{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T21:47:11Z","timestamp":1775771231394,"version":"3.50.1"},"reference-count":52,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Individuals with arrhythmia who survived COVID-19 could be susceptible to long-term cardiovascular complications and clinical outcomes. Methods: We performed a retrospective cohort study of adults with a history of arrhythmia in the Montefiore Health System (1 January 2016\u201317 August 2024). COVID-19 status was determined by a positive or negative polymerase-chain-reaction test. Outcomes included all-cause mortality, first-time myocardial infarction (MI), heart failure (HF), ischemic or hemorrhagic stroke, and major adverse cardiovascular events (MACE: defined as MI, HF, stroke, or death) &gt; 30 days post-index date. Cox proportional hazards and Fine\u2013Gray competing risk models, adjusted for demographic, clinical, socioeconomic, and COVID-19 vaccination variables, were employed. The association of outcomes with blood biomarkers taken at time of infection were also assessed in hospitalized COVID-19 patients. Results: Among the 6830 arrhythmia patients, 985 were hospitalized for COVID-19, 1591 were not hospitalized for COVID-19, and 4254 did not have COVID-19. Patients hospitalized for COVID-19 had a higher risk of all-cause mortality (adjusted hazard ratio = 2.90, 95% confidence-interval [2.08, 4.04]), first-time MI, HF, and MACE compared to controls without COVID-19. No increased risk was observed among non-hospitalized COVID-19-positive patients compared to controls, except for all-cause mortality. Older age, male sex, Medicaid, and significant comorbidities were associated with the risk of MACE. Elevated levels of creatinine, lactate dehydrogenase, D-dimer, neutrophil-to-lymphocyte ratio, low hemoglobin, and low left ventricular ejection fraction during infection were associated with higher future MACE risk. Conclusions. In individuals with arrhythmia, severe COVID-19 is associated with increased long-term risks of mortality and new-onset cardiovascular complications, while mild infection with mortality risk. These findings highlight the need for long-term cardiovascular monitoring in this population.<\/jats:p>","DOI":"10.3390\/diagnostics16010038","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T11:30:18Z","timestamp":1766489418000},"page":"38","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long-Term Cardiovascular and Mortality Risk in Patients with Pre-Existing Arrhythmia Post-SARS-CoV-2 Infection"],"prefix":"10.3390","volume":"16","author":[{"given":"Suhani","family":"Pahuja","sequence":"first","affiliation":[{"name":"Department of Radiology, Albert Einstein College of Medicine and Montefiore Health System, Bronx, NY 10647, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2231-0172","authenticated-orcid":false,"given":"Roham","family":"Hadidchi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Albert Einstein College of Medicine and Montefiore Health System, Bronx, NY 10647, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janhavi","family":"Tonge","sequence":"additional","affiliation":[{"name":"Department of Radiology, Albert Einstein College of Medicine and Montefiore Health System, Bronx, NY 10647, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6471-4569","authenticated-orcid":false,"given":"Sonya","family":"Henry","sequence":"additional","affiliation":[{"name":"Department of Radiology, Albert Einstein College of Medicine and Montefiore Health System, Bronx, NY 10647, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6403-2827","authenticated-orcid":false,"given":"Tim Q.","family":"Duong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Albert Einstein College of Medicine and Montefiore Health System, Bronx, NY 10647, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","first-page":"e199","article-title":"2014 AHA\/ACC\/HRS guideline for the management of patients with atrial fibrillation: A report of the American College of Cardiology\/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society","volume":"130","author":"January","year":"2014","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e190","DOI":"10.1016\/j.hrthm.2017.10.035","article-title":"2017 AHA\/ACC\/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Executive summary: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society","volume":"15","author":"Stevenson","year":"2018","journal-title":"Heart Rhythm"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1001\/jama.2024.22451","article-title":"Atrial Fibrillation: A Review","volume":"333","author":"Ko","year":"2025","journal-title":"JAMA"},{"key":"ref_5","first-page":"101127","article-title":"Atrial fibrillation is a risk factor for major adverse cardiovascular events in COVID-19","volume":"43","author":"Cutler","year":"2022","journal-title":"Int. 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