Sustained right ventricular dysfunction in severe COVID-19: The role of disseminated intravascular coagulation.
Echocardiography
; 39(4): 584-591, 2022 04.
Article
in English
| MEDLINE | ID: covidwho-1741372
ABSTRACT
BACKGROUND:
Acute right ventricular (RV) failure is common in patients hospitalized with COVID-19. Compared to the conventional echocardiographic parameters, right ventricular longitudinal strain (RVLS) is more sensitive and accurate for the diagnosis of RV systolic dysfunction.OBJECTIVE:
Our purpose was to investigate the sustained RV dysfunction echo-quantified by RVLS in patients recovered from severe COVID-19. Furthermore, we aimed to assess whether disseminated intravascular coagulation (DIC) has a key role to predict the impaired RV strain.METHODS:
Of 198 consecutive COVID-19 patients hospitalized from March 1, 2020, to April 15, 2020, 45 selected patients who survived from severe COVID-19 were enrolled in the study and referred to our echo-lab for transthoracic echocardiography 6-months after discharge. RVLS was calculated as the mean of the strain values of RV free wall. DIC was defined with a validated scoring system DIC score equal to or more than 5 is compatible with overt-DIC. Categories of acute respiratory distress syndrome (ARDS) were defined based on PaO2 /FiO2 ratio.RESULTS:
A total 26 of 45 patients showed impaired RVLS at 6-months' follow-up. DIC score was significantly higher in patients with worse RVLS than in those with better RVLS (4.8 ± .5 vs. 3.6 ± .6, p =.03). Stages of ARDS did not modulate this relationship. Finally, overt-DIC results the only independent predictor of sustained RV dysfunction (OR 1.233, 95% CI 1.041-1.934, p =.043).CONCLUSIONS:
Sustained RV impairment frequently occurs in patients recovered from severe COVID-19. DIC plays a key role, resulting in an independent predictor of sustained RV dysfunction.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Respiratory Distress Syndrome
/
Ventricular Dysfunction, Right
/
Disseminated Intravascular Coagulation
/
COVID-19
/
Heart Failure
Type of study:
Cohort study
/
Diagnostic study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Echocardiography
Journal subject:
Cardiology
/
Diagnostic Imaging
Year:
2022
Document Type:
Article
Affiliation country:
Echo.15332
Similar
MEDLINE
...
LILACS
LIS