Acute pulmonary hypertension and short-term outcomes in severe Covid-19 patients needing intensive care.
Acta Anaesthesiol Scand
; 65(6): 761-769, 2021 Jul.
Article
in English
| MEDLINE | ID: covidwho-1138068
ABSTRACT
INTRODUCTION:
Critically ill Covid-19 pneumonia patients are likely to develop the sequence of acute pulmonary hypertension, right ventricular (RV) strain, and eventually RV failure due to known pathophysiology (endothelial inflammation plus thrombo-embolism) that promotes increased pulmonary vascular resistance and pulmonary artery pressure. This study aimed to investigate the occurrence of acute pulmonary hypertension (aPH) as per established trans-thoracic echocardiography (TTE) criteria in Covid-19 patients receiving intensive care and to explore whether short-term outcomes are affected by the presence of aPH.METHODS:
Medical records were reviewed for patients treated in the intensive care units at a tertiary university hospital over a month. The presence of aPH on the TTE was noted, and plasma NTproBNP and troponin were measured as markers of cardiac failure and myocardial injury, respectively. Follow-up data were collected 21 d after the performance of TTE.RESULTS:
In total, 26 of 67 patients (39%) had an assessed systolic pulmonary artery pressure of > 35 mmHg (group aPH), meeting the TTE definition of aPH. NTproBNP levels (median [range] 1430 [102-30 300] vs. 470 [45-29 600] ng L-1 ; P = .0007), troponin T levels (63 [22-352] vs. 15 [5-407] ng L-1 ; P = .0002), and the 21-d mortality rate (46% vs. 7%; P < .001) were substantially higher in patients with aPH compared to patients not meeting aPH criteria.CONCLUSION:
TTE-defined acute pulmonary hypertension was frequently observed in severely ill Covid-19 patients. Furthermore, aPH was linked to biomarker-defined myocardial injury and cardiac failure, as well as an almost sevenfold increase in 21-d mortality.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Critical Care
/
SARS-CoV-2
/
COVID-19
/
Hypertension, Pulmonary
Type of study:
Cohort study
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Country/Region as subject:
Europa
Language:
English
Journal:
Acta Anaesthesiol Scand
Year:
2021
Document Type:
Article
Affiliation country:
Aas.13819
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