Abstract 15983: New Left Ventricular Systolic Dysfunction in Hospitalized Patients With Covid-19

Abstract

Introduction: Left ventricular systolic dysfunction (LVSD) has been observed in COVID-19 and is thought to be multifactorial. The epidemiology of stress cardiomyopathy in these patients has not been studied. Methods: Transthoracic echocardiograms (TTE) were evaluated in consecutive COVID-19 patients admitted to a large tertiary care center in Chicago, Illinois. Subjects with new LVEF ≤50% with prior normal LVEF or unknown baseline LVEF were compared to those with LVEF >50% or previously known LVSD. InterTAK scores were calculated for all patients with new LVSD, and a cutoff of 50 was used to delineate the likelihood of stress-induced cardiomyopathy. Two-tailed student t-test of unequal variance and Chi-squared testing were used for analysis of continuous and categorical variables, respectively, with p<0.05 considered statistically significant. Results: Of hospitalized patients with COVID-19 (n=982), 231 (23.5%) underwent TTE. Thirty patients (13.0%) were found to have new LVSD. Patients with new LVSD had higher peak troponin and rates of ICU admission and incidence of in-hospital mortality compared to patients without new LVSD (Table). Ten patients (33%) with new LVSD had InterTAK scores ≥50. Compared to those with low InterTAK scores, these patients were more likely to be female, have lower peak d-dimer, and a trend towards lower troponin as well as rates of ICU admission and mortality. Only two patients with new LV dysfunction were noted to have Takotsubo patterns on TTE. Conclusions: In hospitalized patients with COVID-19, new LVSD was rare but associated with an increased risk of critical illness requiring intensive care, intubation and in-hospital mortality. The etiology of new LVSD in COVID-19 is likely multifactorial, but those with LV dysfunction likely secondary to stress-induced cardiomyopathy have a trend towards improved mortality.