Key result
Aortic valve stenosis was associated with 11 times higher odds of in-hospital mortality (OR 11) compared to normal aortic valves in hospitalized COVID-19 patients.
Why the study?
Cardiac complications can occur during acute and post-infection phases of COVID-19, motivating evaluation of echocardiographic characteristics associated with in-hospital mortality and changes at follow-up.
Do abnormal echocardiographic findings predict in-hospital mortality in hospitalized COVID-19 patients?
Cohort (n=146)
No
Do abnormal echocardiographic findings predict in-hospital mortality in hospitalized COVID-19 patients?
Abnormal echocardiographic findings, including left ventricle wall hypokinesia, aortic valve stenosis, dilated IVC, and elevated PASP, are significant predictors of in-hospital mortality in COVID-19 patients.
Aortic stenosis may flag high-risk COVID-19 inpatients; leaves open whether echocardiography should guide triage or therapy.
Introduction: Evidence showed that cardiac complications may occur in coronavirus disease-19 (COVID-19) during the acute and post-infection phases. This study aimed to evaluate the association between the echocardiographic characteristics and in-hospital mortality of COVID-19 patients as well as the changes after one-month follow-up. Method: All adult (≥18 years old) hospitalized COVID-19 patients in need of echocardiography based on the guideline of the Iranian Society of Echocardiography for performing various types of echocardiography during the COVID-19 pandemic were included in this study. An expert cardiologist performed the echocardiography on all patients and also on all available patients one month after discharge. Results: 146 hospitalized cases of COVID-19 and 81 cases available for 1-month follow-up echocardiography were studied in this prospective study. Left ventricle wall hypokinesia, aorta valve stenosis, dilated Inferior Vena Cava (IVC), and Pulmonary Artery Systolic Pressure (PASP) of more than 35 were associated with 3.59 (95% CI: 1.19-10.79, p = 0.02), 11 (95% CI: 3.3 - 36.63, p = 0.001), 5.58 (95% CI: 1.04-29.41, p = 0.041), and 2.91 (95% CI: 1.35 - 6.3, p = 0.001) times higher odds of mortality than healthy subjects. In 1-month follow-up of patients, deterioration in LVEF (p = 0.03) was detected in the not-fully vaccinated patients, and a significant decrease in PASP was observed in all cases (p = 0.04); but these changes were not clinically important. Conclusion: Left ventricle wall hypokinesia, aorta valve stenosis, dilated IVC, and PASP ≥ 35 were predictors of in-hospital mortality in our study. There were not any potential clinically significant differences in one-month echocardiographic follow-ups of the studied patients.
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Aghili et al. (2022) conducted a cohort in COVID-19 (n=146). Aortic valve stenosis vs. Normal aortic valve was evaluated on In-hospital mortality (OR 11, 95% CI 3.3-36.63, p=0.001). Aortic valve stenosis was associated with 11 times higher odds of in-hospital mortality (OR 11) compared to normal aortic valves in hospitalized COVID-19 patients.
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