Title : Association of 2D Echocardiogram Findings and Survival Rate in Severe and Critical COVID-19 Adult Patients: A Single Center Retrospective Study
Abstract:
Introduction: Studies show transthoracic 2D echocardiogram findings are varied in terms of right and left ventricular systolic function in COVID-19 patients. This three-month retrospective cohort analyzed 135 Severe and Critical COVID-19 adult patients admitted at Cardinal Santos Medical Center, primarily for right ventricular systolic function (RVSF) via transthoracic 2D echocardiogram and its association to in-hospital mortality. Other parameters such as age, sex, co-morbidities, inflammatory markers, initial therapeutics and occurrence of prothrombotic events were also studied.
Methods: Total of 135 COVID-19 Severe and Critical COVID-19 patients were included from March 2021 to May 2021. Demographics, clinical characteristics, and echocardiographic findings were obtained via chart review. Descriptive statistics were used to summarize the findings and Kaplan Meier analysis was used to determine the estimated survival rate.
Results: Regardless of disease severity, RVSF values were noted to be normal and were not associated with in-hospital mortality (p-value: 0.052). However, there is significant difference between TAPSE of survivors and non-survivors (p-value: 0.002), and TAPSE <17 mm were noted to have lower estimated survival rate. Results also show that age, Critical COVID, CKD, and initiating hemoperfusion, elevated ferritin, D-dimer, procalcitonin, and withholding Tocilizumab and anticoagulation were contributing factors to in-hospital mortality. This study shows that prothrombotic events are not directly associated with in-hospital mortality.
Conclusion: Right ventricular systolic function is preserved in Severe and Critical COVID-19 patients. However, TAPSE values are significant between survivors and non-survivors. Likewise, RVSF findings are not directly correlated with clinical characteristics in determining survival rate.
Keywords: COVID-19, Echocardiography, TAPSE
What will audience learn from your presentation?
- This study will be able to supplement current guidelines on use of echocardiography for severe and critical COVID-19 patients
- Results of this study can be used in prognosticating severe and critical COVID-19 patients, especially on the interaction between 2D echocardiography parameters and inflammatory markers
- The framework of this study can be further used in future research on the value of right ventricular systolic function echocardiographic parameter in the management and prognostication of COVID-19 disease severity
