Key result
Impaired left ventricular ejection fraction was significantly and independently associated with 30-day all-cause mortality (HR 12.19) in patients hospitalized with acute COVID-19 infection.
Why the study?
Impaired cardiac function and pre-existing cardiovascular disease may be associated with poor prognosis in patients with COVID-19 infection, prompting comprehensive cardiovascular characterization in admitted patients.
Does impaired cardiac function predict 30-day all-cause mortality in patients hospitalized with acute COVID-19 infection?
Cohort (n=123)
No
Does impaired cardiac function predict 30-day all-cause mortality in patients hospitalized with acute COVID-19 infection?
Hazard Ratio: 12.19 (95% CI 2.87–51.83)
p-value: p=0.001
Impaired left and right ventricular function, as well as elevated myocardial distress markers, are significantly associated with increased 30-day mortality in patients hospitalized with acute COVID-19 infection.
May support echocardiography for prognostication in acute COVID-19; hypothesis-generating and requires prospective validation.
BACKGROUND: COVID-19 infection may cause severe respiratory distress and is associated with increased morbidity and mortality. Impaired cardiac function and/or pre-existing cardiovascular disease may be associated with poor prognosis. In the present study, we report a comprehensive cardiovascular characterization in the first consecutive collective of patients that was admitted and treated at the University Hospital of Tübingen, Germany. METHODS: 123 consecutive patients with COVID-19 were included. Routine blood sampling, transthoracic echocardiography and electrocardiography were performed at hospital admission. RESULTS: We found that impaired left-ventricular and right-ventricular function as well as tricuspid regurgitation > grade 1 were significantly associated with higher mortality. Furthermore, elevated levels of myocardial distress markers (troponin-I and NT pro-BNP) were associated with poor prognosis in this patient collective. CONCLUSION: Impaired cardiac function is associated with poor prognosis in COVID-19 positive patients. Consequently, treatment of these patients should include careful guideline-conform cardiovascular evaluation and treatment. Thus, formation of a competent Cardio-COVID-19 team may represent a major clinical measure to optimize therapy of cardiovascular patients during this pandemic.
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Rath et al. (2020) conducted a cohort in COVID-19 (n=123). Impaired left ventricular ejection fraction (LVEF ≤ 50%) vs. Normal left ventricular ejection fraction was evaluated on 30-day all-cause mortality (HR 12.19, 95% CI 2.87-51.83, p=0.001). Impaired left ventricular ejection fraction was significantly and independently associated with 30-day all-cause mortality (HR 12.19) in patients hospitalized with acute COVID-19 infection.
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