Early Cardiovascular Phenotypes in Patients with Acute Respiratory Failure during the Initial Covid-19 Pandemic
Annales Francaises de Medecine d'Urgence
; 12(2):77-86, 2022.
Article
in French
| Scopus | ID: covidwho-1879396
ABSTRACT
Objective:
The main objective was to compare the prevalence of left ventricular (LV) and/or right ventricular (RV) dysfunction in patients admitted to the Emergency Department (ED) with an acute respiratory failure (ARF) related to Covid-19 or not.Methods:
We prospectively enrolled consecutive adult patients (24/7) during one month in the Covid-19 unit of our ED who presented with ARF. In each patient, a RT-PCR test, chest CT scan, and level 2 echocardiography were systematically performed before any therapeutic intervention. Distinct cardiovascular phenotypes were distinguished LV or RV failure, hypovolemia ± LV hyperkinesia, and normal hemodynamic profile.Results:
Of the 517 patients admitted to the Covid-19 unit during the study period, 78 presented with ARF (15%), and echocardiography was performed in 62 of them (age 73 ± 14 years;SpO2 90 ± 4%;lactate 2.1 ± 1.3 mmol/l). Twenty-two patients (35%) were diagnosed with Covid-19 pneumonia. LV failure was more frequently observed in the control group (15 [38%] vs. 2 [9%];P = 0.016), irrespective of LV ejection fraction, as well as RV failure (12 [30%] vs. 1 [5%];P = 0.018). In contrast, Covid-19 patients exhibited more frequently a normal hemodynamic profile or hypovolemia associated or not with vasoplegia (20 [91%] vs. 21 [53%];P = 0.002). Hospital mortality reached 18% (N = 11). All patients with Covid-19 pneumonia and early LV and/or RV failure died during their hospitalization.Conclusions:
Non-Covid-19 ARF patients mainly exhibited LV/RV dysfunction, whereas patients with Covid-19 had a normal or hypovolemic cardiovascular phenotype. © SFMU et Lavoisier SAS 2022
Full text:
Available
Collection:
Databases of international organizations
Database:
Scopus
Language:
French
Journal:
Annales Francaises de Medecine d'Urgence
Year:
2022
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS