Impaired Myocardial Function Is Prognostic for Severe Respiratory Failure in the Course of COVID-19 Infection

Frontiers in Cardiovascular Medicine

Karin Müller¹  Philippa Jaeger¹  Monika Zdanyte¹  Katja Witzel¹  Verena Warm¹  Tobias Geisler¹  Alvaro Petersen-Uribe¹  Meinrad Gawaz¹  David Heinzmann¹  Elli Tavlaki¹  Alban Avdiu¹  Dominik Rath¹  Peter Martus² 

[1] Department of Cardiology and Angiology, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Tübingen, Germany;Institute for Clinical Epidemiology and Applied Biostatistics, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Tübingen, Germany;

关键词: COVID-19;    mechanical ventilation;    mortality;    myocardial function;    prognosis;   

DOI  :  10.3389/fcvm.2021.584108

来源: Frontiers

【 摘 要 】

COVID-19 may lead to severe acute respiratory distress syndrome (ARDS) resulting in increased morbidity and mortality. Heart failure and/or pre-existing cardiovascular disease may correlate with poor outcomes and thus require special attention from treating physicians. The present study sought to investigate a possible impact of impaired myocardial function as well as myocardial distress markers on mortality or ARDS with need for mechanical ventilation in 157 consecutive patients with confirmed SARS-CoV-2 infection. All patients were admitted and treated at the University Hospital of Tübingen, Germany, during the first wave of the pandemic. Electrocardiography, echocardiography, and routine blood sampling were performed at hospital admission. Impaired left-ventricular and right-ventricular function, tricuspid regurgitation > grade 1, and elevated RV-pressure as well as thrombotic and myocardial distress markers (D-dimers, NT-pro-BNP, and troponin-I) were associated with mechanical ventilation and/or all-cause mortality. Impaired cardiac function is more frequent amidst ARDS, leading to subsequent need for mechanical ventilation, and thus denotes a poor outcome in COVID-19. Since a causal treatment for SARS-CoV-2 infection is still lacking, guideline-compliant cardiovascular evaluation and treatment remains the best approach to improve outcomes in COVID-19 patients with cardiovascular comorbidities.

【 授权许可】

CC BY