학술논문
Cardiac Characteristics of the First Two Waves of COVID-19 in Denmark and the Prognostic Value of Echocardiography: The ECHOVID-19 Study.
Document Type
Article
Author
Christensen, Jacob; Davidoski, Filip Søskov; Skaarup, Kristoffer Grundtvig; Lassen, Mats Christian Højbjerg; Alhakak, Alia Sead; Sengeløv, Morten; Nielsen, Anne Bjerg; Johansen, Niklas Dyrby; Bundgaard, Henning; Hassager, Christian; Jabbari, Reza; Carlsen, Jørn; Kirk, Ole; Kristiansen, Ole Peter; Nielsen, Olav Wendelboe; Ulrik, Charlotte Suppli; Sivapalan, Pradeesh; Gislason, Gunnar; Iversen, Kasper; Jensen, Jens Ulrik Stæhr
Source
Subject
*SARS-CoV-2
*COVID-19 pandemic
*GLOBAL longitudinal strain
*PROGNOSIS
*COVID-19
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Language
ISSN
0008-6312
Abstract
Introduction: COVID-19 has spread globally in waves, and Danish treatment guidelines have been updated following the first wave. We sought to investigate whether the prognostic values of echocardiographic parameters changed with updates in treatment guidelines and the emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, 20E (EU1) and alpha (B.1.1.7), and further to compare cardiac parameters between patients from the first and second wave. Methods: A total of 305 patients hospitalized with COVID-19 were prospectively included, 215 and 90 during the first and second wave, respectively. Treatment in the study was defined as treatment with remdesivir, dexamethasone, or both. Patients were assumed to be infected with the dominant SARS-CoV-2 variant at the time of their hospitalization. Results: Mean age for the first versus second wave was 68.7 ± 13.6 versus 69.7 ± 15.8 years, and 55% versus 62% were males. Left ventricular (LV) systolic and diastolic function was worse in patients hospitalized during the second wave (LV ejection fraction [LVEF] for first vs. second wave = 58.5 ± 8.1% vs. 52.4 ± 10.6%, p < 0.001; and global longitudinal strain [GLS] = 16.4 ± 4.3% vs. 14.2 ± 4.3%, p < 0.001). In univariable Cox regressions, reduced LVEF (hazard ratio [HR] = 1.07 per 1% decrease, p = 0.002), GLS (HR = 1.21 per 1% decrease, p < 0.001), and tricuspid annular plane systolic excursion (HR = 1.18 per 1 mm decrease, p < 0.001) were associated with COVID-related mortality, but only GLS remained significant in fully adjusted analysis (HR = 1.14, p = 0.02). Conclusion: Reduced GLS was associated with COVID-related mortality independently of wave, treatment, and the SARS-CoV-2 variant. LV function was significantly impaired in patients hospitalized during the second wave. [ABSTRACT FROM AUTHOR]