RT Journal Article
SR Electronic
T1 Pulmonary hypertension and right ventricular involvement in hospitalised patients with COVID-19
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1324
OP 1331
DO 10.1136/heartjnl-2020-317355
VO 106
IS 17
A1 Matteo Pagnesi
A1 Luca Baldetti
A1 Alessandro Beneduce
A1 Francesco Calvo
A1 Mario Gramegna
A1 Vittorio Pazzanese
A1 Giacomo Ingallina
A1 Antonio Napolano
A1 Renato Finazzi
A1 Annalisa Ruggeri
A1 Silvia Ajello
A1 Giulio Melisurgo
A1 Paolo Guido Camici
A1 Paolo Scarpellini
A1 Moreno Tresoldi
A1 Giovanni Landoni
A1 Fabio Ciceri
A1 Anna Mara Scandroglio
A1 Eustachio Agricola
A1 Alberto Maria Cappelletti
YR 2020
UL http://heart.bmj.com/content/106/17/1324.abstract
AB Objective 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).Methods 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.Results 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).Conclusions 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.Trial registration number NCT04318366