• Gianluca Bagnato, Egidio Imbalzano, Caterina Oriana Aragona, Carmelo Ioppolo, Pierpaolo Di Micco, Daniela La Rosa, Francesco Costa, Antonio Micari, Simona Tomeo, Natalia Zirilli, Angela Sciacqua, Tommaso D'Angelo, Irene Cacciola, Alessandra Bitto, Natasha Irrera, Vincenzo Russo, William Neal Roberts, Sebastiano Gangemi, and Antonio Giovanni Versace.
• Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy.
• Medicina (Kaunas). 2022 Apr 11; 58 (4).

AbstractBackground and objectives: COVID-19 is associated with an aberrant inflammatory response that may trigger new-onset cardiac arrhythmias. The aim of this study was to assess the mortality risk in hospitalized COVID-19 patients according to IL-6 serum levels and new-onset atrial fibrillation (AF) according to PaO2/FiO2 stratification. Materials and Methods: 175 COVID-19 patients (25 new-onset AF, 22 other types of AF and 128 no-AF) were included in this single-center, retrospective study; clinical and demographic data, vital signs, electrocardiograms and laboratory results were collected and analyzed. The primary outcome of the study was to evaluate the mortality rate in new-onset AF patients according to IL-6 serum levels and PaO2/FiO2 stratification. Results: The incidence of new-onset AF in the study population was 14.2%. Compared to the no-AF group, new-onset AF patients were older with a positive history of chronic kidney disease and heart failure, had higher IL-6, creatinine and urea serum levels whereas their platelet count was reduced. After PaO2/FiO2 stratification, 5-days mortality rate was higher in new-onset AF patients compared to patients with other types of AF and no-AF patients, and mortality risk increases 5.3 fold compared to no-AF (p = 0.0014) and 4.8 fold compared to other forms of AF (p = 0.03). Conclusions: New-onset AF is common in COVID-19 patients and is associated with increased IL-6 serum levels and early mortality. Further studies are needed to support the use of IL-6 as an early molecular target for COVID-19 patients to reduce their high rate of mortality.

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