EXPRESS: Association of Right Ventricular Dysfunction and Pulmonary Hypertension with Adverse 30-Day Outcomes in COVID-19 Patients

Background: Cardiac manifestations in COVID-19 are multifactorial and are associated with increased mortality The clinical utility and prognostic value of echocardiography in COVID-19 inpatients is not clearly defined We aim to identify echocardiographic parameters that are associated with 30-day clinical outcomes secondary to COVID-19 hospitalization Methods: This retrospective cohort study was conducted in a large tertiary hospital in New York City during the COVID-19 pandemic It included 214 adult inpatients with a laboratory-confirmed diagnosis of COVID-19 by reverse transcriptase polymerase chain reaction assay (RT-PCR) for SARS-CoV-2 on nasopharyngeal swab and had a transthoracic echocardiogram performed during the index hospitalization Primary outcome was 30-day all-cause inpatient mortality Secondary outcomes were 30-day utilization of mechanical ventilator support, vasopressors, or renal replacement therapy Results: Mild right ventricular systolic dysfunction (odds ratio (OR): 3 51, 95% confidence interval (CI): 1 63–7 57, p = 0 001), moderate to severe right ventricular systolic dysfunction (OR: 7 30, 95% CI: 2 20–24 25, p = 0 001), pulmonary hypertension (OR: 5 39, 95% CI: 1 96–14 86, p = 0 001), and moderate to severe tricuspid regurgitation (OR: 3 92, 95% CI: 1 71–9 03, p = 0 001) were each associated with increased odds of 30-day all-cause inpatient mortality Pulmonary hypertension and moderate to severe right ventricular dysfunction were each associated with increased odds of 30-day utilization of mechanical ventilator support and vasopressors Conclusions: Right ventricular dysfunction, pulmonary hypertension, and moderate to severe tricuspid regurgitation were associated with increased odds for 30-day inpatient mortality This study highlights the importance of echocardiography and its clinical utility and prognostic value for evaluating hospitalized COVID-19 patients © The Author(s) 2021