Impaired cardiac function is associated with mortality in patients with acute COVID-19 infection

Dominik Rath, Álvaro Petersen-Uribe, Alban Avdiu, Katja Witzel, Philippa Jaeger, Monika Zdanyte, David Heinzmann, Elli Tavlaki, Karin Müller, Meinrad Paul Gawaz, Dominik Rath, Álvaro Petersen-Uribe, Alban Avdiu, Katja Witzel, Philippa Jaeger, Monika Zdanyte, David Heinzmann, Elli Tavlaki, Karin Müller, Meinrad Paul Gawaz

Abstract

Background: COVID-19 infection may cause severe respiratory distress and is associated with increased morbidity and mortality. Impaired cardiac function and/or pre-existing cardiovascular disease may be associated with poor prognosis. In the present study, we report a comprehensive cardiovascular characterization in the first consecutive collective of patients that was admitted and treated at the University Hospital of Tübingen, Germany.

Methods: 123 consecutive patients with COVID-19 were included. Routine blood sampling, transthoracic echocardiography and electrocardiography were performed at hospital admission.

Results: We found that impaired left-ventricular and right-ventricular function as well as tricuspid regurgitation > grade 1 were significantly associated with higher mortality. Furthermore, elevated levels of myocardial distress markers (troponin-I and NT pro-BNP) were associated with poor prognosis in this patient collective.

Conclusion: Impaired cardiac function is associated with poor prognosis in COVID-19 positive patients. Consequently, treatment of these patients should include careful guideline-conform cardiovascular evaluation and treatment. Thus, formation of a competent Cardio-COVID-19 team may represent a major clinical measure to optimize therapy of cardiovascular patients during this pandemic.

Keywords: COVID-19; Cardiac function; Cardiovascular disease; Heart failure; Prognosis.

Conflict of interest statement

The authors have nothing to declare.

Figures

Fig. 1
Fig. 1
Upper row: Kaplan–Meier curves showing cumulative event-free survival for the endpoint all-cause death stratified according to LVEF, RV function and TR. Lower row: bar diagrams showing distribution of LVEF, RV-function and TR between survivors and non-survivors. TR tricuspid regurgitation
Fig. 2
Fig. 2
Laboratory values at admission stratified according to survivors and non-survivors

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Source: PubMed

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