AUTHOR=Li Yuman , Fang Lingyun , Zhu Shuangshuang , Xie Yuji , Wang Bin , He Lin , Zhang Danqing , Zhang Yongxing , Yuan Hongliang , Wu Chun , Li He , Sun Wei , Zhang Yanting , Li Meng , Cui Li , Cai Yu , Wang Jing , Yang Yali , Lv Qing , Zhang Li , Johri Amer M. , Xie Mingxing 

TITLE=Echocardiographic Characteristics and Outcome in Patients With COVID-19 Infection and Underlying Cardiovascular Disease

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.642973

DOI=10.3389/fcvm.2021.642973

ISSN=2297-055X

ABSTRACT=BACKGROUND: The cardiac manifestations of COVID-19 patients with cardiovascular disease (CVD) remain unclear. We aimed to investigate the prognostic value of echocardiographic parameters in patients with COVID-19 infection and underlying CVD.  
METHODS: One hundred and fifty-seven consecutive hospitalized COVID-19 patients were enrolled. Left ventricular (LV) and right ventricular (RV) structure and function were assessed using bedside echocardiography. 
RESULTS: Eighty-nine of the 157 patients (56.7 %) had underlying CVD. Compared with patients without CVD, those with CVD had a higher mortality (22.5% vs. 4.4%, p =0.002) and experienced more clinical events including acute respiratory distress syndrome, acute heart injury or deep vein thrombosis. CVD patients presented with poorer LV diastolic and RV systolic function compared to those without CVD. RV dysfunction (30.3%) was the most frequent, followed by LV diastolic dysfunction (9.0%) and LV systolic dysfunction (5.6%) in CVD patients. CVD patients with high-sensitivity troponin I (hs-TNI) elevation or requiring mechanical ventilation therapy demonstrated worsening RV function compared with those with normal hs-TNI or nonintubated patients, whereas LV systolic or diastolic function were similar. Impaired RV function was associated with elevated hs-TNI level. At a 3-month follow-up after discharge, an improvement in RV function was observed on repeated echocardiography. RV function and elevated hs-TNI level were independent predictors of higher mortality in COVID-19 patients with CVD. 
CONCLUSIONS: Patients with COVID-19 infection and underlying CVD displayed impaired LV diastolic and RV function, whereas LV systolic function was normal in most patients. Importantly, RV function parameters are predictive of higher mortality.