Right Ventricular Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis.
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 MAINRESULTS:
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 (nâ¯=â¯7; ORâ¯=â¯3.10; 95% confidence interval [CI] 1.72-5.58; pâ¯=â¯0.0002), 56.3% versus 30.6% in patients with or without right ventricular dilatation (nâ¯=â¯6; ORâ¯=â¯2.43; 95% CI 1.41-4.18; pâ¯=â¯0.001), and 52.9% versus 14.8% in patients with or without pulmonary hypertension (nâ¯=â¯3; ORâ¯=â¯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.Keywords
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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