Background: COVID-19 could lead to severe acute respiratory syndrome leading to myocardial injury. It is associated with high morbidity and mortality. COVID-19 progression severity can be predicted by cardiac signs. Biomarkers can be used for early detection of cardiac injury and damage and prediction of severe prognosis ultimately. Echocardiography is used for therapeutic management and diagnostic procedures for COVID-19 patients. Detection of subtle cardiac damage early allows for providing efficient treatment.
Objective: The aim of the current study was to predict early cardiac involvement in COVID-19 depending on different laboratory and echocardiographic parameters.
Patients and methods: This prospective analytical observational study included a total of 100 patients diagnosed as positive COVID-19, depending on polymerase chain reaction ‘PCR' of nasopharyngeal swabs. Patients underwent full echocardiographic assessment, electrocardiogram (ECG) and laboratory investigations just upon admission. Further grouping of patients according to clinical deterioration was done to detect the prognostic value of investigations.
Results: Group I of clinically deteriorated patients had more lymphopenia (mean ±SD: 954.2± 6.5x109 /l), higher neutrophils-lymphocytic ratio (mean ±SD: 3.9± 0.2), less TAPSE (tricuspid annular plane systolic excursion) (mean ±SD: 14.85 ± 3.29mm) and more basal RV (right ventricle) diameter (mean ±SD: 39.93 ± 3.08 mm) in comparison with clinically stable patients. Deterioration of TAPSE (p value = 0.017) & basal RV diameter (p value = 0.044) were found to have significant relation with grading of respiratory failure using PO2/FiO2 ratio which had significant positive correlation with RV diameter (p value= Conclusions: TAPSE & basal RV diameter can early predict cardiac involvement in COVID 19 disease and have the prognostic ability to predict the degree of respiratory failure in deteriorated patients.