RESUMO
BACKGROUND: The aim of this study was to determine the association of right ventricular function with in-hospital mortality and mortality 1 year after discharge in patients hospitalized for COVID-19 pneumonia. METHODS: The study was conducted in Van Yuzuncu Yil University Faculty of Medicine hospital between February 10, 2021 and August 10, 2022. A total of 156 patients hospitalized in intensive care and wards due to COVID-19 pneumonia were included in this study. Echocardiography was performed in all patients. RESULTS: Among the demographic findings of the patients included in the study, male gender, patients hospitalized in the intensive care unit (ICU), patients receiving O2 support, and smokers were found to have higher mortality rates during hospitalization. At the end of 1 year, the mortality rate was higher in patients who were hospitalized in the ICU received O2 support and had diabetes mellitus. Among echocardiographic findings, those with a low left ventricular ejection fraction had higher early and 1-year mortality rates. Of the right ventricular functions, low fractional area change, high systolic pulmonary artery pressure (SPAP), shortened pulmonary acceleration time, low right ventricle systolic wave S' velocity, increased right atrium area, and inferior vena cava diameter were found to be associated with high mortality. Increased right atrial area and inferior vena cava diameter, increased SPAP, and shortened pulmonary acceleration time were found to be significant in 1-year mortality. The presence of pericardial effusion was associated with mortality during hospitalization but not with 1-year mortality. B-type natriuretic peptide, D-dimer, and hemoglobin levels were significantly correlated with both hospital mortality and 1-year mortality. CONCLUSIONS: In the follow-up of COVID-19 pneumonia, right ventricular function is considered to be an important factor in early and late mortality. It could be helpful to establish a follow-up program for discharged patients from the parameters involved in mortality.
RESUMO
BACKGROUND: COVID-19 has continued to aggressively spread and kill. The incidence of complications and associated mortality rates are high. Cardiac damage, which is related to survival, is one of these. The purpose of this study is to assess the role of BNP, a cardiac biomarker, in predicting mortality in COVID-19. MATERIALS AND METHODS: This single-center, prospective observational study was performed from July to September 2020 in a tertiary university hospital designated for the treatment of COVID-19 patients. Patients whose diagnoses were confirmed with real-time polymerase chain reaction (RT-PCR) tested nasopharyngeal swabs and with thoracic computed tomography (CT) findings compatible with COVID-19 pneumonia were included in the study. All clinical and laboratory data were obtained within the first 24 hours of hospital admission. To determine the risk of in-hospital death, patients were followed from admission until their discharge (1 to 15 days). The primary outcome was in-hospital death, defined as the case-fatality ratio. RESULTS: Among all biomarkers that were included in the multivariate analysis only high BNP levels was independently associated with mortality [Mean 1.012, 95% CI (1.005 - 1.02 pg/mL) (p = 0.002)]. Mortality was found to be significantly associated with older age and higher BNP, LDH, AST, HGB, PLT, ferritin, D-dimer, and CRP levels. In addition, mortality was found to be higher with longer duration of hospitalization (p = 0.041). CONCLUSIONS: Our fundamental goal for COVID-19 is to determine whether the hospitalized patients are in the mortality risk group at an early stage of disease. Adding measurement of BNP levels to routine laboratory tests for COVID-19 may be a practical approach to determine the patients with a high risk of mortality.
