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PACE - manuscript for review
COVID+. In addition, we observed a temporal relationship between new onset atrial tachyarrhythmia and hemodynamic compromise in individuals who were COVID+ which might explain their increased in-hospital mortality. In fact, of the 16 individuals with COVID-19 and a new onset atrial tachyarrhythmia who subsequently died, 12 (75%) had hemodynamic compromise immediately after developing the atrial tachyarrhythmia.
atrial tachyarrhythmia in critically ill individuals is thought to be driven by both individual factors such as myocardial dysfunction due to infection, drugs, and cytokine levels 19 as well as by critical care interventions such as vasopressor use and mechanical ventilation. 20-23 The occurrence of atrial tachyarrhythmia during critical illness has been associated with poor outcomes, including increased hospital mortality,9 increased duration of ICU admission, and 1-year adjusted survival.7 However, to our knowledge, the consequences of atrial tachyarrhythmia in COVID-19 related critical illness have not been previously reported.
We found that the short-term effect of atrial tachyarrhythmia on COVID+ participants was distinct from that seen in those who were COVID-, with a marked temporal correlation between onset of atrial tachyarrhythmia and hemodynamic compromise seen uniquely among a group of COVID+ individuals who were mechanically ventilated and requiring significant levels of ventilator support. COVID+ participants who developed atrial tachyarrhythmia with concurrent