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    Echocardiography findings in COVID-19 patients admitted to intensive care units: a multi-national observational study (the ECHO-COVID study)

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    Authors
    Huang, Stephen
    Vignon, Philippe
    Mekontso-Dessap, Armand
    Tran, Ségolène
    Prat, Gwenael
    Chew, Michelle
    Balik, Martin
    Sanfilippo, Filippo
    Banauch, Gisela
    Clau-Terre, Fernando
    Morelli, Andrea
    De Backer, Daniel
    Cholley, Bernard
    Slama, Michel
    Charron, Cyril
    Goudelin, Marine
    Bagate, Francois
    Bailly, Pierre
    Blixt, Patrick-Johansson
    Masi, Paul
    Evrard, Bruno
    Orde, Sam
    Mayo, Paul
    McLean, Anthony S
    Vieillard-Baron, Antoine
    Show allShow less
    UMass Chan Affiliations
    Medicine
    Document Type
    Journal Article
    Publication Date
    2022-04-21
    Keywords
    COVID-19
    Cardiac function
    Echocardiography
    Intensive care unit
    
    Metadata
    Show full item record
    Link to Full Text
    https://doi.org/10.1007/s00134-022-06685-2
    Abstract
    Purpose: Severely ill patients affected by coronavirus disease 2019 (COVID-19) develop circulatory failure. We aimed to report patterns of left and right ventricular dysfunction in the first echocardiography following admission to intensive care unit (ICU). Methods: Retrospective, descriptive study that collected echocardiographic and clinical information from severely ill COVID-19 patients admitted to 14 ICUs in 8 countries. Patients admitted to ICU who received at least one echocardiography between 1st February 2020 and 30th June 2021 were included. Clinical and echocardiographic data were uploaded using a secured web-based electronic database (REDCap). Results: Six hundred and seventy-seven patients were included and the first echo was performed 2 [1, 4] days after ICU admission. The median age was 65 [56, 73] years, and 71% were male. Left ventricle (LV) and/or right ventricle (RV) systolic dysfunction were found in 234 (34.5%) patients. 149 (22%) patients had LV systolic dysfunction (with or without RV dysfunction) without LV dilatation and no elevation in filling pressure. 152 (22.5%) had RV systolic dysfunction. In 517 patients with information on both paradoxical septal motion and quantitative RV size, 90 (17.4%) had acute cor pulmonale (ACP). ACP was associated with mechanical ventilation (OR > 4), pulmonary embolism (OR > 5) and increased PaCO2. Exploratory analyses showed that patients with ACP and older age were more likely to die in hospital (including ICU). Conclusion: Almost one-third of this cohort of critically ill COVID-19 patients exhibited abnormal LV and/or RV systolic function in their first echocardiography assessment. While LV systolic dysfunction appears similar to septic cardiomyopathy, RV systolic dysfunction was related to pressure overload due to positive pressure ventilation, hypercapnia and pulmonary embolism. ACP and age seemed to be associated with mortality in this cohort.
    Source
    Huang S, Vignon P, Mekontso-Dessap A, Tran S, Prat G, Chew M, Balik M, Sanfilippo F, Banauch G, Clau-Terre F, Morelli A, De Backer D, Cholley B, Slama M, Charron C, Goudelin M, Bagate F, Bailly P, Blixt PJ, Masi P, Evrard B, Orde S, Mayo P, McLean AS, Vieillard-Baron A; ECHO-COVID research group. Echocardiography findings in COVID-19 patients admitted to intensive care units: a multi-national observational study (the ECHO-COVID study). Intensive Care Med. 2022 Jun;48(6):667-678. doi: 10.1007/s00134-022-06685-2. Epub 2022 Apr 21. PMID: 35445822; PMCID: PMC9022062.
    DOI
    10.1007/s00134-022-06685-2
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/51531
    PubMed ID
    35445822
    Rights
    © 2022. Springer-Verlag GmbH Germany, part of Springer Nature.
    ae974a485f413a2113503eed53cd6c53
    10.1007/s00134-022-06685-2
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