Impaired cardiac function is associated with mortality in patients with acute COVID-19 infection

Clin Res Cardiol. 2020 Dec;109(12):1491-1499. doi: 10.1007/s00392-020-01683-0. Epub 2020 Jun 14.

Abstract

Background: COVID-19 infection may cause severe respiratory distress and is associated with increased morbidity and mortality. Impaired cardiac function and/or pre-existing cardiovascular disease may be associated with poor prognosis. In the present study, we report a comprehensive cardiovascular characterization in the first consecutive collective of patients that was admitted and treated at the University Hospital of Tübingen, Germany.

Methods: 123 consecutive patients with COVID-19 were included. Routine blood sampling, transthoracic echocardiography and electrocardiography were performed at hospital admission.

Results: We found that impaired left-ventricular and right-ventricular function as well as tricuspid regurgitation > grade 1 were significantly associated with higher mortality. Furthermore, elevated levels of myocardial distress markers (troponin-I and NT pro-BNP) were associated with poor prognosis in this patient collective.

Conclusion: Impaired cardiac function is associated with poor prognosis in COVID-19 positive patients. Consequently, treatment of these patients should include careful guideline-conform cardiovascular evaluation and treatment. Thus, formation of a competent Cardio-COVID-19 team may represent a major clinical measure to optimize therapy of cardiovascular patients during this pandemic.

Keywords: COVID-19; Cardiac function; Cardiovascular disease; Heart failure; Prognosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19 / diagnosis
  • COVID-19 / mortality*
  • COVID-19 / physiopathology
  • COVID-19 / therapy
  • Female
  • Germany
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Tricuspid Valve Insufficiency / diagnosis
  • Tricuspid Valve Insufficiency / mortality*
  • Tricuspid Valve Insufficiency / physiopathology
  • Tricuspid Valve Insufficiency / therapy
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / mortality*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / therapy
  • Ventricular Dysfunction, Right / diagnosis
  • Ventricular Dysfunction, Right / mortality*
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Dysfunction, Right / therapy
  • Ventricular Function, Left*
  • Ventricular Function, Right*