Echocardiographic Features of Cardiac Injury Related to COVID-19 and Their Prognostic Value: A Systematic Review.

BACKGROUND: The available information on the echocardiographic features of cardiac injury related to the novel coronavirus disease 2019 (COVID-19) and their prognostic value are scattered in the different literature. Therefore, the aim of this study was to investigate the echocardiographic features of cardiac injury related to COVID-19 and their prognostic value. METHODS: Published studies were identified through searching PubMed, Embase (Elsevier), and Google scholar databases. The search was performed using the different combinations of the keywords "echocard*," "cardiac ultrasound," "TTE," "TEE," "transtho*," or "transeso*" with "COVID-19," "sars-COV-2," "novel corona, or "2019-nCOV." Two researchers independently screened the titles and abstracts and full texts of articles to identify studies that evaluated the echocardiographic features of cardiac injury related to COVID-19 and/or their prognostic values. RESULTS: Of 783 articles retrieved from the initial search, 11 (8 cohort and 3 cross-sectional studies) met our eligibility criteria. Rates of echocardiographic abnormalities in COVID-19 patients varied across different studies as follow: RV dilatation from 15.0% to 48.9%; RV dysfunction from 3.6% to 40%; and LV dysfunction 5.4% to 40.0%. Overall, the RV abnormalities were more common than LV abnormalities. The majority of the studies showed that there was a significant association between RV abnormalities and the severe forms and death of COVID-19. CONCLUSION: The available evidence suggests that RV dilatation and dysfunction may be the most prominent echocardiographic abnormality in symptomatic patients with COVID-19, especially in those with more severe or deteriorating forms of the disease. Also, RV dysfunction should be considered as a poor prognostic factor in COVID-19 patients.

The outcome of ST-elevation myocardial infarction by sex: a retrospective cohort study.

We aimed to compare in-hospital mortality (IHM) of acute myocardial infarction (AMI) between male and females. We assessed the association of sex with IHM after AMI using simple and multivariate cox regression models. Results were presented as crude and adjusted hazard ratios along with their 95% confidence interval (HR; 95% CI). Multivariable Cox regression analysis revealed females had a higher risk of death than males after ST-elevation MI (STEMI) (adjusted HR [95% CI]: 1.64 [1.15-2.36]; p = 0.007). In subgroup analysis by age group, this significantly increased risk was only observed in 50- to 64-year-old females. There were no significant differences between genders after non-STEMI and unspecified MI. Women aged 50 to 64 years had higher IHM after STEMI than men.

What is this study about? Cardiovascular diseases are one of the leading causes of death and disability in both males and females worldwide. Over the few last decades, with the development of novel techniques for the treatment of heart attacks, its prognosis has dramatically improved, although adverse outcomes remain high in female patients. Nevertheless, sex differences in death rates following heart attacks are still poorly understood. Hence, we compared the in-hospital death rate between male and female patients following a heart attack. What were the study results? Women are more likely to die during hospitalization following a heart attack in which the artery supplying the heart muscle was completely blocked, when compared with similarly aged men. This increased risk was most prominent between 50 to 64 years of age. However, the risk of in-hospital death was similar between men and women following a heart attack in which the artery supplying the heart muscle was not completely blocked. What do the results of the study mean? Women who have a heart attack with complete blockage of an artery supplying heart muscle are more likely to die during hospitalization when compared with men.