Factores de riesgo de mortalidad en pacientes con infección por SARS-CoV-2 y fibrilación auricular: datos del registro SEMI-COVID-19
Javier Azaña Gómez, Luis M Pérez-Belmonte, Manuel Rubio-Rivas, José Bascuñana, Raúl Quirós-López, María Luisa Taboada Martínez, Esther Montero Hernandez, Fernando Roque-Rojas, Manuel Méndez-Bailón, Ricardo Gómez-Huelgas
Medicina Clínica, doi:10.1016/j.medcli.2022.01.008
Introducción: La fibrilación auricular y las comorbilidades asociadas a ella suponen un factor de riesgo de mortalidad, morbilidad y de desarrollo de complicaciones en los pacientes ingresados por COVID-19. Objetivos: Describir las características clínicas, epidemiológicas, radiológicas y analíticas de los pacientes con fibrilación auricular ingresados por COVID-19 en Espa ña. De forma secundaria, se pretende identificar aquellas variables que se asocian con mortalidad y mal pronóstico de la COVID-19 en pacientes que presentan fibrilación auricular. Métodos: Estudio retrospectivo, observacional y multicéntrico de ámbito nacional de pacientes hospitalizados por COVID-19 desde el 1 de marzo hasta el 1 de octubre de 2020. Los datos fueron obtenidos del Registro SEMI-COVID-19 de la Sociedad Espa ñola de Medicina Interna (SEMI) en el que participan 150 hospitales espa ñoles. Resultados: De un total de 16.461 pacientes en el registro SEMI-COVID-19, 1.816 (11%) tenían antecedente de fibrilación auricular y el número de fallecidos entre los pacientes con fibrilación auricular ascendió a 738 (41%). En cuanto a la clínica, los pacientes fallecidos ingresaron con una frecuencia cardíaca mayor (88,38 vs. 84,95; p > 0,01), con mayor porcentaje de insuficiencia respiratoria (67,2 vs. 20,1%; p < 0,01) y mayor taquipnea (58 vs. 30%; p< 0,09). En el análisis multivariante, el tratamiento con ACOD tuvo un papel protector para la mortalidad por infección por COVID-19 (OR: 0,597; IC: 0,402-0,888; p = 0,011). Conclusiones: Tanto el tratamiento previo con ACOD como el tratamiento con ACOD durante el ingreso parecen tener un papel protector en los pacientes con fibrilación auricular, aunque este hecho debería ser comprobado con estudios prospectivos.
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