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Pericardial Involvement in Patients Hospitalized With COVID‐19: Prevalence, Associates, and Clinical Implications
BACKGROUND: The scope of pericardial involvement in COVID‐19 infection is unknown. We aimed to evaluate the prevalence, associates, and clinical impact of pericardial involvement in hospitalized patients with COVID‐19. METHODS AND RESULTS: Consecutive patients with COVID‐19 underwent clinical and ec...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075494/ https://www.ncbi.nlm.nih.gov/pubmed/35311354 http://dx.doi.org/10.1161/JAHA.121.024363 |
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author | Ghantous, Eihab Szekely, Yishay Lichter, Yael Levi, Erez Taieb, Philippe Banai, Ariel Sapir, Orly Granot, Yoav Lupu, Lior Hochstadt, Aviram Merdler, Ilan Borohovitz, Ariel Sadon, Sapir Ingbir, Merav Laufer‐Perl, Michal Banai, Shmuel Topilsky, Yan |
author_facet | Ghantous, Eihab Szekely, Yishay Lichter, Yael Levi, Erez Taieb, Philippe Banai, Ariel Sapir, Orly Granot, Yoav Lupu, Lior Hochstadt, Aviram Merdler, Ilan Borohovitz, Ariel Sadon, Sapir Ingbir, Merav Laufer‐Perl, Michal Banai, Shmuel Topilsky, Yan |
author_sort | Ghantous, Eihab |
collection | PubMed |
description | BACKGROUND: The scope of pericardial involvement in COVID‐19 infection is unknown. We aimed to evaluate the prevalence, associates, and clinical impact of pericardial involvement in hospitalized patients with COVID‐19. METHODS AND RESULTS: Consecutive patients with COVID‐19 underwent clinical and echocardiographic examination, irrespective of clinical indication, within 48 hours as part of a prospective predefined protocol. Protocol included clinical symptoms and signs suggestive of pericarditis, calculation of modified early warning score, ECG and echocardiographic assessment for pericardial effusion, left and right ventricular systolic and diastolic function, and hemodynamics. We identified predictors of mortality and assessed the adjunctive value of pericardial effusion on top of clinical and echocardiographic parameters. The study included 530 patients. Pericardial effusion was found in 75 (14%), but only 17 patients (3.2%) fulfilled the criteria for acute pericarditis. Pericardial effusion was independently associated with modified early warning score, brain natriuretic peptide, and right ventricular function. It was associated with excess mortality (hazard ratio [HR], 2.44; P=0.0005) in nonadjusted analysis. In multivariate analysis adjusted for modified early warning score and echocardiographic and hemodynamic parameters, it was marginally associated with mortality (HR, 1.86; P=0.06) and improvement in the model fit (P=0.07). Combined assessment for pericardial effusion with modified early warning score, left ventricular ejection fraction, and tricuspid annular plane systolic excursion was an independent predictor of outcome (HR, 1.86; P=0.02) and improved model fit (P=0.02). CONCLUSIONS: In hospitalized patients with COVID‐19, pericardial effusion is prevalent, but rarely attributable to acute pericarditis. It is associated with myocardial dysfunction and mortality. A limited echocardiographic examination, including left ventricular ejection fraction, tricuspid annular plane systolic excursion, and assessment for pericardial effusion, can contribute to outcome prediction. |
format | Online Article Text |
id | pubmed-9075494 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90754942022-05-10 Pericardial Involvement in Patients Hospitalized With COVID‐19: Prevalence, Associates, and Clinical Implications Ghantous, Eihab Szekely, Yishay Lichter, Yael Levi, Erez Taieb, Philippe Banai, Ariel Sapir, Orly Granot, Yoav Lupu, Lior Hochstadt, Aviram Merdler, Ilan Borohovitz, Ariel Sadon, Sapir Ingbir, Merav Laufer‐Perl, Michal Banai, Shmuel Topilsky, Yan J Am Heart Assoc Original Research BACKGROUND: The scope of pericardial involvement in COVID‐19 infection is unknown. We aimed to evaluate the prevalence, associates, and clinical impact of pericardial involvement in hospitalized patients with COVID‐19. METHODS AND RESULTS: Consecutive patients with COVID‐19 underwent clinical and echocardiographic examination, irrespective of clinical indication, within 48 hours as part of a prospective predefined protocol. Protocol included clinical symptoms and signs suggestive of pericarditis, calculation of modified early warning score, ECG and echocardiographic assessment for pericardial effusion, left and right ventricular systolic and diastolic function, and hemodynamics. We identified predictors of mortality and assessed the adjunctive value of pericardial effusion on top of clinical and echocardiographic parameters. The study included 530 patients. Pericardial effusion was found in 75 (14%), but only 17 patients (3.2%) fulfilled the criteria for acute pericarditis. Pericardial effusion was independently associated with modified early warning score, brain natriuretic peptide, and right ventricular function. It was associated with excess mortality (hazard ratio [HR], 2.44; P=0.0005) in nonadjusted analysis. In multivariate analysis adjusted for modified early warning score and echocardiographic and hemodynamic parameters, it was marginally associated with mortality (HR, 1.86; P=0.06) and improvement in the model fit (P=0.07). Combined assessment for pericardial effusion with modified early warning score, left ventricular ejection fraction, and tricuspid annular plane systolic excursion was an independent predictor of outcome (HR, 1.86; P=0.02) and improved model fit (P=0.02). CONCLUSIONS: In hospitalized patients with COVID‐19, pericardial effusion is prevalent, but rarely attributable to acute pericarditis. It is associated with myocardial dysfunction and mortality. A limited echocardiographic examination, including left ventricular ejection fraction, tricuspid annular plane systolic excursion, and assessment for pericardial effusion, can contribute to outcome prediction. John Wiley and Sons Inc. 2022-01-21 /pmc/articles/PMC9075494/ /pubmed/35311354 http://dx.doi.org/10.1161/JAHA.121.024363 Text en © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Ghantous, Eihab Szekely, Yishay Lichter, Yael Levi, Erez Taieb, Philippe Banai, Ariel Sapir, Orly Granot, Yoav Lupu, Lior Hochstadt, Aviram Merdler, Ilan Borohovitz, Ariel Sadon, Sapir Ingbir, Merav Laufer‐Perl, Michal Banai, Shmuel Topilsky, Yan Pericardial Involvement in Patients Hospitalized With COVID‐19: Prevalence, Associates, and Clinical Implications |
title | Pericardial Involvement in Patients Hospitalized With COVID‐19: Prevalence, Associates, and Clinical Implications |
title_full | Pericardial Involvement in Patients Hospitalized With COVID‐19: Prevalence, Associates, and Clinical Implications |
title_fullStr | Pericardial Involvement in Patients Hospitalized With COVID‐19: Prevalence, Associates, and Clinical Implications |
title_full_unstemmed | Pericardial Involvement in Patients Hospitalized With COVID‐19: Prevalence, Associates, and Clinical Implications |
title_short | Pericardial Involvement in Patients Hospitalized With COVID‐19: Prevalence, Associates, and Clinical Implications |
title_sort | pericardial involvement in patients hospitalized with covid‐19: prevalence, associates, and clinical implications |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075494/ https://www.ncbi.nlm.nih.gov/pubmed/35311354 http://dx.doi.org/10.1161/JAHA.121.024363 |
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