Key result
RV dysfunction is linked to ~197% greater risk of adverse outcomes in hospitalized COVID-19 patients.
Why the study?
The role and common echocardiographic features of transthoracic echocardiography in hospitalized patients with COVID-19 and their association with myocardial injury and outcomes were not well defined.
What are the most common transthoracic echocardiogram parameters in hospitalized COVID-19 patients and are they associated with inpatient mortality?
Cohort (n=87)
No
What are the most common transthoracic echocardiogram parameters in hospitalized COVID-19 patients and are they associated with inpatient mortality?
Odds Ratio: 2.97 (95% CI 1.11–7.94)
p-value: p=<0.03
In hospitalized COVID-19 patients, right ventricular dysfunction on echocardiography is common and significantly associated with inpatient mortality, whereas COVID-19-induced myocarditis is rare.
RV dysfunction on echo was associated with mortality in COVID-19 inpatients; hypothesis-generating and requires prospective validation before guiding care.
OBJECTIVE: To identify the most common transthoracic echocardiogram (TTE) parameters in patients hospitalised with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) and their association with myocardial injury and outcomes. METHODS: A retrospective, single-centre, observational, exploratory cohort study was performed at the height of the COVID-19 pandemic. All SARS-CoV-2 polymerase chain reaction (PCR) positive patients who underwent a TTE during their inpatient admission between 1 March 2020 and 31 October 2020 were analysed. The most frequent cardiovascular risk factor profile and echocardiographic features were investigated. RESULTS: A total of 87 patients met the eligibility criteria. A salient 41.4% (n=36) of our cohort succumbed to this devastating virus. More than half of our hospital population (58.6%) were admitted to the intensive care unit (ITU) and this was significantly associated with inpatient mortality (OR: 7.14, CI 2.53 to 20.19, p<0.001). Hypertension was the most common cardiovascular risk factor (51.7%) with no additional prominence in non-survivors (OR: 2.33, CI 0.97 to 5.61, p=0.059). Remarkably, 90.8% of our cohort demonstrated a preserved left ventricular ejection fraction, although 69.1% had elevated troponin levels. Only 1 patient (1.1%) was given a diagnostic label of myocarditis. A raised pulmonary artery systolic pressure (36.8%) andright ventricle (RV) dysfunction (26.4%) were the most common echocardiographic features. In particular, the presence of RV dysfunction was significantly related to adverse outcomes (OR: 2.97, CI 1.11 to 7.94, p<0.03). CONCLUSIONS: In this cohort of extremely unwell patients hospitalised with COVID-19 pneumonitis, the presence of RV dysfunction or admission to ITU was significantly associated with inpatient case fatality ratio. Moreover, COVID-19-induced myocarditis remains extremely rare.
No takes yet. Share an insight, caveat, or question.
Babu et al. (2022) conducted a cohort in SARS-CoV-2/COVID-19 (n=87). Right ventricle (RV) dysfunction vs. Absence of RV dysfunction was evaluated on Adverse outcomes (OR 2.97, 95% CI 1.11 to 7.94, p=<0.03). In hospitalized patients with COVID-19, the presence of right ventricular dysfunction on echocardiography was significantly associated with adverse outcomes (OR 2.97; 95% CI 1.11-7.94; p<0.03).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: