Coronavirus disease 2019 (COVID-19) is associated with acute respiratory distress syndrome (ARDS) and cardiovascular complications, including myocarditis, severe arrhythmias, acute coronary syndromes, and pulmonary embolism. Researchers performed a study to identify the clinical conditions and echocardiographic parameters associated with in-hospital mortality in COVID-19.
According to the study, transthoracic echocardiography (TTE) might be a useful tool in the risk stratification of patients with COVID-19. The results of the study were published in the European Journal of Clinical Investigation. The researchers carried out a multicentre retrospective observational study that included seven Italian centers. Patients hospitalized with COVID-19 were included in the study population. The association between baseline variables and the risk of in-hospital mortality was assessed through multivariable logistic regression and competing risk analysis.
The following findings were noted.
a. Out of 1401 patients admitted at the participating centers with a confirmed diagnosis of COVID-19, 226 (16.1%) underwent transthoracic echocardiography (TTE) and were included in the present analysis.
b. In-hospital death occurred in 68 patients (30.1%).
c. At multivariable analysis, left ventricular ejection fraction (LVEF, P < .001), tricuspid annular plane systolic excursion (TAPSE, P < .001) and ARDS (P < .001) were independently associated with in-hospital mortality.
d. At competing risk analysis, we found a significantly higher risk of mortality in patients with ARDS vs. those without ARDS (HR: 7.66; CI: 3.95-14.8), in patients with TAPSE ≤17 mm vs. those with TAPSE >17 mm (HR: 5.08; CI: 3.15- 8.19) and in patients with LVEF ≤50% vs. those with LVEF >50% (HR: 4.06; CI: 2.50-6.59).
The authors concluded that “cardiovascular complications can negatively impact outcomes of patients with COVID-19. Clinical and echocardiographic parameters such as LVEF ≤50%, TAPSE ≤17 mm, and ARDS might help to identify patients at higher risk for in-hospital mortality.”
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