Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan-Feb:57:19-24.
doi: 10.1016/j.hrtlng.2022.08.007. Epub 2022 Aug 11.

Influence of right ventricular structure and function on hospital outcomes in COVID-19 patients

Jozef Oweis  1 , Annie Leamon  2 , Ali H Al-Tarbsheh  2 , Katharine Goodspeed  2 , Ciril Khorolsky  3 , Paul Feustel  4 , Usman Naseer  2 , Isam Albaba  2 , Sai Anoosh Parimi  2 , Boris Shkolnik  5 , Anupama Tiwari  5 , Amit Chopra  5 , Mikhail Torosoff  3
Affiliations

Influence of right ventricular structure and function on hospital outcomes in COVID-19 patients

Jozef Oweis et al. Heart Lung. 2023 Jan-Feb.

Abstract

Background: The impact of the right ventricular (RV) structure and function on the in-hospital outcomes in patients with COVID-19 infection has not been rigorously investigated.

Objectives: The main aim of our study was to investigate in-hospital outcomes including mortality, ICU admission, mechanical ventilation, pressor support, associated with RV dilatation, and RV systolic dysfunction in COVID-19 patients without a history of pulmonary hypertension.

Methods: It was a single academic tertiary center, retrospective cohort study of 997 PCR-confirmed COVID-19 patients. One hundred ninty-four of those patients did not have a history of pulmonary hypertension and underwent transthoracic echocardiography at the request of the treating physicians for clinical indications. Clinical endpoints which included mortality, ICU admission, need for mechanical ventilation or pressor support were abstracted from the electronic charts.

Results: Patients' mean age was 68+/-16 years old and 42% of the study population were females. COPD was reported in 13% of the study population, whereas asthma was 10%, and CAD was 25%. The mean BMI was 29.8+/-9.5 kg/m2. Overall mortality was 27%, 46% in ICU patients, and 9% in the rest of the cohort. There were no significant differences in co-morbidities between expired patients and the survivors. A total of 19% of patients had evidence of RV dilatation and 17% manifested decreased RV systolic function. RV dilatation or decreased RV systolic function were noted in 24% of the total study population. RV dilatation was significantly more common in expired patients (15% vs 29%, p = 0.026) and was associated with increased mortality in patients treated in the ICU (HR 2.966, 95%CI 1.067-8.243, p = 0.037), who did not need require positive pressure ventilation, IV pressor support or acute hemodialysis.

Conclusions: In hospitalized COVID-19 patients without a history of pulmonary hypertension, RV dilatation is associated with a 2-fold increase in inpatient mortality and a 3-fold increase in ICU mortality.

Keywords: COVID-19; Echocardiogram; Right ventricular dilatation; Right ventricular dysfunction.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest None.

Figures

Fig 1
Fig. 1
AssociationbetweenICUadmissions,positivepressureventilation,andRVdilatation. In the studies with available data endpoints, including current one (star), visual assessment reveals strong positive correlation between RV dilatation and mortality (Panel A), RV dilatation and positive pressure ventilation (Panel B), and positive pressure ventilation and mortality (Panel C).,,,, , , , , , ,
See this image and copyright information in PMC

Comment in

References

    1. Moody W.E., Mahmoud-Elsayed H.M., Senior J., et al. Impact of right ventricular dysfunction on mortality in patients hospitalized with COVID-19, according to race. CJC Open. 2021;3:91–100. doi: 10.1016/j.cjco.2020.09.016. - DOI - PMC - PubMed
    1. Pagnesi M., Baldetti L., Beneduce A., et al. Pulmonary hypertension and right ventricular involvement in hospitalised patients with COVID-19. Heart. 2020;106:1324–1331. doi: 10.1136/heartjnl-2020-317355. - DOI - PMC - PubMed
    1. Zheng Y.Y., Ma Y.T., Zhang J.Y., Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. May 2020;17:259–260. doi: 10.1038/s41569-020-0360-5. - DOI - PMC - PubMed
    1. Kirkpatrick J.N., Mitchell C., Taub C., Kort S., Hung J., Swaminathan M. ASE statement on protection of patients and echocardiography service providers during the 2019 novel coronavirus outbreak: endorsed by the American College of Cardiology. J Am Soc Echocardiogr. 2020;33:648–653. doi: 10.1016/j.echo.2020.04.001. - DOI - PMC - PubMed
    1. Lan Y., Liu W., Zhou Y. Right Ventricular Damage in COVID-19: association Between Myocardial Injury and COVID-19. Review. 2021;8 doi: 10.3389/fcvm.2021.606318. 2021-February-16. - DOI - PMC - PubMed