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Cardiac dysfunction and mortality in critically ill patients with COVID‐19: A Swedish multicentre observational study

BACKGROUND: The prevalence and importance of cardiac dysfunction in critically ill patients with COVID‐19 in Sweden is not yet established. The aim of the study was to assess the prevalence of cardiac dysfunction and elevated pulmonary artery pressure (PAP), and its influence on mortality in patient...

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Autores principales: Holmqvist, Jacob, Beck‐Friis, Josefine, Jensen, Carl, Dalla, Keti, Mårdstam, Simon, Christensen, Jens, Nordén, Nina, Widing, Hannes, Rosén‐Wetterholm, Elin, Cavefors, Oscar, Yilmaz, Aylin, Cronhjort, Maria, Redfors, Björn, Oras, Jonatan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111275/
https://www.ncbi.nlm.nih.gov/pubmed/35122232
http://dx.doi.org/10.1111/aas.14039
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author Holmqvist, Jacob
Beck‐Friis, Josefine
Jensen, Carl
Dalla, Keti
Mårdstam, Simon
Christensen, Jens
Nordén, Nina
Widing, Hannes
Rosén‐Wetterholm, Elin
Cavefors, Oscar
Yilmaz, Aylin
Cronhjort, Maria
Redfors, Björn
Oras, Jonatan
author_facet Holmqvist, Jacob
Beck‐Friis, Josefine
Jensen, Carl
Dalla, Keti
Mårdstam, Simon
Christensen, Jens
Nordén, Nina
Widing, Hannes
Rosén‐Wetterholm, Elin
Cavefors, Oscar
Yilmaz, Aylin
Cronhjort, Maria
Redfors, Björn
Oras, Jonatan
author_sort Holmqvist, Jacob
collection PubMed
description BACKGROUND: The prevalence and importance of cardiac dysfunction in critically ill patients with COVID‐19 in Sweden is not yet established. The aim of the study was to assess the prevalence of cardiac dysfunction and elevated pulmonary artery pressure (PAP), and its influence on mortality in patients with COVID‐19 in intensive care in Sweden. METHODS: This was a multicentre observational study performed in five intensive care units (ICUs) in Sweden. Patients admitted to participating ICU with COVID‐19 were examined with echocardiography within 72 h from admission and again after 4 to 7 days. Cardiac dysfunction was defined as left ventricular (LV) dysfunction (ejection fraction <50% and/or regional hypokinesia) or right ventricular (RV) dysfunction (defined as TAPSE <17 mm or visually assessed moderate/severe RV dysfunction). RESULTS: We included 132 patients, of whom 127 (96%) were intubated. Cardiac dysfunction was found in 42 (32%) patients. Most patients had cardiac dysfunction at the first assessment (n = 35) while a few developed cardiac dysfunction later (n = 7) and some changed type of dysfunction (n = 3). LV dysfunction was found in 21 and RV dysfunction in 19 patients, while 5 patients had combined dysfunction. Elevated PAP was found in 34 patients (26%) and was more common in patients with RV dysfunction. RV dysfunction and elevated PAP were independently associated with an increased risk of death (OR 3.98, p = .013 and OR 3.88, p = .007, respectively). CONCLUSIONS: Cardiac dysfunction occurs commonly in critically ill patients with COVID‐19 in Sweden. RV dysfunction and elevated PAP are associated with an increased risk of death.
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spelling pubmed-91112752022-05-17 Cardiac dysfunction and mortality in critically ill patients with COVID‐19: A Swedish multicentre observational study Holmqvist, Jacob Beck‐Friis, Josefine Jensen, Carl Dalla, Keti Mårdstam, Simon Christensen, Jens Nordén, Nina Widing, Hannes Rosén‐Wetterholm, Elin Cavefors, Oscar Yilmaz, Aylin Cronhjort, Maria Redfors, Björn Oras, Jonatan Acta Anaesthesiol Scand Intensive Care and Physiology BACKGROUND: The prevalence and importance of cardiac dysfunction in critically ill patients with COVID‐19 in Sweden is not yet established. The aim of the study was to assess the prevalence of cardiac dysfunction and elevated pulmonary artery pressure (PAP), and its influence on mortality in patients with COVID‐19 in intensive care in Sweden. METHODS: This was a multicentre observational study performed in five intensive care units (ICUs) in Sweden. Patients admitted to participating ICU with COVID‐19 were examined with echocardiography within 72 h from admission and again after 4 to 7 days. Cardiac dysfunction was defined as left ventricular (LV) dysfunction (ejection fraction <50% and/or regional hypokinesia) or right ventricular (RV) dysfunction (defined as TAPSE <17 mm or visually assessed moderate/severe RV dysfunction). RESULTS: We included 132 patients, of whom 127 (96%) were intubated. Cardiac dysfunction was found in 42 (32%) patients. Most patients had cardiac dysfunction at the first assessment (n = 35) while a few developed cardiac dysfunction later (n = 7) and some changed type of dysfunction (n = 3). LV dysfunction was found in 21 and RV dysfunction in 19 patients, while 5 patients had combined dysfunction. Elevated PAP was found in 34 patients (26%) and was more common in patients with RV dysfunction. RV dysfunction and elevated PAP were independently associated with an increased risk of death (OR 3.98, p = .013 and OR 3.88, p = .007, respectively). CONCLUSIONS: Cardiac dysfunction occurs commonly in critically ill patients with COVID‐19 in Sweden. RV dysfunction and elevated PAP are associated with an increased risk of death. John Wiley and Sons Inc. 2022-02-13 2022-05 /pmc/articles/PMC9111275/ /pubmed/35122232 http://dx.doi.org/10.1111/aas.14039 Text en © 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation 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 Intensive Care and Physiology
Holmqvist, Jacob
Beck‐Friis, Josefine
Jensen, Carl
Dalla, Keti
Mårdstam, Simon
Christensen, Jens
Nordén, Nina
Widing, Hannes
Rosén‐Wetterholm, Elin
Cavefors, Oscar
Yilmaz, Aylin
Cronhjort, Maria
Redfors, Björn
Oras, Jonatan
Cardiac dysfunction and mortality in critically ill patients with COVID‐19: A Swedish multicentre observational study
title Cardiac dysfunction and mortality in critically ill patients with COVID‐19: A Swedish multicentre observational study
title_full Cardiac dysfunction and mortality in critically ill patients with COVID‐19: A Swedish multicentre observational study
title_fullStr Cardiac dysfunction and mortality in critically ill patients with COVID‐19: A Swedish multicentre observational study
title_full_unstemmed Cardiac dysfunction and mortality in critically ill patients with COVID‐19: A Swedish multicentre observational study
title_short Cardiac dysfunction and mortality in critically ill patients with COVID‐19: A Swedish multicentre observational study
title_sort cardiac dysfunction and mortality in critically ill patients with covid‐19: a swedish multicentre observational study
topic Intensive Care and Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111275/
https://www.ncbi.nlm.nih.gov/pubmed/35122232
http://dx.doi.org/10.1111/aas.14039
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