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Cardiac dysfunction and mortality in critically ill patients with COVID-19: A Swedish multicentre observational study.
Holmqvist, Jacob; Beck-Friis, Josefine; Jensen, Carl; Dalla, Keti; Mårdstam, Simon; Christensen, Jens; Nordén, Nina; Widing, Hannes; Rosén-Wetterholm, Elin; Cavefors, Oscar; Yilmaz, Aylin; Cronhjort, Maria; Redfors, Björn; Oras, Jonatan.
  • Holmqvist J; Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • Beck-Friis J; Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital/Sahlgrenska, Gothenburg, Sweden.
  • Jensen C; Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • Dalla K; Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Mårdstam S; Department of Anesthesiology and Intensive Care Medicine, NU Hospital Group, Trollhättan, Sweden.
  • Christensen J; Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • Nordén N; Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital/Mölndal, Gothenburg, Sweden.
  • Widing H; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
  • Rosén-Wetterholm E; Department of Anaesthesia and Intensive Care, Södersjukhuset, Stockholm, Sweden.
  • Cavefors O; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
  • Yilmaz A; Department of Anaesthesia and Intensive Care, Södersjukhuset, Stockholm, Sweden.
  • Cronhjort M; Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • Redfors B; Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital/Mölndal, Gothenburg, Sweden.
  • Oras J; Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Acta Anaesthesiol Scand ; 66(5): 606-614, 2022 05.
Article in English | MEDLINE | ID: covidwho-1672923
ABSTRACT

BACKGROUND:

The prevalence and importance of cardiac dysfunction in critically ill patients with COVID-19 in Sweden is not yet established. The aim of the study was to assess the prevalence of cardiac dysfunction and elevated pulmonary artery pressure (PAP), and its influence on mortality in patients with COVID-19 in intensive care in Sweden.

METHODS:

This was a multicentre observational study performed in five intensive care units (ICUs) in Sweden. Patients admitted to participating ICU with COVID-19 were examined with echocardiography within 72 h from admission and again after 4 to 7 days. Cardiac dysfunction was defined as left ventricular (LV) dysfunction (ejection fraction <50% and/or regional hypokinesia) or right ventricular (RV) dysfunction (defined as TAPSE <17 mm or visually assessed moderate/severe RV dysfunction).

RESULTS:

We included 132 patients, of whom 127 (96%) were intubated. Cardiac dysfunction was found in 42 (32%) patients. Most patients had cardiac dysfunction at the first assessment (n = 35) while a few developed cardiac dysfunction later (n = 7) and some changed type of dysfunction (n = 3). LV dysfunction was found in 21 and RV dysfunction in 19 patients, while 5 patients had combined dysfunction. Elevated PAP was found in 34 patients (26%) and was more common in patients with RV dysfunction. RV dysfunction and elevated PAP were independently associated with an increased risk of death (OR 3.98, p = .013 and OR 3.88, p = .007, respectively).

CONCLUSIONS:

Cardiac dysfunction occurs commonly in critically ill patients with COVID-19 in Sweden. RV dysfunction and elevated PAP are associated with an increased risk of death.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ventricular Dysfunction, Right / Ventricular Dysfunction, Left / COVID-19 / Heart Diseases Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: Acta Anaesthesiol Scand Year: 2022 Document Type: Article Affiliation country: Aas.14039

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ventricular Dysfunction, Right / Ventricular Dysfunction, Left / COVID-19 / Heart Diseases Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: Acta Anaesthesiol Scand Year: 2022 Document Type: Article Affiliation country: Aas.14039