Frontiers in Cardiovascular Medicine (May 2023)

Association between echocardiographic features and inflammatory biomarkers with clinical outcomes in COVID-19 patients in Saudi Arabia

  • Samah I. Abohamr,
  • Samah I. Abohamr,
  • Rami M. Abazid,
  • Mohammed K. Alhumaid,
  • Abubaker E. Abdulrahim,
  • Mubarak A. Aldossari,
  • Lamiaa Khedr,
  • Rehab H. Werida,
  • Haifa S. Alkheledan,
  • Yazeed S. Aleid,
  • Sara W. Abdelhamid,
  • Abdulmohsen Al Mefarrej,
  • Ahmed W. Abdelhamid,
  • Mohammad Hasan Alaboud,
  • Omar T. Alhasan,
  • Hanem M. Gomaa,
  • Eman Elsheikh,
  • Eman Elsheikh

DOI
https://doi.org/10.3389/fcvm.2023.1134601
Journal volume & issue
Vol. 10

Abstract

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BackgroundRespiratory infections are one of the most common comorbidities identified in hospitalized patients. The coronavirus disease 2019 (COVID-19) pandemic greatly impacted healthcare systems, including acute cardiac services.AimThis study aimed to describe the echocardiographic findings of patients with COVID-19 infections and their correlations with inflammatory biomarkers, disease severity, and clinical outcomes.MethodsThis observational study was conducted between June 2021 and July 2022. The analysis included all patients diagnosed with COVID-19 who had transthoracic echocardiographic (TTE) scans within 72 h of admission.ResultsThe enrolled patients had a mean age of 55.6 ± 14.7 years, and 66.1% were male. Of the 490 enrolled patients, 203 (41.4%) were admitted to the intensive care unit (ICU). Pre-ICU TTE findings showed significantly higher incidence right ventricular dysfunction (28 [13.8%] vs. 23 [8.0%]; P = 0.04) and left ventricular (LV) regional wall motion abnormalities (55 [27.1%] vs. 29 [10.1%]; p < 0.001) in ICU patients compared to non-ICU patients. In-hospital mortality was 11 (2.2%), all deaths of ICU patients. The most sensitive predictors of ICU admission (p < 0.05): cardiac troponin I level (area under the curve [AUC] = 0.733), followed by hs-CRP (AUC = 0.620), creatine kinase-MB (AUC = 0.617), D-dimer (AUC = 0.599), and lactate dehydrogenase (AUC = 0.567). Binary logistic regression showed that reduced LV ejection fraction (LVEF), elevated pulmonary artery systolic pressure, and dilated right ventricle were echocardiographic predictors of poor outcomes (p < 0.05).ConclusionEchocardiography is a valuable tool in assessing admitted patients with COVID-19. Lower LVEF, pulmonary hypertension, higher D-dimer, C-reactive protein, and B-type natriuretic peptide levels were predictors of poor outcomes.

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