Abstract
Background
Focused transthoracic echocardiography (fTTE) has emerged as a critical diagnostic tool during the COVID-19 pandemic, allowing for efficient cardiac imaging while minimizing staff exposure. The utility of fTTE in predicting clinical outcomes in COVID-19 remains under investigation.
Methods
We conducted a retrospective study of 2,266 hospitalized patients at Rush University Medical Center with COVID-19 infection between March and November 2020 who received a fTTE. fTTE data were analyzed for association with primary adverse outcomes (60-day mortality) and with secondary adverse outcomes (need for renal replacement therapy, need for invasive ventilation, shock, and venous thromboembolism).
Results
Of the 427 hospitalized patients who had a fTTE performed (mean 62 years, 43% female), 109 (26%) had died by 60 days. Among patients with an available fTTE measurement, right ventricular (RV) dilation was noted in 34% (106/309), 43% (166/386) had RV dysfunction, and 17% (72/421) had left ventricular (LV) dysfunction. In multivariable models accounting for fTTE data, RV dilation was significantly associated with 60-day mortality (OR 1.93 [CI 1.13–3.3], p = 0.016). LV dysfunction was not significantly associated with 60-day mortality (OR 0.95 [CI: 0.51–1.78], p = 0.87).
Conclusions
Abnormalities in RV echocardiographic parameters are adverse prognosticators in COVID-19 disease. Patients with RV dilation experienced double the risk for 60-day mortality due to COVID-19. To our knowledge, this is the largest study to date that highlights the adverse prognostic implications of RV dilation as determined through fTTE in hospitalized COVID-19 patients.
【저자키워드】 COVID-19, Mortality, Prognosis, echocardiography, 【초록키워드】 knowledge, COVID-19 pandemic, Infection, diagnostic, risk, Venous Thromboembolism, invasive ventilation, COVID-19 disease, Clinical outcome, adverse outcome, Retrospective study, Shock, female, Patient, prognostic, utility, university, Critical, association, renal replacement therapy, Cardiac imaging, dysfunction, hospitalized COVID-19 patients, center, RV dysfunction, multivariable model, LV dysfunction, implication, highlight, Result, analyzed, performed, died, significantly, conducted, hospitalized patient, echocardiographic parameter, ventricular, with COVID-19, 【제목키워드】 COVID-19 disease, morbidity, predictor,