Assessing the Outcomes of Hospitalized Patients with COVID-19 on Amiodarone

Background: In vitro, studies have suggested that amiodarone can inhibit SARS-CoV-2 replication, potentially benefiting COVID-19 patients. Objective: This study investigates whether patients with a history of atrial fibrillation on amiodarone have improved outcomes compared to those not on amiodarone, focusing on mortality rates, length of hospital stays, and disease severity. Methods: Using a multiple logistic regression model, we assessed associations between clinical predictors and in-hospital mortality among 616 COVID-19 positive patients with a history of atrial fibrillation. The analysis included comparisons between patients on amiodarone and those not on the medication at admission or discharge. Time-to-event analysis was also performed using the Kaplan-Meier estimator and Cox proportional hazards regression model. Results: Out of 616 patients, 57 (9.25%) were on amiodarone before admission. In-hospital mortality was observed in 148 (24.03%) patients, with 19.30% in the amiodarone group and 24.31% in the non-amiodarone group. Amiodarone use at admission was not significantly associated with reduced mortality (OR=0.63, 95% CI 0.31-1.28, p=0.20). Cox regression analysis also showed no significant difference in survival (HR=0.601, 95% CI 0.321-1.127, p=0.11). Similarly, amiodarone use did not significantly affect the likelihood of requiring mechanical ventilation (OR=1.366, 95% CI 0.688-2.711, p=0.3732). Conclusion: Amiodarone use in COVID-19 patients with atrial fibrillation was not significantly associated with improved in-hospital mortality or reduced need for mechanical ventilation. These findings suggest that while amiodarone may have potential in vitro benefits, further clinical trials are needed to establish its efficacy and safety in COVID-19 treatment.