A new study shows that the presence of right ventricular (RV) dilation assessed by echocardiography was strongly associated with death in patients hospitalized with COVID-19. Edgar Argulian, MD, of Icahn School of Medicine at Mount Sinai, New York, and colleagues reported the findings, which were published online Friday in JACC: Cardiovascular Imaging.
The study retrospectively analyzed 110 echocardiograms performed in patients with confirmed COVID-19 infections who were hospitalized in March and April at Mount Sinai Hospital. A focused echocardiographic study protocol was used to limit the sonographer’s potential exposure to the virus. The mean age of the patients studied was 66 years, and 36% were female patients. About 30% of patients were intubated and mechanically ventilated. Patients were categorized as having RV dilation if the diameter of the right ventricle, measured at the base, exceeded 4.1 cm in diastole. RV dilation occurred in 31% of patients included in the analysis; these patients were compared with the remaining patients with normal RV dimensions.
The study’s endpoint of in-hospital mortality occurred in 21 (20%) of the patients studied. On multivariate analysis, RV enlargement was the only variable significantly associated with mortality (odds ratio, 4.5; 95% confidence interval, 1.5-13.7; p = 0.005). The authors acknowledge that this is a small, single-center study, and it should therefore be interpreted with caution, but they concluded that “right ventricular dilation was strongly associated with in-hospital mortality.”
None of the authors reported any conflicts of interests or disclosures.
Argulian E, Sud K, Vogel B, et al. Right Ventricular Dilation in Hospitalized Patients with COVID-19 Infection. JACC Cardiovasc Imaging 2020 May 15. https://imaging.onlinejacc.org/content/early/2020/05/13/j.jcmg.2020.05.010