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Right Ventricular Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis.
Paternoster, Gianluca; Bertini, Pietro; Innelli, Pasquale; Trambaiolo, Paolo; Landoni, Giovanni; Franchi, Federico; Scolletta, Sabino; Guarracino, Fabio.
  • Paternoster G; Division of Cardiac Resuscitation, Cardiovascular Anesthesia and Intensive Care, San Carlo Hospital, Potenza, Italy.
  • Bertini P; Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
  • Innelli P; Intensive Coronary Care Unit, Division of Cardiology, San Carlo Hospital, Potenza, Italy.
  • Trambaiolo P; Intensive Coronary Care Unit, Sandro Pertini Hospital, Roma, Italy.
  • Landoni G; Department of Anesthesia and Intensive Care, Istituto di Ricerca a Carattere Scientifico, San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. Electronic address: landoni.giovanni@hsr.it.
  • Franchi F; Department of Medicine, Surgery and Neuroscience, Anesthesia and Intensive Care Unit, University of Siena, Siena, Italy.
  • Scolletta S; Department of Medicine, Surgery and Neuroscience, Anesthesia and Intensive Care Unit, University of Siena, Siena, Italy.
  • Guarracino F; Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
J Cardiothorac Vasc Anesth ; 35(11): 3319-3324, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1174724
ABSTRACT

OBJECTIVE:

This systematic review and meta-analysis aimed to describe the features of right ventricular impairment and pulmonary hypertension in coronavirus disease (COVID-19) and assess their effect on mortality.

DESIGN:

The authors carried out a systematic review and meta-analysis of observational studies.

SETTING:

The authors performed a search through PubMed, the International Clinical Trials Registry Platform, and the Cochrane Library for studies reporting right ventricular dysfunction in patients with COVID-19 and outcomes.

PARTICIPANTS:

The search yielded nine studies in which the appropriate data were available.

INTERVENTIONS:

Pooled odds ratios were calculated according to the random-effects model. MEASUREMENTS AND MAIN

RESULTS:

Overall, 1,450 patients were analyzed, and half of them were invasively ventilated. Primary outcome was mortality at the longest follow-up available. Mortality was 48.5% versus 24.7% in patients with or without right ventricular impairment (n = 7; OR = 3.10; 95% confidence interval [CI] 1.72-5.58; p = 0.0002), 56.3% versus 30.6% in patients with or without right ventricular dilatation (n = 6; OR = 2.43; 95% CI 1.41-4.18; p = 0.001), and 52.9% versus 14.8% in patients with or without pulmonary hypertension (n = 3; OR = 5.75; 95% CI 2.67-12.38; p < 0.001).

CONCLUSION:

Mortality in patients with COVID-19 requiring respiratory support and with a diagnosis of right ventricular dysfunction, dilatation, or pulmonary hypertension is high. Future studies should highlight the mechanisms of right ventricular derangement in COVID-19, and early detection of right ventricular impairment using ultrasound might be important to individualize therapies and improve outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ventricular Dysfunction, Right / COVID-19 / Hypertension, Pulmonary Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: J Cardiothorac Vasc Anesth Journal subject: Anesthesiology / Cardiology Year: 2021 Document Type: Article Affiliation country: J.jvca.2021.04.008

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ventricular Dysfunction, Right / COVID-19 / Hypertension, Pulmonary Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: J Cardiothorac Vasc Anesth Journal subject: Anesthesiology / Cardiology Year: 2021 Document Type: Article Affiliation country: J.jvca.2021.04.008