaccines.Coronavirus disease 2019 (COVID-19), a viral respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a pandemic which is overwhelming health care systems worldwide. Conclusion: While vaccines have not been linked to heart rhythm disorders, the introduction of COVID-19 vaccines in 2020 showed a significant association with atrial fibrillation. Of note, deaths were predominantly within the 50-year-old and above age group. Interestingly, influenza vaccines, polyvalent polysaccharide pneumococcal (PPSV23) vaccine, pneumococcal 13-valent (PCV13) vaccine, zoster vaccine, and tetanus-containing vaccines were significantly associated with reduced atrial fibrillation. Among these events, atrial fibrillation was reported 2149 times in association with various vaccines. Results: Over 1,300,000 adverse events were reported between 1990-2021. Disproportionality signal analysis was conducted by measuring reporting odds ratio (ROR) with 95% confidence interval (CI). Methods: We used the Food and Drug Administration (FDA) Vaccine Adverse Event Reporting System (VAERS) between 1990-2021 to search for atrial fibrillation and other less prevalent arrhythmias. However, vaccines have not been well-studied regarding their effects on heart rhythm disorders. ABSTRACT Background: Vaccines have been mainly described to provide cardioprotective effects with rare reports showing rare association with myopericarditis. ![]()
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