1. Pulmonary hypertension and right ventricular involvement in hospitalised patients with COVID-19
- Author
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Francesco Calvo, Fabio Ciceri, Mario Gramegna, Giacomo Ingallina, Eustachio Agricola, Alessandro Beneduce, Silvia Ajello, Giovanni Landoni, Moreno Tresoldi, Vittorio Pazzanese, Paolo Scarpellini, Renato Finazzi, Matteo Pagnesi, Annalisa Ruggeri, Paolo G. Camici, Alberto Cappelletti, Antonio Napolano, Giulio Melisurgo, Luca Baldetti, Anna Mara Scandroglio, Pagnesi, Matteo, Baldetti, Luca, Beneduce, Alessandro, Calvo, Francesco, Gramegna, Mario, Pazzanese, Vittorio, Ingallina, Giacomo, Napolano, Antonio, Finazzi, Renato, Ruggeri, Annalisa, Ajello, Silvia, Melisurgo, Giulio, Camici, Paolo Guido, Scarpellini, Paolo, Tresoldi, Moreno, Landoni, Giovanni, Ciceri, Fabio, Scandroglio, Anna Mara, Agricola, Eustachio, and Cappelletti, Alberto Maria
- Subjects
Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Hypertension, Pulmonary ,Ventricular Dysfunction, Right ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Comorbidity ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Internal medicine ,Outcome Assessment, Health Care ,Severity of illness ,Prevalence ,medicine ,echocardiography ,Humans ,030212 general & internal medicine ,Correlation of Data ,Pandemics ,SARS-CoV-2 ,business.industry ,COVID-19 ,Oxygenation ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Icu admission ,Hospitalization ,Italy ,Echocardiography ,pulmonary vascular disease ,Pulmonary artery ,Cardiology ,Female ,Coronavirus Infections ,Cardiology and Cardiovascular Medicine ,business - Abstract
ObjectiveTo 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).MethodsThis 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 ResultsA 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%, pConclusionsAmong 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.Trial registration numberNCT04318366
- Published
- 2020
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