Causal associations between COVID-19 and atrial fibrillation: A bidirectional Mendelian randomization study

Xiaoyu Zhang; Biyan Wang; Tao Geng; Di Liu; Qiuyue Tian; Xiaoni Meng; Qiaoyun Zhang; Mengyang Jiang; Yiqiang Zhang; Manshu Song; Wei Wang; Youxin Wang; Baoguo Wang

doi:10.1016/j.numecd.2021.11.010

Causal associations between COVID-19 and atrial fibrillation: A bidirectional Mendelian randomization study

Nutr Metab Cardiovasc Dis. 2022 Apr;32(4):1001-1009. doi: 10.1016/j.numecd.2021.11.010. Epub 2021 Nov 20.

Authors

Xiaoyu Zhang¹, Biyan Wang², Tao Geng³, Di Liu², Qiuyue Tian², Xiaoni Meng², Qiaoyun Zhang², Mengyang Jiang⁴, Yiqiang Zhang⁴, Manshu Song⁵, Wei Wang⁶, Youxin Wang⁷, Baoguo Wang⁸

Affiliations

¹ Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
² Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
³ Geriatric Department, Emergency General Hospital, Beijing, China.
⁴ Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China.
⁵ School of Medical and Health Sciences, Edith Cowan University, Perth 60127, Australia.
⁶ Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China; School of Medical and Health Sciences, Edith Cowan University, Perth 60127, Australia; Centre for Precision Health, Edith Cowan University, Perth 6027, Australia.
⁷ Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China; School of Medical and Health Sciences, Edith Cowan University, Perth 60127, Australia. Electronic address: wangy@ccmu.edu.cn.
⁸ Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China. Electronic address: wangbg@ccmu.edu.cn.

Abstract

Background and aims: Observational studies showed that coronavirus disease (2019) (COVID-19) attacks universally and its most menacing progression uniquely endangers the elderly with cardiovascular disease (CVD). The causal association between COVID-19 infection or its severity and susceptibility of atrial fibrillation (AF) remains unknown.

Methods and results: The bidirectional causal relationship between COVID-19 (including COVID-19, hospitalized COVID-19 compared with not hospitalized COVID-19, hospitalized COVID-19 compared with the general population, and severe COVID-19) and AF are determined by using two-sample Mendelian randomization (MR) analysis. Genetically predicted severe COVID-19 was not significantly associated with the risk of AF [odds ratio (OR), 1.037; 95% confidence interval (CI), 1.005-1.071; P = 0.023, q = 0.115]. In addition, genetically predicted AF was also not causally associated with severe COVID-19 (OR, 0.993; 95% CI, 0.888-1.111; P = 0.905, q = 0.905). There was no evidence to support the association between genetically determined COVID-19 and the risk of AF (OR, 1.111; 95% CI, 0.971-1.272; P = 0.127, q = 0.318), and vice versa (OR, 1.016; 95% CI, 0.976-1.058; P = 0.430, q = 0.851). Besides, no significant association was observed for hospitalized COVID-19 with AF. MR-Egger analysis indicated no evidence of directional pleiotropy.

Conclusion: Overall, this MR study provides no clear evidence that COVID-19 is causally associated with the risk of AF.

Keywords: Atrial fibrillation; Bidirectional Mendelian randomization; Coronavirus disease 2019.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Atrial Fibrillation* / diagnosis
Atrial Fibrillation* / epidemiology
Atrial Fibrillation* / genetics
COVID-19* / epidemiology
COVID-19* / genetics
Genome-Wide Association Study
Humans
Mendelian Randomization Analysis
Polymorphism, Single Nucleotide