Abstract
The Coronavirus Disease (COVID-19) pandemic imposed a high burden of morbidity and mortality. In COVID-19, direct lung parenchymal involvement and pulmonary microcirculation dysfunction may entail pulmonary hypertension (PH). PH and direct cardiac injury beget right ventricular dysfunction (RVD) occurrence, which has been frequently reported in COVID-19 patients; however, the prevalence of RVD and its impact on outcomes during COVID-19 are still unclear. This study aims to evaluate the prevalence of RVD and associated outcomes in patients with COVID-19, through a Systematic Review and Meta-Analysis. MEDLINE and EMBASE were systematically searched from inception to 15th July 2021. All studies reporting either the prevalence of RVD in COVID-19 patients or all-cause death according to RVD status were included. The pooled prevalence of RVD and Odds Ratio (OR) for all-cause death according to RVD status were computed and reported. Subgroup analysis and meta-regression were also performed. Among 29 studies (3813 patients) included, pooled prevalence of RVD was 20.4% (95% CI 17.1–24.3%; 95% PI 7.8–43.9%), with a high grade of heterogeneity. No significant differences were found across geographical locations, or according to the risk of bias. Severity of COVID-19 was associated with increased prevalence of RVD at meta-regression. The presence of RVD was found associated with an increased likelihood of all-cause death (OR 3.32, 95% CI 1.94–5.70). RVD was found in 1 out of 5 COVID-19 patients, and was associated with all-cause mortality. RVD may represent one crucial marker for prognostic stratification in COVID-19; further prospective and larger are needed to investigate specific management and therapeutic approach for these patients.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease (COVID-19), plagued the world during 2020, with the World Health Organization declaring a pandemic state earlier in the year[1]
Moving from this, this systematic review and meta-analysis aimed to estimate the prevalence of right ventricular dysfunction (RVD) among patients with COVID-19 and to explore its impact on all-cause mortality
In our meta-analysis, we reported a large variation of prediction intervals (PI), up to 44%; this information may be useful to interpret the findings of our study: our results indicates that, depending on the method used to define RVD and the clinical setting, the prevalence of RVD in patients with COVID-19 may be higher than expected
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease (COVID-19), plagued the world during 2020, with the World Health Organization declaring a pandemic state earlier in the year[1]. Pulmonary microvascular pathologic changes, right ventricular pressure overload, and direct myocardial injury exert a synergic detrimental effect on the right ventricular function. Clarification of the prevalence of RVD, and its associated outcomes in patients with COVID19, may promote the implementation of tailored strategies for the screening, prevention, and treatment of right ventricular impairment. Amid this pandemic, systematic review and meta-analysis have been depicted as essential tools to provide a timely and comprehensive synthesis of evidence during the COVID-19 p andemic[10]. Moving from this, this systematic review and meta-analysis aimed to estimate the prevalence of RVD among patients with COVID-19 and to explore its impact on all-cause mortality
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
