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Cardiac dysfunction and mortality in critically ill patients with COVID‐19: A Swedish multicentre observational study
Author(s) -
Holmqvist Jacob,
BeckFriis Josefine,
Jensen Carl,
Dalla Keti,
Mårdstam Simon,
Christensen Jens,
Nordén Nina,
Widing Hannes,
RosénWetterholm Elin,
Cavefors Oscar,
Yilmaz Aylin,
Cronhjort Maria,
Redfors Björn,
Oras Jonatan
Publication year - 2022
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.14039
Subject(s) - medicine , cardiac dysfunction , organ dysfunction , intensive care , ejection fraction , cardiology , observational study , cardiac surgery , hypokinesia , heart failure , intensive care medicine , sepsis
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.