Bedside echocardiography to predict mortality of covid-19 patients beyond clinical data: data from the provar-covid study
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | http://hdl.handle.net/1843/62522 |
Resumo: | 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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2024-01-09T19:37:45Z2024-01-09T19:37:45Z202154(e0382-20211910.1590/0037-8682-0382-202116789849http://hdl.handle.net/1843/62522Introduction: 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.engUniversidade Federal de Minas GeraisUFMGBrasilMED - DEPARTAMENTO DE CLÍNICA MÉDICARevista da Sociedade Brasileira de Medicina TropicalCOVID-19EchocardiographyPrognosisSARS-CoV-2MortalityCOVID-19EchocardiographyPrognosisSARS-CoV-2MortalityBedside echocardiography to predict mortality of covid-19 patients beyond clinical data: data from the provar-covid studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.1590/0037-8682-0382-2021Sander Luis Gomes PimentelRodrigo Tavares Lanna RochaRenan Mello OliveiraMárcia de Melo BarbosaCraig SableAntonio Luiz Pinho RibeiroAndrea Zawacki BeatonMaria Carmo Pereira NunesBruno Ramos NascimentoJuliane FrancoKaciane Krauss Bruno OliveiraClara Leal FragaFrederico Vargas Botinha de MacedoLeonardo Arruda de Moraes RasoRenata Eliane de ÁvilaLuiza Pereira Afonso Dos Santosapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/62522/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALBedside echocardiography to predict mortality of COVID-19 pdfa.pdfBedside echocardiography to predict mortality of COVID-19 pdfa.pdfapplication/pdf741184https://repositorio.ufmg.br/bitstream/1843/62522/2/Bedside%20echocardiography%20to%20predict%20mortality%20of%20COVID-19%20pdfa.pdf136d08eacd0ea140514d1f377da2ea84MD521843/625222024-01-09 17:36:45.93oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2024-01-09T20:36:45Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.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 Sander Luis Gomes Pimentel COVID-19 Echocardiography Prognosis SARS-CoV-2 Mortality 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 |
Sander Luis Gomes Pimentel |
author_facet |
Sander Luis Gomes Pimentel Rodrigo Tavares Lanna Rocha Renan Mello Oliveira Márcia de Melo Barbosa Craig Sable Antonio Luiz Pinho Ribeiro Andrea Zawacki Beaton Maria Carmo Pereira Nunes Bruno Ramos Nascimento Juliane Franco Kaciane Krauss Bruno Oliveira Clara Leal Fraga Frederico Vargas Botinha de Macedo Leonardo Arruda de Moraes Raso Renata Eliane de Ávila Luiza Pereira Afonso Dos Santos |
author_role |
author |
author2 |
Rodrigo Tavares Lanna Rocha Renan Mello Oliveira Márcia de Melo Barbosa Craig Sable Antonio Luiz Pinho Ribeiro Andrea Zawacki Beaton Maria Carmo Pereira Nunes Bruno Ramos Nascimento Juliane Franco Kaciane Krauss Bruno Oliveira Clara Leal Fraga Frederico Vargas Botinha de Macedo Leonardo Arruda de Moraes Raso Renata Eliane de Ávila Luiza Pereira Afonso Dos Santos |
author2_role |
author author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Sander Luis Gomes Pimentel Rodrigo Tavares Lanna Rocha Renan Mello Oliveira Márcia de Melo Barbosa Craig Sable Antonio Luiz Pinho Ribeiro Andrea Zawacki Beaton Maria Carmo Pereira Nunes Bruno Ramos Nascimento Juliane Franco Kaciane Krauss Bruno Oliveira Clara Leal Fraga Frederico Vargas Botinha de Macedo Leonardo Arruda de Moraes Raso Renata Eliane de Ávila Luiza Pereira Afonso Dos Santos |
dc.subject.por.fl_str_mv |
COVID-19 Echocardiography Prognosis SARS-CoV-2 Mortality |
topic |
COVID-19 Echocardiography Prognosis SARS-CoV-2 Mortality COVID-19 Echocardiography Prognosis SARS-CoV-2 Mortality |
dc.subject.other.pt_BR.fl_str_mv |
COVID-19 Echocardiography Prognosis SARS-CoV-2 Mortality |
description |
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.issued.fl_str_mv |
2021 |
dc.date.accessioned.fl_str_mv |
2024-01-09T19:37:45Z |
dc.date.available.fl_str_mv |
2024-01-09T19:37:45Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/62522 |
dc.identifier.doi.pt_BR.fl_str_mv |
10.1590/0037-8682-0382-2021 |
dc.identifier.issn.pt_BR.fl_str_mv |
16789849 |
identifier_str_mv |
10.1590/0037-8682-0382-2021 16789849 |
url |
http://hdl.handle.net/1843/62522 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Revista da Sociedade Brasileira de Medicina Tropical |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de Minas Gerais |
dc.publisher.initials.fl_str_mv |
UFMG |
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Brasil |
dc.publisher.department.fl_str_mv |
MED - DEPARTAMENTO DE CLÍNICA MÉDICA |
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Universidade Federal de Minas Gerais |
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