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In-hospital COVID-19 infection echocardiographic analysis: a Brazilian, tertiary single-centre experience
Marcelo Luiz Campos Vieira1, Tania Regina Afonso2, Alessandra Joslin Oliveira2
1Laboratory of Echocardiography, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701, São Paulo, ZIP code: 05651-901, Brazil. mluiz766@terra.com.br.
Insights
In-hospital echocardiography in COVID-19 patients revealed normal findings in 46% of cases. However, tricuspid velocity can predict adverse outcomes like mortality, pulmonary thromboembolism, and acute renal failure.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Limited data exists on echocardiography use for COVID-19 patients in Brazil.
- Assessing echocardiographic parameters can help predict severe outcomes in hospitalized COVID-19 patients.
Purpose of the Study:
- To evaluate echocardiographic parameters in hospitalized COVID-19 patients.
- To determine the predictive value of echocardiography for a composite endpoint of mortality, pulmonary thromboembolism, or acute renal failure.
Main Methods:
- Prospective echocardiographic study of 111 consecutive COVID-19 patients in Brazil.
- Correlation of echocardiographic findings with biomarkers, clinical data, and thoracic CT scans.
- Analysis of in-hospital composite endpoint including mortality, pulmonary thromboembolism, and renal failure.
Main Results:
- Echocardiography was normal in 46% of patients; 18% had reduced left ventricle ejection fraction.
- Tricuspid velocity showed a correlation with the composite endpoint (AUC ROC: 0.739).
- Echocardiographic parameters did not correlate with mortality, biomarkers, or other clinical events.
Conclusions:
- Echocardiography is frequently normal in COVID-19 patients, but can reveal cardiac dysfunction.
- Tricuspid velocity is a potential predictor for adverse outcomes in hospitalized COVID-19 patients.
- Further research is needed to fully understand the role of echocardiography in managing COVID-19.
Background:
Information is lacking concerning in-hospital echocardiography analysis of COVID-19 infection in Brazil. We evaluated echocardiographic parameters to predict a composite endpoint of mortality, pulmonary thromboembolism or acute renal failure.
Methods:
A prospective full echocardiographic study of consecutive patients hospitalized with COVID-19, single tertiary centre in Brazil. We correlated echocardiographic findings to biomarkers, clinical information, thoracic tomography, and in-hospital composite endpoint of mortality, pulmonary thromboembolism or renal failure.
Results:
One hundred eleven patients from March to October 2020, 67 ± 17 years, 65 (58.5%) men, death was observed in 21/111 (18.9%) patients, 48 (43%) required mechanical ventilation, myocardial infarction occurred in 10 (9%), pulmonary thromboembolism in 7 (6.3%) patients, haemodialysis was required for 9 (9.8%). Echocardiography was normal in 51 (46%) patients, 20 (18%) presented with decreased left ventricle ejection, 18 (16.2%) had abnormal left ventricle global longitudinal strain, 35 (31%) had diastolic dysfunction, 6 (5.4%) had an E/e'ratio > 14, 19 (17.1%) presented with right ventricle dilated/dysfunction, 31 (28%) had pericardial effusion. The echocardiographic parameters did not correlate with mortality, biomarkers, clinical events. Tricuspid velocity was related to the composite endpoint of mortality, pulmonary thromboembolism or acute renal failure (p: 00.3; value: 2.65 m/s; AUC ROC curve: 0.739; sensitivity: 73.3; specificity: 66.7; CI: 0.95, inferior: 0.613; superior: 0,866).
Conclusions:
Among hospitalized patients with COVID-19, echocardiography was normal in 51(46%) patients, and 20 (18%) patients presented with a decreased left ventricle ejection fraction. Tricuspid velocity was related to the composite endpoint of mortality, pulmonary thromboembolism or acute renal failure.
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