Aims: Pulmonary involvement in Coronavirus disease 2019 (COVID-19) may affect right ventricular (RV) function and pulmonary pressures. The prognostic value of tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (PAPS), and TAPSE/PAPS ratios have been poorly investigated in this clinical setting. Methods and results: This is a multicenter Italian study, including consecutive patients hospitalized for COVID-19. In-hospital mortality and pulmonary embolism (PE) were identified as the primary and secondary outcome measures, respectively. The study included 227 (16.1%) subjects (mean age 68 ± 13 years); intensive care unit (ICU) admission was reported in 32.2%. At competing risk analysis, after stratifying the population into tertiles, according to TAPSE, PAPS, and TAPSE/PAPS ratio values, patients in the lower TAPSE and TAPSE/PAPS tertiles, as well as those in the higher PAPS tertiles, showed a significantly higher incidence of death vs. the probability to be discharged during the hospitalization. At univariable logistic regression analysis, TAPSE, PAPS, and TAPSE/PAPS were significantly associated with a higher risk of death and PE, both in patients who were and were not admitted to ICU. At adjusted multivariable regression analysis, TAPSE, PAPS, and TAPSE/PAPS resulted in independently associated risk of in-hospital death (TAPSE: OR 0.85, CI 0.74–0.97; PAPS: OR 1.08, CI 1.03–1.13; TAPSE/PAPS: OR 0.02, CI 0.02 × 10 −1 –0.2) and PE (TAPSE: OR 0.7, CI 0.6–0.82; PAPS: OR 1.1, CI 1.05–1.14; TAPSE/PAPS: OR 0.02 × 10 −1 , CI 0.01 × 10 −2 –0.04). Conclusions: Echocardiographic evidence of RV systolic dysfunction, increased PAPS, and poor RV-arterial coupling may help to identify COVID-19 patients at higher risk of mortality and PE during hospitalization.
【저자키워드】 COVID-19, coronavirus, outcome, pulmonary hypertension, right ventricular dysfunction, TAPSE, RV–arterial coupling, 【초록키워드】 Coronavirus disease 2019, Hospitalized, Mortality, intensive care, Hospitalization, risk, pulmonary, ICU, Probability, Patient, death, age, incidence, multicenter, Admission, Evidence, Analysis, COVID-19 patient, pulmonary artery pressure, In-hospital death, regression analysis, dysfunction, Prognostic value, Logistic regression analysis, higher risk, subject, help, secondary outcome measures, clinical setting, Affect, tricuspid, multivariable, identify, significantly, reported, investigated, adjusted, significantly higher, discharged, competing, admitted to ICU, consecutive patient, Italian study, univariable, ventricular, 【제목키워드】 pulmonary, echocardiography, function, pressure, right, with COVID-19,