Analysis of the increase in AF mortality during the first year of Covid-19 in the US.

Introduction: In the United States the impact of the COVID-19 pandemic on atrial fibrillation (AF) related mortality has not been described. Methods: AF related mortality data were extracted for the years 2018-2020 from the Centers for Disease Control and Prevention (CDC), the Wide-ranging Online Data for Epidemiologic Research (WONDER) database. We compared main causes of AF related mortality and age adjusted mortality rate (AAMR) among different subgroups in the years 2018-2019 vs 2020 to reveal patterns of increased mortality. Results: Compared to 2018-2019, we observed a 18% increase in AF related age adjusted mortality in 2020 (52.2 vs 44.25 per 100,000 vs population). In 2020, COVID-19 was the third most common main cause of death among people with AF (8% of deaths, AAMR of 4.9 per 100,000). Examination of the relative increase in AF related mortality among different subgroups revealed a more prominent increase among males (21% increase vs 14.5% among females) those younger than 65 years old (30% increase, vs. 16% among those younger than 65 years old), and among racial and ethnic minorities. Conclusion: There was a sharp rise in AF related mortality during the first pandemic year. Males, those from younger age groups, and ethnic minority groups showed the largest increases in mortality. Targeted health policies could help address the disparities observed in this analysis.