ECHOCARDIOGRAPHIC ABNORMALITIES ARE COMMON AMONG PATIENTS WITH COVID-19 INFECTION AND INDEPENDENTLY CONFER INCREASED RISK OF IN-HOSPITAL MORTALITY

Background Biomarker-evidenced myocardial injury is common among patients with COVID-19 infection and confers an increased risk of mortality Prevalence and incremental prognostic impact of myocardial dysfunction is unknown Methods Consecutive COVID-19 patients undergoing clinical echocardiography during their index hospitalization at three New York City hospitals were studied Images were analyzed by a central core lab blinded to all clinical data LV dysfunction was defined as LVEF < 55% and RV dysfunction as TAPSE <1 6 cm or S’<10 mm/s Results 733 patients (64 ± 15 years, 61% men) were studied Myocardial injury (elevated troponin) occurred in 21% of patients, among whom either LV or RV myocardial dysfunction occurred in 72% (LV: 54%, RV:24%) Myocardial dysfunction was more common among patients with myocardial injury vs without (LV: 54 vs 32% p<0 001;RV: 24 vs 10% p=0 001) During inpatient follow-up (median 15 [IQR 6-35] days), in-hospital mortality occurred in 34% with myocardial injury and 44% with LV or RV dysfunction vs 23% without myocardial injury (p<0 001) Risk for death was greatest among patients with combined myocardial dysfunction and myocardial injury, and less with myocardial injury alone [Figure] Conclusion Echo-evidenced myocardial dysfunction occurs in nearly three quarters of patients with myocardial injury and is a powerful predictor of in-hospital mortality [Formula presented]