Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study
Abstract INTRODUCTION: Cardiac involvement seems to impact prognosis of COVID-19, being more frequent in critically ill patients. We aimed to assess the prognostic value of right ventricular (RV) and left ventricular (LV) dysfunction, evaluated by bedside echocardiography (echo), in patients hospita...
Published in: | Revista da Sociedade Brasileira de Medicina Tropical |
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Sociedade Brasileira de Medicina Tropical (SBMT)
2021
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Online Access: | https://doi.org/10.1590/0037-8682-0382-2021 https://doaj.org/article/47a2071884254e29ae4a5b41a935697c |
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ftdoajarticles:oai:doaj.org/article:47a2071884254e29ae4a5b41a935697c 2023-05-15T15:13:51+02:00 Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study Sander Luis Gomes Pimentel Bruno Ramos Nascimento Juliane Franco Kaciane Krauss Bruno Oliveira Clara Leal Fraga Frederico Vargas Botinha de Macedo Leonardo Arruda de Moraes Raso Renata Eliane de Ávila Luiza Pereira Afonso dos Santos Rodrigo Tavares Lanna Rocha Renan Mello Oliveira Márcia de Melo Barbosa Craig Sable Antonio Luiz Pinho Ribeiro Andrea Zawacki Beaton Maria Carmo Pereira Nunes 2021-09-01T00:00:00Z https://doi.org/10.1590/0037-8682-0382-2021 https://doaj.org/article/47a2071884254e29ae4a5b41a935697c EN eng Sociedade Brasileira de Medicina Tropical (SBMT) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100334&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0382-2021 https://doaj.org/article/47a2071884254e29ae4a5b41a935697c Revista da Sociedade Brasileira de Medicina Tropical, Vol 54 (2021) COVID-19 Echocardiography Prognosis SARS-Cov-2 Mortality Arctic medicine. Tropical medicine RC955-962 article 2021 ftdoajarticles https://doi.org/10.1590/0037-8682-0382-2021 2022-12-31T03:21:22Z Abstract INTRODUCTION: Cardiac involvement seems to impact prognosis of COVID-19, being more frequent in critically ill patients. We aimed to assess the prognostic value of right ventricular (RV) and left ventricular (LV) dysfunction, evaluated by bedside echocardiography (echo), in patients hospitalized with COVID-19. METHODS: Patients admitted in 2 reference hospitals in Brazil from Jul to Sept/2020 with confirmed COVID-19 and moderate/severe presentations underwent clinical and laboratory evaluation, and focused bedside echo (GE Vivid-IQ), at the earliest convenience, with remote interpretation. The association between demographics, clinical comorbidities and echo variables with all-cause hospital mortality was assessed, and factors significant at p<0.10 were put into multivariable models. RESULTS: Total 163 patients were enrolled, 59% were men, mean age 64±16 years, and 107 (66%) were admitted to intensive care. Comorbidities were present in 144 (88%) patients: hypertension 115 (71%), diabetes 61 (37%) and heart failure 22 (14%). In-hospital mortality was 34% (N=56). In univariate analysis, echo variables significantly associated with death were: LV ejection fraction (LVEF, OR=0.94), RV fractional area change (OR=0.96), tricuspid annular plane systolic excursion (TAPSE, OR=0.83) and RV dysfunction (OR=5.3). In multivariate analysis, after adjustment for clinical and demographic variables, independent predictors of mortality were age≥63 years (OR=5.53, 95%CI 1.52-20.17), LVEF<64% (OR=7.37, 95%CI 2.10-25.94) and TAPSE<18.5 mm (OR=9.43, 95% CI 2.57-35.03), and the final model had good discrimination, with C-statistic=0.83 (95%CI 0.75-0.91). CONCLUSION: Markers of RV and LV dysfunction assessed by bedside echo are independent predictors of mortality in hospitalized COVID-19 patients, after adjustment for clinical variables. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista da Sociedade Brasileira de Medicina Tropical 54 |
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Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
COVID-19 Echocardiography Prognosis SARS-Cov-2 Mortality Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
COVID-19 Echocardiography Prognosis SARS-Cov-2 Mortality Arctic medicine. Tropical medicine RC955-962 Sander Luis Gomes Pimentel Bruno Ramos Nascimento Juliane Franco Kaciane Krauss Bruno Oliveira Clara Leal Fraga Frederico Vargas Botinha de Macedo Leonardo Arruda de Moraes Raso Renata Eliane de Ávila Luiza Pereira Afonso dos Santos Rodrigo Tavares Lanna Rocha Renan Mello Oliveira Márcia de Melo Barbosa Craig Sable Antonio Luiz Pinho Ribeiro Andrea Zawacki Beaton Maria Carmo Pereira Nunes Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study |
topic_facet |
COVID-19 Echocardiography Prognosis SARS-Cov-2 Mortality Arctic medicine. Tropical medicine RC955-962 |
description |
Abstract INTRODUCTION: Cardiac involvement seems to impact prognosis of COVID-19, being more frequent in critically ill patients. We aimed to assess the prognostic value of right ventricular (RV) and left ventricular (LV) dysfunction, evaluated by bedside echocardiography (echo), in patients hospitalized with COVID-19. METHODS: Patients admitted in 2 reference hospitals in Brazil from Jul to Sept/2020 with confirmed COVID-19 and moderate/severe presentations underwent clinical and laboratory evaluation, and focused bedside echo (GE Vivid-IQ), at the earliest convenience, with remote interpretation. The association between demographics, clinical comorbidities and echo variables with all-cause hospital mortality was assessed, and factors significant at p<0.10 were put into multivariable models. RESULTS: Total 163 patients were enrolled, 59% were men, mean age 64±16 years, and 107 (66%) were admitted to intensive care. Comorbidities were present in 144 (88%) patients: hypertension 115 (71%), diabetes 61 (37%) and heart failure 22 (14%). In-hospital mortality was 34% (N=56). In univariate analysis, echo variables significantly associated with death were: LV ejection fraction (LVEF, OR=0.94), RV fractional area change (OR=0.96), tricuspid annular plane systolic excursion (TAPSE, OR=0.83) and RV dysfunction (OR=5.3). In multivariate analysis, after adjustment for clinical and demographic variables, independent predictors of mortality were age≥63 years (OR=5.53, 95%CI 1.52-20.17), LVEF<64% (OR=7.37, 95%CI 2.10-25.94) and TAPSE<18.5 mm (OR=9.43, 95% CI 2.57-35.03), and the final model had good discrimination, with C-statistic=0.83 (95%CI 0.75-0.91). CONCLUSION: Markers of RV and LV dysfunction assessed by bedside echo are independent predictors of mortality in hospitalized COVID-19 patients, after adjustment for clinical variables. |
format |
Article in Journal/Newspaper |
author |
Sander Luis Gomes Pimentel Bruno Ramos Nascimento Juliane Franco Kaciane Krauss Bruno Oliveira Clara Leal Fraga Frederico Vargas Botinha de Macedo Leonardo Arruda de Moraes Raso Renata Eliane de Ávila Luiza Pereira Afonso dos Santos Rodrigo Tavares Lanna Rocha Renan Mello Oliveira Márcia de Melo Barbosa Craig Sable Antonio Luiz Pinho Ribeiro Andrea Zawacki Beaton Maria Carmo Pereira Nunes |
author_facet |
Sander Luis Gomes Pimentel Bruno Ramos Nascimento Juliane Franco Kaciane Krauss Bruno Oliveira Clara Leal Fraga Frederico Vargas Botinha de Macedo Leonardo Arruda de Moraes Raso Renata Eliane de Ávila Luiza Pereira Afonso dos Santos Rodrigo Tavares Lanna Rocha Renan Mello Oliveira Márcia de Melo Barbosa Craig Sable Antonio Luiz Pinho Ribeiro Andrea Zawacki Beaton Maria Carmo Pereira Nunes |
author_sort |
Sander Luis Gomes Pimentel |
title |
Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study |
title_short |
Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study |
title_full |
Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study |
title_fullStr |
Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study |
title_full_unstemmed |
Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study |
title_sort |
bedside echocardiography to predict mortality of covid-19 patients beyond clinical data: data from the provar-covid study |
publisher |
Sociedade Brasileira de Medicina Tropical (SBMT) |
publishDate |
2021 |
url |
https://doi.org/10.1590/0037-8682-0382-2021 https://doaj.org/article/47a2071884254e29ae4a5b41a935697c |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista da Sociedade Brasileira de Medicina Tropical, Vol 54 (2021) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100334&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0382-2021 https://doaj.org/article/47a2071884254e29ae4a5b41a935697c |
op_doi |
https://doi.org/10.1590/0037-8682-0382-2021 |
container_title |
Revista da Sociedade Brasileira de Medicina Tropical |
container_volume |
54 |
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1766344369591287808 |