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Rigshospitalet - a part of Copenhagen University Hospital
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New-onset atrial fibrillation: incidence, characteristics, and related events following a national COVID-19 lockdown of 5.6 million people

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  • Anders Holt
  • Gunnar H Gislason
  • Morten Schou
  • Bochra Zareini
  • Tor Biering-Sørensen
  • Matthew Phelps
  • Kristian Kragholm
  • Charlotte Andersson
  • Emil L Fosbøl
  • Morten Lock Hansen
  • Thomas A Gerds
  • Lars Køber
  • Christian Torp-Pedersen
  • Morten Lamberts
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Aim To determine the incidence, patient characteristics, and related events associated with new-onset atrial fibrillation (AF) during a national COVID-19 lockdown. Methods Using nationwide Danish registries, we included all patients, aged 18-90 years, receiving a new-onset AF diagnosis and results 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 CHA 2DS 2-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). Conclusions 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.

Original languageEnglish
JournalEuropean Heart Journal
Volume41
Issue number32
Pages (from-to)3072-3079
Number of pages8
ISSN0195-668X
DOIs
Publication statusPublished - 1 Jun 2020

    Research areas

  • Atrial fibrillation, COVID-19 pandemic, Collateral damage, National lockdown, Pandemics, Prevalence, Humans, Middle Aged, Male, Incidence, COVID-19, Young Adult, SARS-CoV-2, Pneumonia, Viral/complications, Time Factors, Aged, 80 and over, Betacoronavirus, Adult, Female, Registries, Retrospective Studies, Risk Assessment/methods, Risk Factors, Atrial Fibrillation/epidemiology, Brain Ischemia/epidemiology, Denmark/epidemiology, Adolescent, Aged, Coronavirus Infections/complications

ID: 60806620