Echocardiography Can Determine Mortality Risk in COVID-19 Patients

Transthoracic echocardiography (TTE) plays a role in pinpointing the risk a COVID-19-positive patient has of dying.

In a study published July 21 in the European Journal of Clinical Investigation, a team of investigators from Italy determined that left ventricular ejection fraction and tricuspid annular plane systolic excursion are independently associated with whether a hospitalized COVID-19 patient will die.

“Cardiovascular complications can negatively impact on outcomes of patients with COVID-19,” said the team led by Angelo Silverio from the University of Salerno. “Clinical and echocardiographic parameters…might help to identify patients at higher risk for in-hospital mortality.”

Their findings also indicated that patients with acute respiratory distress syndrome (ARDS) had a higher mortality risk than did unaffected patients.

Despite being proven effective for diagnosing critical-care patients who have suspected or confirmed cardiac disease, TTE requires close contact. Consequently, it’s hard to use it with COVID-19 patients – and it is recommended on an essential case-by-case basis – as it could place echocardiographers at increased infection risk.

For this study, the team was interested in identifying if there were any association between certain clinical characteristics and echocardiography factors and inpatient mortality. To find out, they assessed data from 1,401 COVID-19-positive patients who were treated in seven Italian hospitals between March 2020 to April 2020. Of the group, 226 underwent TTE within 48 hours of hospital admission, and 68 patients died while hospitalized.

Based on their evaluation, the team determined that reduced left ventricular ejection fraction, reduced tricuspid annular plane systolic excursion, and ARDS were all independently associated with inpatient mortality. Specifically, left ventricular ejection fraction of 50 percent or less had a hazard ratio of 4.06. Additionally, tricuspid annular plan systolic excursion of 17 mm or less and ARDS had hazard ratios of 5.08 and 7.66, respectively.

The team also found that men were more negative affected that women with 51 of 141 male patients dying while hospitalized.

Further investigations are needed to confirm these preliminary findings, the team concluded.

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