Abstract

Introduction: A new infectious outbreak sustained by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now spreading all around the world. The aim of this study was to evaluate the prognostic value of left ventricular global longitudinal strain (LV-GLS) and right ventricular longitudinal strain (RV-LS) in patients with coronavirus disease 2019 (COVID-19). Hypothesis: As some studies have shown that COVID-19 could affect the cardiovascular system due to the capability of pathogenity of the virus, biventricular functions could be affected in the tissue level even though the routine evaluations of the heart functions seem normal. Methods: In this prospective, single-center study, data were gathered from patients treated for COVID-19, who had biventricular systolic function and no history of coronary artery disease. Two-dimensional echocardiography (2-DE) and speckle tracking echocardiography (STE) images were obtained for all patients. Patients were divided into three groups: those with severe COVID-19 infection, those with non-severe COVID-19 infection, and those without COVID-19 infection (the control group). Data regarding clinical characteristics and laboratory findings were obtained from electronic medical records. The primary endpoint was in-hospital mortality. Results: A total of 100 patients hospitalized for COVID-19 were included in this study. The mean age of the severe group (n = 44) was 59.1 ± 12.9, 40% of whom were male. The mean age of the non-severe group (n = 56) was 53.7 ± 15.1, 58% of whom were male. Of these patients, 22 died in the hospital. In patients in the severe group, LV-GLS and RV-LS were decreased compared to patients in the non-severe and control groups (LV-GLS: -14.5 ± 1.8 vs. -16.7 ± 1.3 vs. -19.4 ± 1.6, respectively [p < 0.001]; RV-LS: -17.2 ± 2.3 vs. -20.5 ± 3.2 vs. -27.3 ± 3.1, respectively [p < 0.001]). The presence of cardiac injury, D-dimer, arterial oxygen saturation (SaO2), LV-GLS (OR:1.63, 95% confidence interval [CI] 1.08-2.47; p = 0.010) and RV-LS (OR:1.55, 95% CI 1.07-2.25; p = 0.019) were identified as independent predictors of mortality via multivariate analysis. Conclusions: LV-GLS and RV-LS are independent predictors of in-hospital mortality in patients with COVID-19.

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