Right Ventricular Dysfunction Patterns among Patients with COVID-19 in the Intensive Care Unit: A Retrospective...

Area of Science:

• Cardiology
• Critical Care Medicine
• Infectious Diseases

Background:

• Right ventricular (RV) dysfunction is prevalent in hospitalized COVID-19 patients.
• Echocardiographic parameters used to define RV dysfunction can vary, impacting epidemiological assessments.
• Understanding RV dysfunction in COVID-19 is crucial for patient management and prognosis.

Purpose of the Study:

• To determine the prevalence of RV function abnormalities using common echocardiographic parameters in ICU patients with COVID-19.
• To investigate the impact of RV dilatation on different echocardiographic parameters of RV function.
• To assess the association between RV dysfunction and 60-day mortality in this patient cohort.

Main Methods:

• Retrospective cohort study of 116 ICU patients with COVID-19.
• Echocardiograms were performed within 7 days of ICU admission.
• RV dysfunction and dilatation defined by guideline thresholds for TAPSE, RV fractional area change, RVFWS, and RV dimensions; mortality assessed via logistic regression.

Main Results:

• 69% of patients exhibited RV dysfunction by at least one parameter; 36.3% of these had RV dilatation.
• Common RV dysfunction patterns included multiple abnormalities, abnormal RVFWS/TAPSE, or isolated TAPSE abnormality.
• RV dysfunction was significantly associated with increased 60-day mortality (OR 2.91), particularly with two or more parameter abnormalities.

Conclusions:

• Significant heterogeneity exists in RV function abnormalities among ICU COVID-19 patients, with varying patterns associated with RV dilatation.
• RV dysfunction, identified by any echocardiographic parameter, is linked to higher mortality.
• A multiparameter echocardiographic evaluation is essential for accurate recognition of RV dysfunction in COVID-19.