Impact of Right Ventricular Dysfunction on Mortality in Patients Hospitalized with COVID-19 according to Race.

Moody, William E, Mahmoud-Elsayed, Hani M, Senior, Jonathan, Gul, Uzma, Khan-Kheil, Ayisha M, Horne, Sebastian, Banerjee, Amitava, Bradlow, William M, Huggett, Robert, Hothi, Sandeep S, Shahid, Muhammad and Steeds, Richard Paul (2020) Impact of Right Ventricular Dysfunction on Mortality in Patients Hospitalized with COVID-19 according to Race. CJC open. ISSN 2589-790X.

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Abstract

Background

Epidemiological studies suggest that black, Asian and minority ethnic (BAME) patients may be at risk of worse outcomes from Coronavirus-19 (COVID-19) but the pathophysiological drivers for this association are unknown. This study sought to investigate the relationship between findings on echocardiography, mortality and race in COVID-19 pneumonia.

Methods

This was a multicenter, retrospective, observational study including 164 adults (61±13years; 78% male; 36% BAME) hospitalized with COVID-19 undergoing echocardiography between March 16 and May 9, 2020 at 3 days (IQR 2 - 5) from admission. The primary outcome was all-cause mortality.

Results

After a median follow up of 31 days (IQR 14 - 42 days), 58 (35%) patients had died. The right ventricle (RV) was dilated in 62 (38%) patients, and 58 (35%) patients had RV systolic dysfunction. Only 2 (1%) patients had left ventricular (LV) dilatation and 133 (81%) had normal or hyperdynamic LV systolic function. Reduced tricuspid annulus planar systolic excursion was associated with elevated D-dimer (ρ = -0.18, p = 0.025) and high-sensitivity cardiac Troponin (ρ = -0.30, p < 0.0001). Reduced RV systolic function (HR, 1.80; 95% CI, 1.05 - 3.09; p = 0.032) was an independent predictor of all-cause mortality after adjustment for demographic and clinical risk factors. Comparing white and BAME individuals, there were no differences in echocardiography findings, biomarkers or mortality.

Conclusions

In patients hospitalized with COVID-19 pneumonia, reduced RV systolic function is prevalent and associated with all-cause mortality. There is however, no racial variation in the early findings on echocardiography, biomarkers or mortality.

Item Type: Article
Subjects: WG Cardiovascular system. Cardiology
Divisions: Emergency Services > Cardiology
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 08 Oct 2020 14:45
Last Modified: 08 Oct 2020 14:45
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3518

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