Abstract
Purpose: Describe echocardiographic characteristics in patients admitted
to intensive care unit by COVID-19 and identify clinical and laboratory
findings associated with an abnormal echocardiogram. Methods: Included
all patients with RT-PCR-confirmed COVID-19 who underwent
echocardiography during hospitalization. Echocardiographic
characteristics were assessed in entire population and in subgroups. We
also analyzed clinical characteristics associated with an abnormal
echocardiogram. An echocardiogram was defined as abnormal when it
demonstrates systolic ventricular dysfunction of any degree (left and/or
right ventricle) and/or high filling pressures (E/E’ ratio>
16; SPAP> 40mmHg, RAP> 15mmHg or diastolic
dysfunction ≥ grade 2) and/or moderate to severe pericardial effusion.
Clinical variables were also assessed using classification tree and
binary logistic regression was performed with characteristics that
showed a statistical significance in univariate analysis. Results: 272
admissions to ICU by COVID-19 were identified. Of these, 159 underwent
echocardiography (58.5%). 39 were excluded by incomplete demographic
data. 72 echocardiograms (60%) were abnormal according to
pre-established criteria. Low occurrence of left and right ventricular
systolic dysfunction was observed, as well as 30.8% of the population
had normal diastolic function. In univariate analysis, characteristics
associated with abnormal echocardiogram were age, elevated troponin,
previous heart failure and SAPS3 score. In regression model, troponin
was the independent marker of abnormal echocardiography in patients
admitted to the intensive care unit by COVID19. This finding was
corroborated by the classification tree. Conclusions: Many manifested
elevated ventricular filling pressures, but the occurrence of
ventricular dysfunction was low. Elevated serum troponin level was the
independent marker associated with an abnormal echocardiogram.