Impaired cardiac function is associated with mortality in patients with acute COVID-19 infection

• Published in: Clinical research in cardiology 2020-12, Vol.109 (12), p.1491-1499
• Main Authors: Rath, Dominik, Petersen-Uribe, Álvaro, Avdiu, Alban, Witzel, Katja, Jaeger, Philippa, Zdanyte, Monika, Heinzmann, David, Tavlaki, Elli, Müller, Karin, Gawaz, Meinrad Paul
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Calcium-binding protein; Cardiac function; Cardiology; Cardiovascular diseases; Coronaviruses; COVID-19; COVID-19 - diagnosis; COVID-19 - mortality; COVID-19 - physiopathology; COVID-19 - therapy; Echocardiography; EKG; Electrocardiography; Female; Germany; Health services; Hospital Mortality; Hospitalization; Humans; Infections; Male; Medicine; Medicine & Public Health; Middle Aged; Morbidity; Mortality; Original Paper; Pandemics; Patients; Prognosis; Prospective Studies; Regurgitation; Risk Assessment; Risk Factors; Time Factors; Tricuspid Valve Insufficiency - diagnosis; Tricuspid Valve Insufficiency - mortality; Tricuspid Valve Insufficiency - physiopathology; Tricuspid Valve Insufficiency - therapy; Troponin; Ventricle; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - physiopathology; Ventricular Dysfunction, Left - therapy; Ventricular Dysfunction, Right - diagnosis; Ventricular Dysfunction, Right - mortality; Ventricular Dysfunction, Right - physiopathology; Ventricular Dysfunction, Right - therapy; Ventricular Function, Left; Ventricular Function, Right; Viral diseases
• ISSN: 1861-0684; 1861-0692
• DOI: 10.1007/s00392-020-01683-0

Background COVID-19 infection may cause severe respiratory distress and is associated with increased morbidity and mortality. Impaired cardiac function and/or pre-existing cardiovascular disease may be associated with poor prognosis. In the present study, we report a comprehensive cardiovascular characterization in the first consecutive collective of patients that was admitted and treated at the University Hospital of Tübingen, Germany. Methods 123 consecutive patients with COVID-19 were included. Routine blood sampling, transthoracic echocardiography and electrocardiography were performed at hospital admission. Results We found that impaired left-ventricular and right-ventricular function as well as tricuspid regurgitation > grade 1 were significantly associated with higher mortality. Furthermore, elevated levels of myocardial distress markers (troponin-I and NT pro-BNP) were associated with poor prognosis in this patient collective. Conclusion Impaired cardiac function is associated with poor prognosis in COVID-19 positive patients. Consequently, treatment of these patients should include careful guideline-conform cardiovascular evaluation and treatment. Thus, formation of a competent Cardio-COVID-19 team may represent a major clinical measure to optimize therapy of cardiovascular patients during this pandemic.