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In this study, the authors used data from nationwide Danish registries of patients aged 18 to 90 years who received a diagnosis of new-onset AF during a national COVID-19 lockdown and patients diagnosed in the corresponding period of the previous year. During the first 3 weeks of lockdown, there was a lower incidence of new-onset AF compared with the corresponding year previously. There was a 47% drop in total numbers. Patients who were diagnosed during lockdown had a lower CHA2DS2-VASc score and were younger, but had more prevalent history of cancer, heart failure, and vascular disease. During lockdown, the adjusted odds ratio of an ischemic stroke or all-cause death was 1.41 compared with the corresponding year prior.
These findings suggest that undiagnosed AF patients may develop complications, which could translate into poorer outcomes during the prolonged or subsequent lockdowns associated with the pandemic.
This abstract is available on the publisher's site.
To determine the incidence, patient characteristics, and related events associated with new-onset atrial fibrillation (AF) during a national COVID-19 lockdown.
METHODS AND RESULTS
Using nationwide Danish registries, we included all patients, aged 18-90 years, receiving a new-onset AF diagnosis during the first 3 months of 2019 and 2020. The main comparison was between patients diagnosed during lockdown (12 March 12-1 April 2020) and patients diagnosed in the corresponding period 1 year previously. We found a lower incidence of new-onset AF during the 3 weeks of lockdown compared with the corresponding weeks in 2019 [incidence rate ratios with 95% confidence intervals (CIs) for the 3 weeks: 0.66 (0.56-0.78), 0.53 (0.45-0.64), and 0.41 (0.34-0.50)]. There was a 47% drop in total numbers (562 vs. 1053). Patients diagnosed during lockdown were younger and with a lower CHA2DS2-VASc score, while history of cancer, heart failure, and vascular disease were more prevalent. During lockdown, 30 (5.3%) patients with new-onset AF suffered an ischaemic stroke and 15 (2.7%) died, compared with 45 (4.3%) and 14 (1.3%) patients during the corresponding 2019 period, respectively. The adjusted odds ratio of a related event (ischaemic stroke or all-cause death) during lock-down compared with the corresponding weeks was 1.41 (95% CI 0.93-2.12).
Following a national lockdown in Denmark, a 47% drop in registered new-onset AF cases was observed. In the event of prolonged or subsequent lockdowns, the risk of undiagnosed AF patients developing complications could potentially translate into poorer outcomes in patients with AF during the COVID-19 pandemic.
New-Onset Atrial Fibrillation: Incidence, Characteristics, and Related Events Following a National COVID-19 Lockdown of 5.6 Million People
Eur Heart J 2020 Jun 24;[EPub Ahead of Print], A Holt, GH Gislason, M Schou, B Zareini, T Biering-Sørensen, M Phelps, K Kragholm, C Andersson, EL Fosbøl, ML Hansen, TA Gerds, L Køber, C Torp-Pedersen, M Lamberts