Association between right ventricular dysfunction and in-hospital mortality in surges of SARS-CoV-2 infection attributed to the Alpha, Delta, and Omicron variants

Omar, Alaa Mabrouk Salem; Hernandez, Nolberto; Botero, Diana Maria Ronderos; Doppalapudi, Sai Krishnaraya; Itare, Vikram; Shin, Dongmin; Mahasamudram, Jaydeep; Pandey, Neelanjana; Allena, Nishant; Sud, Karan; Chilimuri, Sridhar; Bella, Jonathan N.

doi:10.1016/j.ijcha.2022.101150

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…RV dysfunction has been identified as a significant predictor of mortality in various patient populations, including those infected with the SARS-CoV-2 delta strain [13][14][15] . The utilization of noninvasive ventilation (CPAP, BIPAP, AVAPs, etc.)…”

Section: Discussionmentioning

confidence: 99%

A cross-sectional study of echocardiographic characteristics of patients diagnosed with SARS-CoV-2 delta strain

Varshney¹,

Rawat

2023

gcsp

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Background: The delta variant of SARS-CoV-2 has been associated with increased mortality and multi-organ failure, affecting various systems in the body. Cardiovascular manifestations including arrhythmias, heart failure, myocarditis, myocardial damage, and thromboembolism are commonly observed in patients infected with the delta variant. Materials and methods: This study enrolled 106 individuals who tested positive for the delta strain of SARS-CoV-2 using real-time RT-PCR between May 25, 2020, and October 15, 2021. All patients underwent 2-D echocardiography, and based on the severity of their infection, were divided into two groups: serious and non-serious. Results: Univariate correlation analysis showed significant positive correlations between right ventricular (RV) diameter and hs-TnI and D-dimer levels. Conversely, left ventricular ejection fraction (LVEF) was negatively correlated with hs-TnI, C-reactive protein (CRP), and D-dimer levels. Additionally, RV fractional area change (RV-FAC) showed a negative correlation with D- dimer and hs-TnI levels but not with CRP levels. Discussion: RV dysfunction has been identified as an important predictor of mortality in various patient populations, including those infected with the delta variant of SARS-CoV-2. A significant proportion of severe delta variant cases require mechanical ventilation, which can have hemodynamic effects on the ventricular performance. Mechanical ventilation can increase pulmonary arterial pressure and worsen right heart dysfunction, especially when lung-protective ventilation strategies are not optimized. Conclusions: Our study highlights that patients with severe delta variants, particularly those with cardiac injury, may exhibit biventricular systolic dysfunction. Echocardiographic parameters such as LVEF, RV diameter, and RV-FAC were found to be associated with laboratory markers of poor prognosis, including elevated hs-TnI, CRP, and D-dimer levels. 2-D echocardiography can be a valuable tool in identifying early signs of ventricular dysfunction, aiding in the management of this patient population.

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Section: Discussionmentioning

confidence: 99%

A cross-sectional study of echocardiographic characteristics of patients diagnosed with SARS-CoV-2 delta strain

Varshney¹,

Rawat

2023

gcsp

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“…Notably, the incidence of right ventricular (RV) dilation and systolic dysfunction in acute COVID-19 infection is greater than the incidence of left ventricular (LV) systolic dysfunction [29,36,37]. One study from Italy showed that acute respiratory distress syndrome and patients' mortality were significantly associated with RV systolic dysfunction among COVID-19 patients [38].…”

Section: Covid-19 and The Heart: Lessons Learnedmentioning

confidence: 99%

COVID-19 and the Heart: Lessons Learned and Future Research Directions

Lee,

Omar,

Bella

2024

Cardiogenetics

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It has become evident that acute COVID-19 infection can lead to cardiovascular complications. While the exact mechanisms by which COVID-19 affects the cardiovascular system have yet to be fully elucidated, several mechanisms have been proposed, including direct myocardial effects on the virus and systemic inflammation as an indirect result. The cardiovascular complications of COVID-19 have been characterized and described using noninvasive cardiac imaging. The impact of COVID-19 on the cardiovascular system extends beyond the acute phase of the infection and well beyond recovery or the convalescent period. However, the underlying mechanisms of post-viral long-COVID symptoms have yet to be elucidated. It is evident that COVID-19 has become endemic and is here to stay. Future studies are needed (1) to understand the long-term effects of the cardiovascular complications of COVID-19, future cardiovascular events and the impact of mutating variants on cardiovascular complications through data collection and analysis, (2) to identify the most important diagnostic criteria for prognosis of COVID-19 and to understand the disease mechanism through biomarkers and advanced cardiac imaging, including echocardiography and (3) to develop novel strategies to manage and treat these cardiovascular complications using the knowledge gained.

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“…Admittedly, while there is a large unfamiliarity with the extent of CPC and their pathological impact on HLD, the COVID-19 pandemic was perhaps an eye-opener and a reminder for all of us that we need to dive to deeply understand these complex mechanisms (4,5). What was initially recognized as a disease that primarily affects the lungs turned out to be a systemic disease that impacts the heart and the lungs in a very close manner suggesting that COVID-19 follows the outlines of the proposed paradigm of HLD.…”

Section: James Cookmentioning

confidence: 99%

“…Despite that large scientific gaps remain in the pathogenesis of COVID-19, a large literature that suggests the relationship of these inflammations to pulmonary and cardiac involvement in patients with COVID-19 is found, and they seem to be largely interrelated. Furthermore, the impact of previous and forthcoming variant waves may compound our understanding of the pathophysiology of CPC in these patients (5).…”

Section: James Cookmentioning

confidence: 99%

Editorial: The heart lung disease: a need for novel definitions and understanding of pathological overlaps in the COVID-19 era and beyond

Omar,

Chilimuri,

Bella

2023

Front. Cardiovasc. Med.

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Association between right ventricular dysfunction and in-hospital mortality in surges of SARS-CoV-2 infection attributed to the Alpha, Delta, and Omicron variants

Cited by 4 publications

References 17 publications

A cross-sectional study of echocardiographic characteristics of patients diagnosed with SARS-CoV-2 delta strain

A cross-sectional study of echocardiographic characteristics of patients diagnosed with SARS-CoV-2 delta strain

COVID-19 and the Heart: Lessons Learned and Future Research Directions

Editorial: The heart lung disease: a need for novel definitions and understanding of pathological overlaps in the COVID-19 era and beyond

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