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. 2021 Oct 23;19(1):34.
doi: 10.1186/s12947-021-00265-y.

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

Marcelo Luiz Campos Vieira  1 , Tania Regina Afonso  2 , Alessandra Joslin Oliveira  2 , Carolina Stangenhaus  2 , Juliana Cardoso Dória Dantas  2 , Lucas Arraes de França  2 , Edgar Daminelo  2 , Adriana Cordovil  2 , Lara A S Martins  2 , Rodrigo A C Meirelles  2 , Rafael B Piveta  2 , Sérgio Barros-Gomes  2 , Miguel O D Aguiar  2 , Patrícia O Roveri  2 , Wércules A Oliveira  2 , Alessandro C Lianza  2 , Andrea P L Ponchirolli  2 , Líria M L Silva  2 , Rodrigo C P L Costa  2 , Cláudio H Fischer  2 , Samira Saady Morhy  2
Affiliations

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

Marcelo Luiz Campos Vieira et al. Cardiovasc Ultrasound. .

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.

Keywords: COVID-19; Echocardiography; Mortality, pulmonary thromboembolism; Renal failure.

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Conflict of interest statement

There are no conflict of interests.

Figures

Fig. 1
Fig. 1
Images of the complete echocardiographic protocol of the investigation
Fig. 2
Fig. 2
Images of a 45 year-old COVI 19 male patient presenting normal left ventricular ejection fraction (biplane EF: 66%), decreased longitudinal 2D global strain (− 12%), elevated C-reactive protein (12 mg/dL), ground-glass opacities on computed thoracic tomography, under ECMO therapy
Fig. 3
Fig. 3
Distribution of the echocardiographic findings
Fig. 4
Fig. 4
The area under the receiver operating characteristic curve of the tricuspid velocity for predicting a composite endpoint of mortality, pulmonary thromboembolism or acute renal failure for in-hospital COVID-19 patients
See this image and copyright information in PMC

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