Echocardiography- an effective tool for risk assessment of COVID-19 patients
Transthoracic echocardiography (TTE) might be a useful tool in risk stratification of patients with COVID-19, suggests a recent study published in the European Journal of Clinical Investigation.
Coronavirus disease 2019 (COVID-19) is a recently recognized viral infective disease which can be complicated by acute respiratory stress syndrome (ARDS) and cardiovascular complications including severe arrhythmias, acute coronary syndromes, myocarditis and pulmonary embolism.
Angelo Silverio et al. from the Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italyaimed to identify the clinical conditions and echocardiographic parameters associated with in-hospital mortality in COVID-19.
The researchers carried out a multicentre retrospective observational study including seven Italian centres. Patients hospitalized with COVID-19 were included into study population. The association between baseline variables and risk of in-hospital mortality was assessed through multivariable logistic regression and competing risk analyses.
The following findings were found and noted-
a. Out of 1401 patients admitted at the participating centres with 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).
As a result, the authors concluded that "cardiovascular complications can negatively impact on 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."
Furthermore, they inferred that preliminary findings need to be confirmed in larger, prospective studies.