Premorbid echocardiography and risk of hospitalization in COVID-19
The International Journal of Cardiovascular Imaging
; 38(8):1733-1739, 2022.
Article
in English
| ProQuest Central | ID: covidwho-1990682
ABSTRACT
BackgroundCOVID-19 has caused a global pandemic unprecedented in a century. Though primarily a respiratory illness, cardiovascular risk factors predict adverse outcomes. We aimed to investigate the role of baseline echocardiographic abnormalities in further refining risk in addition to clinical risk factors.MethodsAdults with COVID-19 positive RT-PCR test across St Luke’s University Health Network between March 1st 2020-October 31st 2020 were identified. Those with trans-thoracic echocardiography (TTE) within 15–180 days preceding COVID-19 positivity were selected, excluding severe valvular disease, acute cardiac event between TTE and COVID-19, or asymptomatic patients positive on screening. Demographic, clinical, and echocardiographic variables were manually extracted from patients’ EHR and compared between groups stratified by disease severity. Logistic regression was used to identify independent predictors of hospitalization.Results192 patients met inclusion criteria. 87 (45.3%) required hospitalization, 34 (17.7%) suffered severe disease (need for ICU care/mechanical ventilation/in-hospital death). Age, co-morbidities, and several echocardiographic abnormalities were more prevalent in those with moderate-severe disease than in mild disease, with notable exceptions of systolic/diastolic dysfunction. On multivariate analysis, age (OR 1.039, 95% CI 1.011–1.067), coronary artery disease (OR 4.184, 95% CI 1.451–12.063), COPD (OR 6.886, 95% CI 1.396–33.959) and left atrial diameter ≥ 4.0 cm (OR 2.379, 95% CI 1.031–5.493) predicted need for hospitalization. Model showed excellent discrimination (ROC AUC 0.809, 95% CI 0.746–0.873).ConclusionsBaseline left atrial enlargement is an independent risk factor for risk of hospitalization among patients with COVID-19. When available, baseline LA enlargement may identify patients for (1) closer outpatient follow up, and (2) counseling vaccine-hesitancy.
Medical Sciences--Cardiovascular Diseases; COVID-19; Coronavirus disease 2019; Echocardiography; Hospitalization; Risk; Pandemics; Coronary artery disease; Vaccines; Demographic variables; Ventilation; Enlargement; Heart diseases; Multivariate analysis; Viral diseases; Risk analysis; Abnormalities; Coronary artery; Chronic obstructive pulmonary disease; Cardiovascular diseases; Thorax; Cardiovascular disease; Risk factors; Patients; Coronaviruses; Health risks
Full text:
Available
Collection:
Databases of international organizations
Database:
ProQuest Central
Type of study:
Prognostic study
Language:
English
Journal:
The International Journal of Cardiovascular Imaging
Year:
2022
Document Type:
Article
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