tetano
Editor, Senior Moderator
Open Heart
. 2022 May;9(1):e001854.
doi: 10.1136/openhrt-2021-001854.
Evaluating the role of transthoracic echocardiography in hospitalised patients with COVID-19 infection
Aswin Babu[SUP] 1 [/SUP], Zhaoyi Meng[SUP] 2 [/SUP], Nadia Eden[SUP] 2 [/SUP], Daniel Lamb[SUP] 2 [/SUP], Jan Nouza[SUP] 2 [/SUP], Raghav Bhatia[SUP] 3 [/SUP], Irina Chis Ster[SUP] 4 [/SUP], Jonathan Bennett[SUP] 5 [/SUP], Victor Voon[SUP] 2 [/SUP]
Affiliations
Abstract
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.
Keywords: COVID-19; Diagnostic Imaging; Echocardiography; Hypertension.
. 2022 May;9(1):e001854.
doi: 10.1136/openhrt-2021-001854.
Evaluating the role of transthoracic echocardiography in hospitalised patients with COVID-19 infection
Aswin Babu[SUP] 1 [/SUP], Zhaoyi Meng[SUP] 2 [/SUP], Nadia Eden[SUP] 2 [/SUP], Daniel Lamb[SUP] 2 [/SUP], Jan Nouza[SUP] 2 [/SUP], Raghav Bhatia[SUP] 3 [/SUP], Irina Chis Ster[SUP] 4 [/SUP], Jonathan Bennett[SUP] 5 [/SUP], Victor Voon[SUP] 2 [/SUP]
Affiliations
- PMID: 35534093
- DOI: 10.1136/openhrt-2021-001854
Abstract
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.
Keywords: COVID-19; Diagnostic Imaging; Echocardiography; Hypertension.