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Presentations and Outcomes of Severe Cardiac Complications in COVID-19: Rhode Island Experience
Arkadiy Finn1, Atin Jindal1, Vijairam Selvaraj1
1Division of Hospital Medicine, The Miriam Hospital, Providence, Rhode Island.
Insights
COVID-19 can cause severe cardiac complications like myocarditis and cardiomyopathy, leading to a 61% in-hospital mortality rate. Few survivors with COVID-19 cardiomyopathy fully recover cardiac function.
Area of Science:
- Cardiology
- Infectious Diseases
- Internal Medicine
Background:
- COVID-19 has been associated with various cardiovascular complications.
- Understanding the spectrum and outcomes of these complications is crucial for patient management.
Purpose of the Study:
- To characterize the clinical presentations, hospital outcomes, and post-discharge outcomes of severe cardiac complications in patients with COVID-19.
- To investigate the incidence and types of cardiovascular system toxicity associated with COVID-19 infection.
Main Methods:
- Retrospective analysis of 41 patients admitted to Rhode Island hospitals with COVID-19 from April to November 2020.
- Characterization of clinical features, hospital outcomes, and post-discharge outcomes, including echocardiography findings.
Main Results:
- Acute myocarditis (46.3%) and cardiomyopathy (29.3%) were the most frequent cardiac complications.
- Severe cardiac complications were associated with a 61% in-hospital mortality rate.
- Among survivors, only 20% showed recovery of left ventricular function within 12 weeks.
Conclusions:
- COVID-19 can lead to severe cardiac complications with high mortality.
- Cardiac dysfunction in COVID-19 survivors often shows limited recovery.
- Prompt identification and management of cardiac issues in COVID-19 patients are critical.
Abstract:
Forty-one (41) patients admitted to Rhode Island hospitals with COVID-19 from April to November 2020 were identified to have severe cardiac complications. Clinical presentations of cardiovascular system toxicity in COVID-19 included myocarditis, pericarditis, cardiomyopathy, ACS and cardiac arrhythmia. Clinical features, hospital outcomes and post-discharge outcomes were characterized. Acute myocarditis (46.3%) and cardiomyopathy (29.3%) were the most common findings followed by cardiac arrhythmia, acute coronary syndrome, and pericardial disease. Pulmonary involvement of COVID-19 was absent in 41.5% of patients. Comorbid cardiovascular conditions were absent in 29.3% of patients. Severe cardiac complications in COVID-19 were associated with an in-hospital mortality rate of 61%. Among survivors with COVID-19-related cardiomyopathy, only 20% demonstrated recovery of LV function on follow-up echocardiography done within 12 weeks after initial diagnosis. Identification, diagnosis and management of severe cardiac complications in COVID-19 are discussed.