Rifaie Osama, Reda Ahmed, Hatata Ahmed, Gamal Amr, Abdelmonaem Mostafa
Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Interventional Cardiology Unit, Cardiology Department, Ain Shams University Hospital, Mohamed Hilal Street Villa 10, Abbassia, Cairo, P0 11371, Obour City, Egypt.
Egypt Heart J. 2022 Feb 2;74(1):7. doi: 10.1186/s43044-022-00242-4.
COVID-19 pandemic is associated with high morbidity and mortality. Cardiovascular insult is a leading cause of in-hospital mortality in COVID-19 patients, especially right ventricular (RV) dysfunction and massive pulmonary embolism. This study aims to assess short-term impact of COVID 19 infection on (RV) functions among hospitalized patients with moderate or severe illness using bed side trans-thoracic echocardiogram. This study was conducted in 3 isolation hospitals in Cairo, spanning over 3 months during the expected pandemic peak in Egypt in 2020. The study recruited 100 consecutive patients with moderate or severe COVID-19 infection. Four patients refused to participate in the study. Patients with pre-existing structural heart diseases were excluded. All patients underwent full history taking and clinical examination. Bed side echocardiography was done emphasizing on (RV), and (RA) dimensions, (LV) functions and pulmonary artery systolic pressure (PSAS). Cardiac biomarkers were withdrawn and CT angiography was ordered when clinically warranted.
The mean age of the studied cohort was 59.5 ± 8.6 years with males comprising 71.9% of the studied group. (RV) and (RA) dilatation was noted in 8 cases (8.3%). (LV) dysfunction was noted in 11 cases (11.4%). (PASP) showed a statistically significant negative correlation with (LV) function. However, (PSAP) was positively correlated to (RA) and (RV) dimensions, tricuspid regurgitation (TR) jet severity, previous COVID infection and elevated cardiac biomarkers. Mortality was noted in 3 cases (3.1%), all had LV dysfunction with elevated troponin level. Six patients (6.2%) had combined (LV) and (RV) dysfunction.
COVID-19 illness had a negative impact on (RV) and (LV) functions, that could be assessed accurately by trans-thoracic 2 D echocardiogram. The degree of ventricular dysfunction correlated with the rise in cardiac biomarkers as well as the degree of (PASP).
2019冠状病毒病（COVID-19）大流行与高发病率和死亡率相关。心血管损伤是COVID-19患者住院死亡的主要原因，尤其是右心室（RV）功能障碍和大面积肺栓塞。本研究旨在通过床边经胸超声心动图评估COVID-19感染对中度或重度疾病住院患者右心室（RV）功能的短期影响。本研究在开罗的3家隔离医院进行，在2020年埃及预计的大流行高峰期持续了3个月。该研究连续招募了100例中度或重度COVID-19感染患者。4例患者拒绝参与研究。排除有结构性心脏病史的患者。所有患者均进行了全面的病史采集和临床检查。进行床边超声心动图检查，重点关注右心室（RV）、右心房（RA）尺寸、左心室（LV）功能和肺动脉收缩压（PSAS）。采集心脏生物标志物，并在临床需要时进行CT血管造影。
研究队列的平均年龄为59.5±8.6岁，男性占研究组的71.9%。8例（8.3%）出现右心室（RV）和右心房（RA）扩张。11例（11.4%）出现左心室（LV）功能障碍。肺动脉收缩压（PASP）与左心室（LV）功能呈显著负相关。然而，肺动脉收缩压（PSAP）与右心房（RA）和右心室（RV）尺寸、三尖瓣反流（TR）射流严重程度、既往COVID感染及心脏生物标志物升高呈正相关。3例（3.1%）死亡，均有左心室功能障碍且肌钙蛋白水平升高。6例（6.2%）合并左心室（LV）和右心室（RV）功能障碍。
COVID-19疾病对右心室（RV）和左心室（LV）功能有负面影响，经胸二维超声心动图可准确评估。心室功能障碍程度与心脏生物标志物升高以及肺动脉收缩压（PASP）程度相关。
