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Influence of right ventricular structure and function on hospital outcomes in COVID-19 patients.
Oweis, Jozef; Leamon, Annie; Al-Tarbsheh, Ali H; Goodspeed, Katharine; Khorolsky, Ciril; Feustel, Paul; Naseer, Usman; Albaba, Isam; Parimi, Sai Anoosh; Shkolnik, Boris; Tiwari, Anupama; Chopra, Amit; Torosoff, Mikhail.
  • Oweis J; Department of Internal Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America. Electronic address: oweisj@amc.edu.
  • Leamon A; Department of Internal Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Al-Tarbsheh AH; Department of Internal Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Goodspeed K; Department of Internal Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Khorolsky C; Department of Cardiology, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Feustel P; Department of Neuroscience and Experimental Therapeutics, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Naseer U; Department of Internal Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Albaba I; Department of Internal Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Parimi SA; Department of Internal Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Shkolnik B; Department of Pulmonary and Critical Care Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Tiwari A; Department of Pulmonary and Critical Care Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Chopra A; Department of Pulmonary and Critical Care Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
  • Torosoff M; Department of Cardiology, Albany Medical Center, 43 New Scotland Avenue, Albany, New York, 12208, United States of America.
Heart Lung ; 57: 19-24, 2023.
Article in English | MEDLINE | ID: covidwho-1983136
ABSTRACT

BACKGROUND:

The impact of the right ventricular (RV) structure and function on the in-hospital outcomes in patients with COVID-19 infection has not been rigorously investigated.

OBJECTIVES:

The main aim of our study was to investigate in-hospital outcomes including mortality, ICU admission, mechanical ventilation, pressor support, associated with RV dilatation, and RV systolic dysfunction in COVID-19 patients without a history of pulmonary hypertension.

METHODS:

It was a single academic tertiary center, retrospective cohort study of 997 PCR-confirmed COVID-19 patients. One hundred ninty-four of those patients did not have a history of pulmonary hypertension and underwent transthoracic echocardiography at the request of the treating physicians for clinical indications. Clinical endpoints which included mortality, ICU admission, need for mechanical ventilation or pressor support were abstracted from the electronic charts.

RESULTS:

Patients' mean age was 68+/-16 years old and 42% of the study population were females. COPD was reported in 13% of the study population, whereas asthma was 10%, and CAD was 25%. The mean BMI was 29.8+/-9.5 kg/m2. Overall mortality was 27%, 46% in ICU patients, and 9% in the rest of the cohort. There were no significant differences in co-morbidities between expired patients and the survivors. A total of 19% of patients had evidence of RV dilatation and 17% manifested decreased RV systolic function. RV dilatation or decreased RV systolic function were noted in 24% of the total study population. RV dilatation was significantly more common in expired patients (15% vs 29%, p = 0.026) and was associated with increased mortality in patients treated in the ICU (HR 2.966, 95%CI 1.067-8.243, p = 0.037), who did not need require positive pressure ventilation, IV pressor support or acute hemodialysis.

CONCLUSIONS:

In hospitalized COVID-19 patients without a history of pulmonary hypertension, RV dilatation is associated with a 2-fold increase in inpatient mortality and a 3-fold increase in ICU mortality.
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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 / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Heart Lung Year: 2023 Document Type: Article

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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 / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Heart Lung Year: 2023 Document Type: Article