Abstract 10638: The Effectiveness of Covid 19 Vaccines Against New Onset Atrial Fibrillation in Hospitalized Covid 19 Patients

Abstract

Introduction: Cardiovascular complications are prevalent in COVID-19 individuals and have a poor prognosis. A link between atrial fibrillation (AF) and hospitalized COVID-19 patients was reported. Vaccines were shown to be highly effective against COVID-19 infection, poor outcomes and death. Methods: In this retrospective cohort study, we used US Veterans Health Administration COVID-19 Corporate Data Warehouse data to evaluate vaccine protection against new onset AF in patients hospitalized with COVID-19 infection. We included veterans without baseline AF who were hospitalized with COVID-19 between January 01, 2021, and November 10, 2021, and obtained their socio-demographic characteristics, diagnoses, vaccination information, symptoms, all-cause death, and diagnosis of AF during hospitalization. We define “fully vaccinated” at the time of infection as follows: for the BNT162b2 vaccine, at least 7 days from receipt of the second dose; for mRNA-1273 and Ad26.COV2.S, at least 14 days from receipt of the second dose and first dose, respectively. Partially vaccinated patients and patients hospitalized before testing positive were excluded. Considering competing risk from death, the Fine-Gray subdistribution hazard model was used to evaluate the effect of vaccination on new onset AF. Statistical analyses were performed using R (the R project for statistical computing, version 4.0.5). Results: We identified a total of 23,595 veterans hospitalized with COVID-19 positive infection without baseline AF. 1,807 (7.7%) patients were diagnosed with new onset AF before discharge from the hospital. Among vaccinated patients, 363 (6.0%) developed new onset AF, while among unvaccinated patients, 1,004 (5.7%) developed new onset AF. After adjusting for age, BMI, race, ethnicity, gender, diabetes, hypertension, COPD, CVD, and kidney disease, smoking status, alcohol abuse, substance abuse, vaccination was associated with 12% reduction in the risk of new onset AF (adjusted HR=0.88,95%CI:0.79-0.93). Conclusion: For hospitalized patients with COVID-19 infection, vaccination protects against new-onset AF. Further studies are needed to stratify hospitalized patients with COVID-19 at high risk of developing new onset AF.