Echocardiographic Correlates of In-Hospital Death in Patients with Acute COVID-19 Infection: The World Alliance Societies of Echocardiography (WASE-COVID) Study.

MedStar author(s):
Citation: Journal of the American Society of Echocardiography. 2021 May 20PMID: 34023454Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2021Local holdings: Available online through MWHC library: 2007 - presentISSN:
  • 0894-7317
Name of journal: Journal of the American Society of Echocardiography : official publication of the American Society of EchocardiographyAbstract: BACKGROUND: The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus which has led to the global Coronavirus disease-2019 (COVID-19) pandemic is known to adversely affect the cardiovascular system through multiple mechanisms. In this international, multi-center study conducted by the World Alliance Societies of Echocardiography (WASE), we aim to determine the clinical and echocardiographic phenotype of acute cardiac disease in COVID-19 patients, to explore phenotypic differences in different geographic regions across the world, and to identify parameters associated with in-hospital mortality.CONCLUSIONS: LV dysfunction is noted in approximately 20% and RV dysfunction in approximately 30% of patients with acute COVID-19 illness and portend a poor prognosis. Age at presentation, previous lung disease, LDH, LVLS, and RVFWS were independently associated with in-hospital mortality. Regional differences in cardiac phenotype highlight the significant differences in patient acuity as well as echocardiographic utilization in different parts of the world. Copyright (c) 2021. Published by Elsevier Inc.METHODS: We studied 870 patients with acute COVID-19 infection from 13 medical centers in four world regions (Asia, Europe, United States, Latin America) who had undergone transthoracic echocardiograms (TTEs). Clinical and laboratory data were collected, including patient outcomes. Anonymized echocardiograms were analyzed with automated, machine learning-derived algorithms to calculate left ventricular (LV) volumes, ejection fraction (EF), and LV longitudinal strain (LS). Right-sided echocardiographic parameters that were measured included right ventricular (RV) LS, RV free wall strain (FWS), and RV basal diameter (RVBD). Multivariate regression analysis was performed to identify clinical and echocardiographic parameters associated with in-hospital mortality.RESULTS: Significant regional differences were noted in terms of patient co-morbidities, severity of illness, clinical biomarkers, and LV and RV echocardiographic metrics. Overall in-hospital mortality was 21.6%. Parameters associated with mortality in a multivariate analysis were age (OR 1.12 [1.05, 1.22], p = 0.003), previous lung disease (OR 7.32 [1.56, 42.2], p = 0.015), LVLS (OR 1.18 [1.05, 1.36], p = 0.012), lactic dehydrogenase (LDH) (OR 6.17 [1.74, 28.7], p = 0.009), and RVFWS (OR 1.14 [1.04, 1.26], p = 0.007).All authors: Addetia K, Alizadehasl A, Asch FM, Citro R, Descamps T, Karagodin I, Lang RM, Monaghan MJ, Moreo A, Mostafavi A, Narang A, Ordonez Salazar BA, Singulane CC, Soulat-Dufour L, Tucay ES, Tude Rodrigues AC, Vasquez-Ortiz ZY, WASE-COVID Investigators, Woodward GM, Wu C, Xie MFiscal year: FY2021Digital Object Identifier: Date added to catalog: 2021-06-28
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 34023454 Available 34023454

Available online through MWHC library: 2007 - present

BACKGROUND: The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus which has led to the global Coronavirus disease-2019 (COVID-19) pandemic is known to adversely affect the cardiovascular system through multiple mechanisms. In this international, multi-center study conducted by the World Alliance Societies of Echocardiography (WASE), we aim to determine the clinical and echocardiographic phenotype of acute cardiac disease in COVID-19 patients, to explore phenotypic differences in different geographic regions across the world, and to identify parameters associated with in-hospital mortality.

CONCLUSIONS: LV dysfunction is noted in approximately 20% and RV dysfunction in approximately 30% of patients with acute COVID-19 illness and portend a poor prognosis. Age at presentation, previous lung disease, LDH, LVLS, and RVFWS were independently associated with in-hospital mortality. Regional differences in cardiac phenotype highlight the significant differences in patient acuity as well as echocardiographic utilization in different parts of the world. Copyright (c) 2021. Published by Elsevier Inc.

METHODS: We studied 870 patients with acute COVID-19 infection from 13 medical centers in four world regions (Asia, Europe, United States, Latin America) who had undergone transthoracic echocardiograms (TTEs). Clinical and laboratory data were collected, including patient outcomes. Anonymized echocardiograms were analyzed with automated, machine learning-derived algorithms to calculate left ventricular (LV) volumes, ejection fraction (EF), and LV longitudinal strain (LS). Right-sided echocardiographic parameters that were measured included right ventricular (RV) LS, RV free wall strain (FWS), and RV basal diameter (RVBD). Multivariate regression analysis was performed to identify clinical and echocardiographic parameters associated with in-hospital mortality.

RESULTS: Significant regional differences were noted in terms of patient co-morbidities, severity of illness, clinical biomarkers, and LV and RV echocardiographic metrics. Overall in-hospital mortality was 21.6%. Parameters associated with mortality in a multivariate analysis were age (OR 1.12 [1.05, 1.22], p = 0.003), previous lung disease (OR 7.32 [1.56, 42.2], p = 0.015), LVLS (OR 1.18 [1.05, 1.36], p = 0.012), lactic dehydrogenase (LDH) (OR 6.17 [1.74, 28.7], p = 0.009), and RVFWS (OR 1.14 [1.04, 1.26], p = 0.007).

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