Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study

Detalhes bibliográficos
Autor(a) principal: Pimentel,Sander Luis Gomes
Data de Publicação: 2021
Outros Autores: Nascimento,Bruno Ramos, Franco,Juliane, Oliveira,Kaciane Krauss Bruno, Fraga,Clara Leal, Macedo,Frederico Vargas Botinha de, Raso,Leonardo Arruda de Moraes, Ávila,Renata Eliane de, Santos,Luiza Pereira Afonso dos, Rocha,Rodrigo Tavares Lanna, Oliveira,Renan Mello, Barbosa,Márcia de Melo, Sable,Craig, Ribeiro,Antonio Luiz Pinho, Beaton,Andrea Zawacki, Nunes,Maria Carmo Pereira
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista da Sociedade Brasileira de Medicina Tropical
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100334
Resumo: Abstract INTRODUCTION: Cardiac involvement seems to impact prognosis of COVID-19, being more frequent in critically ill patients. We aimed to assess the prognostic value of right ventricular (RV) and left ventricular (LV) dysfunction, evaluated by bedside echocardiography (echo), in patients hospitalized with COVID-19. METHODS: Patients admitted in 2 reference hospitals in Brazil from Jul to Sept/2020 with confirmed COVID-19 and moderate/severe presentations underwent clinical and laboratory evaluation, and focused bedside echo (GE Vivid-IQ), at the earliest convenience, with remote interpretation. The association between demographics, clinical comorbidities and echo variables with all-cause hospital mortality was assessed, and factors significant at p<0.10 were put into multivariable models. RESULTS: Total 163 patients were enrolled, 59% were men, mean age 64±16 years, and 107 (66%) were admitted to intensive care. Comorbidities were present in 144 (88%) patients: hypertension 115 (71%), diabetes 61 (37%) and heart failure 22 (14%). In-hospital mortality was 34% (N=56). In univariate analysis, echo variables significantly associated with death were: LV ejection fraction (LVEF, OR=0.94), RV fractional area change (OR=0.96), tricuspid annular plane systolic excursion (TAPSE, OR=0.83) and RV dysfunction (OR=5.3). In multivariate analysis, after adjustment for clinical and demographic variables, independent predictors of mortality were age≥63 years (OR=5.53, 95%CI 1.52-20.17), LVEF<64% (OR=7.37, 95%CI 2.10-25.94) and TAPSE<18.5 mm (OR=9.43, 95% CI 2.57-35.03), and the final model had good discrimination, with C-statistic=0.83 (95%CI 0.75-0.91). CONCLUSION: Markers of RV and LV dysfunction assessed by bedside echo are independent predictors of mortality in hospitalized COVID-19 patients, after adjustment for clinical variables.
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spelling Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID studyCOVID-19EchocardiographyPrognosisSARS-Cov-2MortalityAbstract INTRODUCTION: Cardiac involvement seems to impact prognosis of COVID-19, being more frequent in critically ill patients. We aimed to assess the prognostic value of right ventricular (RV) and left ventricular (LV) dysfunction, evaluated by bedside echocardiography (echo), in patients hospitalized with COVID-19. METHODS: Patients admitted in 2 reference hospitals in Brazil from Jul to Sept/2020 with confirmed COVID-19 and moderate/severe presentations underwent clinical and laboratory evaluation, and focused bedside echo (GE Vivid-IQ), at the earliest convenience, with remote interpretation. The association between demographics, clinical comorbidities and echo variables with all-cause hospital mortality was assessed, and factors significant at p<0.10 were put into multivariable models. RESULTS: Total 163 patients were enrolled, 59% were men, mean age 64±16 years, and 107 (66%) were admitted to intensive care. Comorbidities were present in 144 (88%) patients: hypertension 115 (71%), diabetes 61 (37%) and heart failure 22 (14%). In-hospital mortality was 34% (N=56). In univariate analysis, echo variables significantly associated with death were: LV ejection fraction (LVEF, OR=0.94), RV fractional area change (OR=0.96), tricuspid annular plane systolic excursion (TAPSE, OR=0.83) and RV dysfunction (OR=5.3). In multivariate analysis, after adjustment for clinical and demographic variables, independent predictors of mortality were age≥63 years (OR=5.53, 95%CI 1.52-20.17), LVEF<64% (OR=7.37, 95%CI 2.10-25.94) and TAPSE<18.5 mm (OR=9.43, 95% CI 2.57-35.03), and the final model had good discrimination, with C-statistic=0.83 (95%CI 0.75-0.91). CONCLUSION: Markers of RV and LV dysfunction assessed by bedside echo are independent predictors of mortality in hospitalized COVID-19 patients, after adjustment for clinical variables.Sociedade Brasileira de Medicina Tropical - SBMT2021-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100334Revista da Sociedade Brasileira de Medicina Tropical v.54 2021reponame:Revista da Sociedade Brasileira de Medicina Tropicalinstname:Sociedade Brasileira de Medicina Tropical (SBMT)instacron:SBMT10.1590/0037-8682-0382-2021info:eu-repo/semantics/openAccessPimentel,Sander Luis GomesNascimento,Bruno RamosFranco,JulianeOliveira,Kaciane Krauss BrunoFraga,Clara LealMacedo,Frederico Vargas Botinha deRaso,Leonardo Arruda de MoraesÁvila,Renata Eliane deSantos,Luiza Pereira Afonso dosRocha,Rodrigo Tavares LannaOliveira,Renan MelloBarbosa,Márcia de MeloSable,CraigRibeiro,Antonio Luiz PinhoBeaton,Andrea ZawackiNunes,Maria Carmo Pereiraeng2021-09-03T00:00:00Zoai:scielo:S0037-86822021000100334Revistahttps://www.sbmt.org.br/portal/revista/ONGhttps://old.scielo.br/oai/scielo-oai.php||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br1678-98490037-8682opendoar:2021-09-03T00:00Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT)false
dc.title.none.fl_str_mv Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study
title Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study
spellingShingle Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study
Pimentel,Sander Luis Gomes
COVID-19
Echocardiography
Prognosis
SARS-Cov-2
Mortality
title_short Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study
title_full Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study
title_fullStr Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study
title_full_unstemmed Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study
title_sort Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study
author Pimentel,Sander Luis Gomes
author_facet Pimentel,Sander Luis Gomes
Nascimento,Bruno Ramos
Franco,Juliane
Oliveira,Kaciane Krauss Bruno
Fraga,Clara Leal
Macedo,Frederico Vargas Botinha de
Raso,Leonardo Arruda de Moraes
Ávila,Renata Eliane de
Santos,Luiza Pereira Afonso dos
Rocha,Rodrigo Tavares Lanna
Oliveira,Renan Mello
Barbosa,Márcia de Melo
Sable,Craig
Ribeiro,Antonio Luiz Pinho
Beaton,Andrea Zawacki
Nunes,Maria Carmo Pereira
author_role author
author2 Nascimento,Bruno Ramos
Franco,Juliane
Oliveira,Kaciane Krauss Bruno
Fraga,Clara Leal
Macedo,Frederico Vargas Botinha de
Raso,Leonardo Arruda de Moraes
Ávila,Renata Eliane de
Santos,Luiza Pereira Afonso dos
Rocha,Rodrigo Tavares Lanna
Oliveira,Renan Mello
Barbosa,Márcia de Melo
Sable,Craig
Ribeiro,Antonio Luiz Pinho
Beaton,Andrea Zawacki
Nunes,Maria Carmo Pereira
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Pimentel,Sander Luis Gomes
Nascimento,Bruno Ramos
Franco,Juliane
Oliveira,Kaciane Krauss Bruno
Fraga,Clara Leal
Macedo,Frederico Vargas Botinha de
Raso,Leonardo Arruda de Moraes
Ávila,Renata Eliane de
Santos,Luiza Pereira Afonso dos
Rocha,Rodrigo Tavares Lanna
Oliveira,Renan Mello
Barbosa,Márcia de Melo
Sable,Craig
Ribeiro,Antonio Luiz Pinho
Beaton,Andrea Zawacki
Nunes,Maria Carmo Pereira
dc.subject.por.fl_str_mv COVID-19
Echocardiography
Prognosis
SARS-Cov-2
Mortality
topic COVID-19
Echocardiography
Prognosis
SARS-Cov-2
Mortality
description Abstract INTRODUCTION: Cardiac involvement seems to impact prognosis of COVID-19, being more frequent in critically ill patients. We aimed to assess the prognostic value of right ventricular (RV) and left ventricular (LV) dysfunction, evaluated by bedside echocardiography (echo), in patients hospitalized with COVID-19. METHODS: Patients admitted in 2 reference hospitals in Brazil from Jul to Sept/2020 with confirmed COVID-19 and moderate/severe presentations underwent clinical and laboratory evaluation, and focused bedside echo (GE Vivid-IQ), at the earliest convenience, with remote interpretation. The association between demographics, clinical comorbidities and echo variables with all-cause hospital mortality was assessed, and factors significant at p<0.10 were put into multivariable models. RESULTS: Total 163 patients were enrolled, 59% were men, mean age 64±16 years, and 107 (66%) were admitted to intensive care. Comorbidities were present in 144 (88%) patients: hypertension 115 (71%), diabetes 61 (37%) and heart failure 22 (14%). In-hospital mortality was 34% (N=56). In univariate analysis, echo variables significantly associated with death were: LV ejection fraction (LVEF, OR=0.94), RV fractional area change (OR=0.96), tricuspid annular plane systolic excursion (TAPSE, OR=0.83) and RV dysfunction (OR=5.3). In multivariate analysis, after adjustment for clinical and demographic variables, independent predictors of mortality were age≥63 years (OR=5.53, 95%CI 1.52-20.17), LVEF<64% (OR=7.37, 95%CI 2.10-25.94) and TAPSE<18.5 mm (OR=9.43, 95% CI 2.57-35.03), and the final model had good discrimination, with C-statistic=0.83 (95%CI 0.75-0.91). CONCLUSION: Markers of RV and LV dysfunction assessed by bedside echo are independent predictors of mortality in hospitalized COVID-19 patients, after adjustment for clinical variables.
publishDate 2021
dc.date.none.fl_str_mv 2021-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100334
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 10.1590/0037-8682-0382-2021
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Medicina Tropical - SBMT
publisher.none.fl_str_mv Sociedade Brasileira de Medicina Tropical - SBMT
dc.source.none.fl_str_mv Revista da Sociedade Brasileira de Medicina Tropical v.54 2021
reponame:Revista da Sociedade Brasileira de Medicina Tropical
instname:Sociedade Brasileira de Medicina Tropical (SBMT)
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reponame_str Revista da Sociedade Brasileira de Medicina Tropical
collection Revista da Sociedade Brasileira de Medicina Tropical
repository.name.fl_str_mv Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT)
repository.mail.fl_str_mv ||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br
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