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Introduction: COVID-19 infection has been associated with right ventricular (RV) dysfunction and poor prognosis. This association is thought to be due to either a direct effect of COVID-19 infection on the myocardium or indirect damage to the lung parenchyma or vasculature. Limited echocardiography protocols for operator protection against COVID-19 has made the evaluation of the RV challenging. The purpose of this study is to evaluate if RV dysfunction by qualitative assessment can be used to predict all-cause mortality. Method(s): This is a single-center retrospective analysis from March 2020 to August 2021. Patients who were older than 18 years old, hospitalized with a positive RT-PCR for COVID-19, and had an echocardiogram while inpatient were included in the study. RV parameters, including RV dilation and dysfunction, were obtained by qualitative assessment. Data analysis was performed with STATA and SPSS. Result(s): A total of 223 patients were included in the analysis. 59.6% were male with a mean age of 64.3 years (SD +/- 16). 67.7% were Hispanic, 11.7% were non-Hispanic White, and 20.6% were Black. Severe COVID-19 infection requiring intensive care unit level of care made up 54.7% of cases (n=122) and the mortality rate was 27.8% (n=62). RV dysfunction and dilation was present in 13.5% (n=28) and 15.2% (n=33) of patients, respectively and occurred more often in patients with severe COVID-19 infection (p<0.01). Logistic binomial correlation showed an exponential increase in the probability of mortality related to RV dysfunction (OR 2.03, p=0.270;graph 1) and a mild decrease in mortality in patients with RV dilation (OR 0.88, p=0.794). However, both associations were not statistically significant. Conclusion(s): RV dysfunction by qualitative assessment could be a potential marker of mortality in patients with COVID-19 infection. The association may be stronger in studies with more power. Interestingly, RV dilation was associated with a mild decrease in mortality in this patient population;however, this may be a biased result due to the small sample size.Copyright © 2022
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Introduction: Left ventricular hypertrophy (LVH) is a risk factor for adverse cardiovascular outcomes such as heart failure and arrhythmia. LVH is characterized by increased left ventricular mass with myocardial fibrosis and may contribute to COVID-19-induced cardiac injury. Hypothesis: LVH is a predictor of poor outcomes in patients with COVID-19. Method(s): We conducted a two-center retrospective study of 415 adult patients hospitalized with COVID-19 from March 2020 to September 2021 who had an echocardiogram performed while inpatient. Baseline characteristics, biomarkers, and hospitalization outcomes were described. LVH was diagnosed by linear measurements with echocardiography. Statistical analyses were performed using SAS 9.4 and SPSS 28. Differences between groups were determined by one-way ANOVA, Wilcoxon rank-sum, or Fisher exact test. Result(s): LVH was present in 34.2% (142/415) of patients. Compared to those without LVH, those with LVH were older (64 vs 68 years, p=0.02), heavier (84.4 vs 89.6 kg, p=0.03), and more likely to be diabetic (39.6% vs 50.0%, p=0.04), hypertensive (61.5% vs 71.8%, p=0.04), and smokers (5.1% vs 12.0%, p=0.02). NT-proBNP (1342 vs 721, p=0.02) and peak troponin I (0.03 vs 0.01, p=0.002) levels were higher in the LVH group. The LVH group had increased rates of myocardial infarction (7% vs 4%), new-onset heart failure (8.5% vs 7.3%), and mortality (35.9% vs 30%), although these findings were not statistically significant. Similarly, logistic regression models showed a sustained effect of age (OR 1.17 [CI 1.02-1.34], for every 10 years), diabetes (OR 1.53 [CI 1.02-2.29]), hypertension (OR 1.59 [CI 1.03-2.4]), and smoking (OR 2.52 [CI 1.2-5.3]) in patients with LVH;however, there was no difference between groups for all outcomes measured. Conclusion(s): LVH was significantly associated with other cardiovascular risk factors and increased cardiac biomarkers, suggesting a higher degree of cardiac injury in LVH patients with COVID-19. Although there was a higher rate of cardiovascular events and mortality in patients with LVH, these findings were not statistically significant. Studies with a larger sample size are needed to determine whether LVH is an independent predictor of COVID-19-induced cardiac injury.
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SESSION TITLE: Studies on COVID-19 Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: COVID-19 associated morbidity and mortality are largely related to hypercoagulability events, including deep vein thrombosis (DVT) and pulmonary embolism (PE), with right ventricular (RV) dysfunction playing a likely role in the severity of outcomes. The purpose of this study is to correlate right ventricular parameters on echocardiography in patients who developed DVT and PE while admitted with COVID-19 infection, and to determine if PE and DVT were related to a higher incidence of adverse outcomes. METHODS: Single-center retrospective study from March 2020 to August 2021 including patients older than 18 years old hospitalized with confirmed COVID-19 by RT-PCR, who had an echocardiogram performed while inpatient. Right ventricular parameters were obtained mostly by linear measurements, with a limited COVID-19 protocol determined by the institution. The presence of PE and DVT were confirmed by chest CT angiography and venous ultrasound, respectively. RESULTS: A total of 223 patients were included in the study (mean age 64.3 +/- 16, 59.6% male, 67.4% Hispanic). Baseline characteristics did not differ when stratified for the outcomes of interest. DVT occurred in 9.4% (n=21) and PE in 19.6% (n=44) patients. PE and DVT were related to a higher rate of ARDS, ICU admission, non-fatal stroke and prolonged length of stay (38.9 vs 16.9 days, p<0.05). Although there was a higher rate of intubation in patients admitted with DVT (p<0.05), it was non-significant for patients with PE. Mortality was similar to patients without thromboembolic events. For PE and DVT, RV dilation was present on 25% (p<0.05) and 14%, and RV dysfunction on 21% and 11%, respectively. CONCLUSIONS: PE and DVT in patients with COVID-19 were related to higher morbidity, but not mortality in this patient population. Interestingly, these events were related to a higher rate of non-fatal stroke, suggesting that hypercoagulability plays a major role in the development of some adverse outcomes. Despite only finding RV dilation as a statistically significant marker present in patients who developed PE, the study was potentially underpowered to find significant differences between groups. CLINICAL IMPLICATIONS: Development of PE and DVT in patients admitted with COVID-19 infection are markers of increased morbidity and higher length of stay. RV dilation might be used as a marker of potential thromboembolic events in this patient population, but more studies with controlled variables are needed to determine it's utility. DISCLOSURES: No relevant relationships by Sharon Andrade-Bucknor No relevant relationships by Mikayla Bowen No relevant relationships by Alexis Jones No relevant relationships by Sukhpreet Kaur No relevant relationships by Neal Olarte No relevant relationships by Beatriz Rivera Rodriguez No relevant relationships by Crystal Yan