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COVID-19 pandemic and trends in new diagnosis of atrial fibrillation: A nationwide analysis of claims data

Atrial fibrillation (AF) is associated with a five-fold increased risk of stroke and a two-fold increased risk of death. We aimed to quantify changes in new diagnoses of AF following the onset of the COVID-19 pandemic. Investigating changes in new diagnoses of AF is of relevance because delayed diag...

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Published in:PloS one 2023-02, Vol.18 (2), p.e0281068-e0281068
Main Authors: Hernandez, Inmaculada, He, Meiqi, Guo, Jingchuan, Tadrous, Mina, Gabriel, Nico, Swabe, Gretchen, Gellad, Walid F, Essien, Utibe R, Saba, Samir, Benjamin, Emelia J, Magnani, Jared W
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cited_by cdi_FETCH-LOGICAL-c692t-2b110cfe6881a388a0d1838c4ea681bc8fc88b6de952c501d10684183c79108e3
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creator Hernandez, Inmaculada
He, Meiqi
Guo, Jingchuan
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Gellad, Walid F
Essien, Utibe R
Saba, Samir
Benjamin, Emelia J
Magnani, Jared W
description Atrial fibrillation (AF) is associated with a five-fold increased risk of stroke and a two-fold increased risk of death. We aimed to quantify changes in new diagnoses of AF following the onset of the COVID-19 pandemic. Investigating changes in new diagnoses of AF is of relevance because delayed diagnosis interferes with timely treatment to prevent stroke, heart failure, and death. Using De-identified Optum's Clinformatics® Data Mart, we identified 19,500,401 beneficiaries continuously enrolled for 12 months in 2016-Q3 2020 with no history of AF. The primary outcome was new AF diagnoses per 30-day interval. Secondary outcomes included AF diagnosis in the inpatient setting, AF diagnosis in the outpatient setting, and ischemic stroke as initial manifestation of AF. We constructed seasonal autoregressive integrated moving average models to quantify changes in new AF diagnoses after the onset of the COVID-19 pandemic (3/11/2020, date of pandemic declaration). We tested whether changes in the new AF diagnoses differed by race and ethnicity. The average age of study participants was 51.0±18.5 years, and 52% of the sample was female. During the study period, 2.7% of the study sample had newly-diagnosed AF. New AF diagnoses decreased by 35% (95% CI, 21%-48%) after the onset of the COVID-19 pandemic, from 1.14 per 1000 individuals (95% CI, 1.05-1.24) to 0.74 per 1000 (95% CI, 0.64 to 0.83, p-value
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We aimed to quantify changes in new diagnoses of AF following the onset of the COVID-19 pandemic. Investigating changes in new diagnoses of AF is of relevance because delayed diagnosis interferes with timely treatment to prevent stroke, heart failure, and death. Using De-identified Optum's Clinformatics® Data Mart, we identified 19,500,401 beneficiaries continuously enrolled for 12 months in 2016-Q3 2020 with no history of AF. The primary outcome was new AF diagnoses per 30-day interval. Secondary outcomes included AF diagnosis in the inpatient setting, AF diagnosis in the outpatient setting, and ischemic stroke as initial manifestation of AF. We constructed seasonal autoregressive integrated moving average models to quantify changes in new AF diagnoses after the onset of the COVID-19 pandemic (3/11/2020, date of pandemic declaration). We tested whether changes in the new AF diagnoses differed by race and ethnicity. 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Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hernandez, Inmaculada</au><au>He, Meiqi</au><au>Guo, Jingchuan</au><au>Tadrous, Mina</au><au>Gabriel, Nico</au><au>Swabe, Gretchen</au><au>Gellad, Walid F</au><au>Essien, Utibe R</au><au>Saba, Samir</au><au>Benjamin, Emelia J</au><au>Magnani, Jared W</au><au>Jeong, Han Eol</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>COVID-19 pandemic and trends in new diagnosis of atrial fibrillation: A nationwide analysis of claims data</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-02-02</date><risdate>2023</risdate><volume>18</volume><issue>2</issue><spage>e0281068</spage><epage>e0281068</epage><pages>e0281068-e0281068</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Atrial fibrillation (AF) is associated with a five-fold increased risk of stroke and a two-fold increased risk of death. We aimed to quantify changes in new diagnoses of AF following the onset of the COVID-19 pandemic. Investigating changes in new diagnoses of AF is of relevance because delayed diagnosis interferes with timely treatment to prevent stroke, heart failure, and death. Using De-identified Optum's Clinformatics® Data Mart, we identified 19,500,401 beneficiaries continuously enrolled for 12 months in 2016-Q3 2020 with no history of AF. The primary outcome was new AF diagnoses per 30-day interval. Secondary outcomes included AF diagnosis in the inpatient setting, AF diagnosis in the outpatient setting, and ischemic stroke as initial manifestation of AF. We constructed seasonal autoregressive integrated moving average models to quantify changes in new AF diagnoses after the onset of the COVID-19 pandemic (3/11/2020, date of pandemic declaration). We tested whether changes in the new AF diagnoses differed by race and ethnicity. The average age of study participants was 51.0±18.5 years, and 52% of the sample was female. During the study period, 2.7% of the study sample had newly-diagnosed AF. New AF diagnoses decreased by 35% (95% CI, 21%-48%) after the onset of the COVID-19 pandemic, from 1.14 per 1000 individuals (95% CI, 1.05-1.24) to 0.74 per 1000 (95% CI, 0.64 to 0.83, p-value&lt;0.001). New AF diagnoses decreased by 37% (95% CI, 13%- 55%) in the outpatient setting and by 29% (95% CI, 14%-43%) in the inpatient setting. The decrease in new AF diagnoses was similar across racial and ethnic subgroups. In a nationwide cohort of 19.5 million individuals, new diagnoses of AF decreased substantially following the onset of the COVID-19 pandemic. Our findings evidence pandemic disruptions in access to care for AF, which are concerning because delayed diagnosis interferes with timely treatment to prevent complications.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36730318</pmid><doi>10.1371/journal.pone.0281068</doi><tpages>e0281068</tpages><orcidid>https://orcid.org/0000-0003-4076-2336</orcidid><orcidid>https://orcid.org/0000-0002-0118-4986</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
ispartof PloS one, 2023-02, Vol.18 (2), p.e0281068-e0281068
issn 1932-6203
1932-6203
language eng
recordid cdi_plos_journals_2771912381
source Access via ProQuest (Open Access); PubMed Central; Coronavirus Research Database
subjects Adult
Age
Aged
Atrial fibrillation
Atrial Fibrillation - complications
Atrial Fibrillation - diagnosis
Atrial Fibrillation - epidemiology
Autoregressive models
Cardiac arrhythmia
Chronic illnesses
Complications
Congestive heart failure
Control
Coronaviruses
COVID-19
COVID-19 - complications
COVID-19 - diagnosis
COVID-19 - epidemiology
COVID-19 Testing
Death
Diagnosis
Disease
Epidemics
Ethnicity
Female
Fibrillation
Health care access
Health risks
Hispanic people
Humans
Incidence
Ischemia
Medical diagnosis
Medicare
Medicine and Health Sciences
Middle Aged
Minority & ethnic groups
Pandemics
Race
Regression analysis
Risk Factors
Social Sciences
Stroke
Stroke - epidemiology
Subgroups
Time series
Trends
title COVID-19 pandemic and trends in new diagnosis of atrial fibrillation: A nationwide analysis of claims data
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