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EPIDEMIOLOGY AND CLINICAL CHARACTERISTICS OF CARDIOVASCULAR DYSFUNCTION IN CRITICALLY ILL COVID-19 PATIENTS: A PROSPECTIVE COHORT STUDY

Authors: Ajeetviswanath Thanjavur Prabhakaran, Karthik Ram Ananthakrishnan; Sulagna Bhattacharjee, Kapil Dev Soni; , Deepthi Siddharthan And Anjan Trikha;

EPIDEMIOLOGY AND CLINICAL CHARACTERISTICS OF CARDIOVASCULAR DYSFUNCTION IN CRITICALLY ILL COVID-19 PATIENTS: A PROSPECTIVE COHORT STUDY

Abstract

Background:Early reports indicate that cardiac involvement can commonly occur in COVID-19 patients. This prospective observational study aimed to evaluate myocardial dysfunction in critically ill COVID-19 patients. Methods:Forty adult patients with confirmed COVID-19 disease admitted to the intensive care unit of a tertiary care hospital were included, following which demographic, baseline laboratory and serial echocardiography was done on days 1, 3, 5 & 7 to assess global or regional wall motion abnormality, left ventricular function [ejection fraction (LVEF), E/e) and right ventricular function [tricuspid annular plane excursion (TAPSE), tricuspid regurgitation (TR) jet)]. Any new onset ECG changes were also noted. Results:Patients (n=40) had median (IQR) age of 51.5 (38.5- 63.5) and median (IQR) SOFA score of 5.5 (5- 7). Median (IQR) P/F ratio of the included patients at the time of recruitment was 250 (180- 300) and median (IQR) Charlsons comorbidity index was 2 (1- 4). Proportion (95% CI) of patients died during hospital stay was 15 (7.1- 29.1) %. We found that, on day 1, 25% patients had mild to moderate LV dysfunction. Although LVEF was statistically higher in patients receiving mechanical ventilation, LVEF, E/e, TAPSE and TR jet did not change significantly from base line till day 7, in both mechanically ventilated and nonventilated patients, or in survivors and non-survivors. However, LVEF correlated with PaO2/FiO2 ratio (P/F) ratio at day 3 (rho= 0.46, p=0.003), 5 (rho= 0.47, p=0.002) and 7 (rho= 0.41, p=0.01), whereas TR jet with correlated inversely wit P/F ratio at day 1 (rho= -0.39, p=0.01) and 3 (rho= -0.39, p=0.01). Conclusion: Our study highlights that although P/F ratio correlated with both left ventricular and right function, the dynamics of both left ventricular and right ventricular function was non- progressive in both mechanically ventilated and as well as spontaneously breathing patients, and similar in both survivors and non survivors.

Keywords

Cardiac Dysfunction COVID-19 SARS-COV2

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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