Features of sinus rhythm restoration in patients with paroxysmal and persistent non-valvular atrial fibrillation and previous COVID-19 infection in iron-deficiency anaemia

Abstract

Background. Currently, there are conclusive data in the literature on the effect of reduced haemoglobin concentration on sinus rhythm restoration in patients with nonvalvular atrial fibrillation. It is relevant to study the features of rhythm restoration in patients with anaemia and atrial fibrillation in COVID-19 infection.
 Aim. To study the effects of iron-deficiency anaemia on sinus rhythm restoration rate and the dose of amiodarone required for this in patients with paroxysmal and persistent non-valvular atrial fibrillation and previous COVID-19 infection.
 Material and methods. The study included 63 patients aged between 53 and 94 years (mean age 60.810.9 years): 26 men (41.3%) and 37 women (58.7%). The patients were divided into groups according to the presence of anaemia and computed tomography staging (CT severity score) of lung damage. Criteria for inclusion: paroxysmal or persistent non-valvular atrial fibrillation; previous COVID-infection (according to the documents, medical records). We took into account medical histories, laboratory and instrumental findings, as well as treatment. The statistical analysis was performed by using the Statistica 13.3 software. The obtained data were presented as M or Me [Q1; Q3]. The differences between the indicators were assessed using Students t test, the MannWhitney U test and the KruskalWallis H test. Nominal variables were compared by using Pearsons 2 test with Yates correction or Fishers criterion. The relationship between the parameters was assessed using the Pearsons or Spearmans correlation coefficient. A p 0.05 was considered statistically significant.
 Results. The patients with normal haemoglobin concentration restored sinus rhythm for 10 [4; 13] hours and the patients with iron-deficiency anaemia for 5.5 [2; 10] hours (p=0.044). In patients with COVID-19 pneumonia, we found a direct correlation between the degree of lung damage and the dose of amiodarone (r=0.33, p 0.05), as well as the time of sinus rhythm restoration (r=0.48, p 0.05).
 Conclusion. The presence of iron-deficiency anaemia in patients with previous COVID-19 infection and paroxysmal and persistent non-valvular atrial fibrillation is associated with a shorter time and a lower dose of amiodarone required for successful sinus rhythm restoration in comparison to patients with normal haemoglobin concentration; in patients with more severe lung damage caused by COVID-19 pneumonia, it takes more time and a large dose of amiodarone for sinus rhythm restoration.