The prognostic value of transthoracic echocardiography findings in hospitalized adult patients with COVID-19: A single-center retrospective analysis

BackgroundCardiac involvement in coronavirus disease 2019 (COVID-19) is associated with poor outcomes. Transthoracic echocardiography (TTE) can be used to assess cardiac structure and function non-invasively, and has been shown to influence management in COVID-19. ObjectivesWe aim to investigate the prognostic value of TTE findings in hospitalized adults with confirmed COVID-19. MethodsAll consecutive hospitalized adult patients with confirmed COVID-19 who underwent TTE assessment between 3rd April 2020 - 6th April 2021 were included. Comprehensive clinical data including TTE findings were collected from electronic medical records. Patients with mild-moderate and severe-critical COVID-19 were compared. Within the severe-critical group, patients who survived hospitalization and died were compared. Further analyses were conducted after matching for age >60 years, obesity, and diabetes. ResultsA total of 488 COVID-19 patients were included in this study; 202 with mild-moderate and 286 severe-critical disease. All mild-moderate patients and 152 severe-critical patients survived hospitalization. In the matched cohorts, TTE findings associated with severe-critical COVID-19 included left ventricular (LV) hypertrophy (OR: 1.91; CI: 1.21 - 3.02), LV diastolic dysfunction (OR: 1.55; CI: 1.00 - 2.38), right ventricular (RV) dysfunction (OR: 3.86; CI: 1.06 - 14.08), wall motion abnormalities (WMAs) (OR: 2.76; CI: 1.28 - 5.96), and any TTE abnormalities (OR: 2.99; CI: 1.73 - 5.17). TTE findings associated with mortality included RV dysfunction (OR: 3.53; CI: 1.12 - 11.19) and WMAs (OR: 2.63; CI: 1.26 - 5.49). ConclusionTTE is a non-invasive modality that can potentially be used for risk-stratification of hospitalized COVID-19 patients. These findings must be confirmed in larger prospective studies.