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Echocardiography findings in COVID-19 patients admitted to intensive care units: a multi-national observational study

Stephen Huang1, Philippe Vignon2, Armand Mekontso-Dessap3

  • 1Intensive Care Medicine, Nepean Hospital, The University of Sydney, Sydney, Australia.

Intensive Care Medicine
|April 21, 2022
PubMed

Insights

Echocardiography revealed that over one-third of critically ill COVID-19 patients had left or right ventricular dysfunction. Acute cor pulmonale (ACP) and older age were linked to higher mortality in these patients.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) can lead to circulatory failure in critically ill patients.
  • Understanding cardiac dysfunction is crucial for managing severe COVID-19 cases.

Purpose of the Study:

  • To investigate the patterns of left and right ventricular dysfunction using echocardiography in patients with severe COVID-19.
  • To identify factors associated with ventricular dysfunction and mortality.

Main Methods:

  • A retrospective, descriptive study involving 677 severely ill COVID-19 patients from 14 ICUs across 8 countries.
  • Echocardiographic and clinical data were collected between February 2020 and June 2021.
  • Data were analyzed from a secured web-based electronic database.

Main Results:

  • 34.5% of patients exhibited left and/or right ventricular systolic dysfunction on initial echocardiography.
  • 22.5% had right ventricular systolic dysfunction, with 17.4% diagnosed with acute cor pulmonale (ACP).
  • ACP was associated with mechanical ventilation, pulmonary embolism, and increased PaCO2; ACP and older age correlated with higher mortality.

Conclusions:

  • Left and right ventricular systolic dysfunction are common in critically ill COVID-19 patients.
  • Right ventricular dysfunction appears linked to pressure overload, while left ventricular dysfunction resembles septic cardiomyopathy.
  • Acute cor pulmonale and advanced age are potential indicators of increased mortality in this population.
Abstract

Keywords:
COVID-19Cardiac functionEchocardiographyIntensive care unit

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