Cardiovascular Ultrasound (Oct 2021)

In-hospital COVID-19 infection echocardiographic analysis: a Brazilian, tertiary single-centre experience

  • Marcelo Luiz Campos Vieira,
  • Tania Regina Afonso,
  • Alessandra Joslin Oliveira,
  • Carolina Stangenhaus,
  • Juliana Cardoso Dória Dantas,
  • Lucas Arraes de França,
  • Edgar Daminelo,
  • Adriana Cordovil,
  • Lara A. S. Martins,
  • Rodrigo A. C. Meirelles,
  • Rafael B. Piveta,
  • Sérgio Barros-Gomes,
  • Miguel O. D. Aguiar,
  • Patrícia O. Roveri,
  • Wércules A. Oliveira,
  • Alessandro C. Lianza,
  • Andrea P. L. Ponchirolli,
  • Líria M. L. Silva,
  • Rodrigo C. P. L. Costa,
  • Cláudio H. Fischer,
  • Samira Saady Morhy

DOI
https://doi.org/10.1186/s12947-021-00265-y
Journal volume & issue
Vol. 19, no. 1
pp. 1 – 10

Abstract

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Abstract Background Information is lacking concerning in-hospital echocardiography analysis of COVID-19 infection in Brazil. We evaluated echocardiographic parameters to predict a composite endpoint of mortality, pulmonary thromboembolism or acute renal failure. Methods A prospective full echocardiographic study of consecutive patients hospitalized with COVID-19, single tertiary centre in Brazil. We correlated echocardiographic findings to biomarkers, clinical information, thoracic tomography, and in-hospital composite endpoint of mortality, pulmonary thromboembolism or renal failure. Results One hundred eleven patients from March to October 2020, 67 ± 17 years, 65 (58.5%) men, death was observed in 21/111 (18.9%) patients, 48 (43%) required mechanical ventilation, myocardial infarction occurred in 10 (9%), pulmonary thromboembolism in 7 (6.3%) patients, haemodialysis was required for 9 (9.8%). Echocardiography was normal in 51 (46%) patients, 20 (18%) presented with decreased left ventricle ejection, 18 (16.2%) had abnormal left ventricle global longitudinal strain, 35 (31%) had diastolic dysfunction, 6 (5.4%) had an E/e’ratio > 14, 19 (17.1%) presented with right ventricle dilated/dysfunction, 31 (28%) had pericardial effusion. The echocardiographic parameters did not correlate with mortality, biomarkers, clinical events. Tricuspid velocity was related to the composite endpoint of mortality, pulmonary thromboembolism or acute renal failure (p: 00.3; value: 2.65 m/s; AUC ROC curve: 0.739; sensitivity: 73.3; specificity: 66.7; CI: 0.95, inferior: 0.613; superior: 0,866). Conclusions Among hospitalized patients with COVID-19, echocardiography was normal in 51(46%) patients, and 20 (18%) patients presented with a decreased left ventricle ejection fraction. Tricuspid velocity was related to the composite endpoint of mortality, pulmonary thromboembolism or acute renal failure.

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