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This single-center observational study examined characteristics of 211 hospitalized patients with COVID-19 to examine the prevalence pulmonary hypertension (PH) and right ventricular dysfunction (RVD) and to compare characteristics and outcomes of patients with versus without these conditions. Of the 200 participants included in the final analysis, 12.0% had PH and 14.5% had RVD. Compared with other patients, those with PH were older, had more cardiac comorbidities at baseline, had evidence of more severe SARS-CoV-2 infection, and had a greater rate of ICU admission or in-hospital death. Compared with other participants, the 14.5% of the participants with RVD had more cardiac comorbidities at baseline but did not have evidence of more severe SARS-CoV-2 infection or increased rate of ICU admission or in-hospital death.
These data suggest that PH is associated with worse outcomes and more severe COVID-19, which may be helpful in risk stratification.
This abstract is available on the publisher's site.
To assess the prevalence, characteristics and prognostic value of pulmonary hypertension (PH) and right ventricular dysfunction (RVD) in hospitalised, non-intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19).
This single-centre, observational, cross-sectional study included 211 patients with COVID-19 admitted to non-ICU departments who underwent a single transthoracic echocardiography (TTE). Patients with poor acoustic window (n=11) were excluded. Clinical, imaging, laboratory and TTE findings were compared in patients with versus without PH (estimated systolic pulmonary artery pressure >35 mm Hg) and with versus without RVD (tricuspid annular plane systolic excursion <17 mm or S wave <9.5 cm/s). The primary endpoint was in-hospital death or ICU admission.
A total of 200 patients were included in the final analysis (median age 62 (IQR 52-74) years, 65.5% men). The prevalence of PH and RVD was 12.0% (24/200) and 14.5% (29/200), respectively. Patients with PH were older and had a higher burden of pre-existing cardiac comorbidities and signs of more severe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (radiological lung involvement, laboratory findings and oxygenation status) compared with those without PH. Conversely, patients with RVD had a higher burden of pre-existing cardiac comorbidities but no evidence of more severe SARS-CoV-2 infection compared with those without RVD. The presence of PH was associated with a higher rate of in-hospital death or ICU admission (41.7 vs 8.5%, p<0.001), while the presence of RVD was not (17.2 vs 11.7%, p=0.404).
Among hospitalised non-ICU patients with COVID-19, PH (and not RVD) was associated with signs of more severe COVID-19 and with worse in-hospital clinical outcome.
Pulmonary Hypertension and Right Ventricular Involvement in Hospitalised Patients With COVID-19
Heart 2020 Jul 16;[EPub Ahead of Print], M Pagnesi, L Baldetti, A Beneduce, F Calvo, M Gramegna, V Pazzanese, G Ingallina, A Napolano, R Finazzi, A Ruggeri, S Ajello, G Melisurgo, PG Camici, P Scarpellini, M Tresoldi, G Landoni, F Ciceri, AM Scandroglio, E Agricola, AM Cappelletti