Thrombosis risk factors in patients with atrial fibrillation according to the CHA2DS2-VASc scales depending on the previous COVID-19 infection
Authors: Sychov O S , Stasyshena O V , Romanova O M , Getman T V , Sribna O V , Zinchenko Y U V , Mikhalieva T V , Ilchyshyna O Y A , Granich V M 
Published: May 2023

Funding Acknowledgements

Type of funding sources: Other. Main funding source(s): In. of cardiology

Introduction

The disease COVID-19, caused by the SARS-CoV-2 coronavirus, is characterized by an increase in the inflammatory response from all systems of the human body, which, in turn, can lead to such a serious complication as coagulopathy.

Purpose

To evaluate the risk factors of thromboembolismaccording to the CHA2DS2-VASc scale in patients with AF depending on the previous coronavirus infection (CI).

Materials and methods

The study included 187 patients aged 62.5±0.9 years (47% men, 53% women). The vast majority of patients (89%) had arterial hypertension (II stage – 80%, III stage – 9%). Chronic forms of coronary heart disease were diagnosed in 53% of patients. The first three groups formed 116 patients who had AF and underwent coronavirus infection (CI). The first group (G1) consisted of 36 patients who did not have AF before CI. The second group (G2) was represented by 25 patients in whom the transition of the paroxysmal form of AF into persistent, or persistent AF into its permanent form occurred. The third group (G3) consisted of 55 patients in whom the form of AF did not change, but in 35 of them the frequency or duration of AF paroxysms increased (subgroup 3a), and in 20 people the frequency or duration of AF paroxysms did not change (subgroup 3b). Two control groups were also formed: K1 - 49 patients with AF who did not have a history of HF, and K2 - 22 patients with extrasystole who experienced HF, but who did not develop AF.

Results

In the course of the work, it was established that patients of the 1st, 2nd and 3rd groups, compared to patients of the first control group, when evaluating the average points on the CHADS2-VASc scale, had a higher risk of thromboembolism (3,06 vs. 2,90, p &lt; 0.001 ). In a detailed analysis of the number of patients who had CHA2DS2VASc - 0 - 2 points and CHA2DS2VASc - ≥ 2 points per minute. of the examined groups, it was found that there were more people with a high risk of thrombus formation among AF patients who underwent CI. In the 1st group (72.2% vs. 27.8%, p &lt; 0.01), in the 2nd group (68% vs. 32%, p &lt; 0.01) and the 3rd group (70.9 % versus 29.1%, p &lt; 0.01). Patients of subgroup 3a compared to subgroup 3b had a higher percentage of complications such as cerebral stroke and TIA in the anamnesis (8.6% vs. 0%), that is, these complications worsen the course of AF after CI.

Conclusions

In patients with newly registered paroxysms of AF or in patients in whom the course of existing AF worsened against the background of a previous CI, there were significantly higher risks of thrombus formation according to the CHA2DS2-VASc scale. Special attention is drawn to patients who did not have this arrhythmia before CI, but who after its occurrence have a higher risk of cardioembolic complications. This indicates the need for prevention of thromboembolism and careful screening for AF.