The prognostic value of transthoracic echocardiography findings in hospitalized adult patients with COVID-19: A single-center retrospective analysis (preprint)

ABSTRACT

Background: Cardiac involvement in coronavirus disease 2019 (COVID-19) is associated with poor outcomes. Transthoracic echocardiography (TTE) can be used to assess cardiac structure and function non-invasively, and has been shown to influence management in COVID-19. Objectives: We aim to investigate the prognostic value of TTE findings in hospitalized adults with confirmed COVID-19. Methods: All consecutive hospitalized adult patients with confirmed COVID-19 who underwent TTE assessment between 3rd April 2020-6th April 2021 were included. Comprehensive clinical data including TTE findings were collected from electronic medical records. Patients with mild-moderate and severe-critical COVID-19 were compared. Within the severe-critical group, patients who survived hospitalization and died were compared. Further analyses were conducted after matching for age >60 years, obesity, and diabetes. Results: A total of 488 COVID-19 patients were included in this study; 202 with mild-moderate and 286 severe-critical disease. All mild-moderate patients and 152 severe-critical patients survived hospitalization. In the matched cohorts, TTE findings associated with severe-critical COVID-19 included left ventricular (LV) hypertrophy (OR 1.91; CI 1.21-3.02), LV diastolic dysfunction (OR 1.55; CI 1.00-2.38), right ventricular (RV) dysfunction (OR 3.86; CI 1.06-14.08), wall motion abnormalities (WMAs) (OR 2.76; CI 1.28-5.96), and any TTE abnormalities (OR 2.99; CI 1.73-5.17). TTE findings associated with mortality included RV dysfunction (OR 3.53; CI 1.12-11.19) and WMAs (OR 2.63; CI 1.26-5.49). Conclusion: TTE is a non-invasive modality that can potentially be used for risk-stratification of hospitalized COVID-19 patients. These findings must be confirmed in larger prospective studies.