Ultrasound signs of PH linked to worse COVID-19 outcomes: Study
Researchers reviewed medical charts of 679 adults hospitalized with infection
The risk of mortality is nine times greater for people who have signs of pulmonary hypertension (PH) on an echocardiogram when they get COVID-19, than people without these signs, a study finds.
The study, “Pulmonary hypertension predicts higher mortality in patients admitted with severe COVID-19 infection,” was published in SAGE Open Medicine.
People with certain health problems are expected to fare worse with COVID-19 and studies have shown that those with heart problems are more likely to have more serious illness from an infection.
Researchers at the New York-Presbyterian Brooklyn Methodist Hospital in Brooklyn wanted to see if having signs of PH — high blood pressure in the pulmonary arteries, which carry blood from the heart to the lungs — also makes COVID-19 worse.
They reviewed the medical charts of 679 adults admitted to the hospital with a COVID-19 diagnosis. “This study was completed prior to the establishment of accepted treatments for COVID-19, as data was collected during the first [three] months of the pandemic,” the researchers noted.
Nearly 9X increased risk of mortality with PH
The participants’ mean age was 64.6 and less than half (47.9%) were women. Of these, 57 had a transthoracic echocardiogram (TTE), which can make moving images of the heart. All had severe COVID-19, meaning they had dyspnea (trouble breathing), hypoxia (low oxygen), or more than half of their lungs were affected by the disease. None had a diagnosis of PH before the echocardiogram.
“The population selected for TTE were those who progressed rapidly during their hospitalization, creating a subset of very severely critically ill patients,” the scientists said.
The patients who had a TTE were significantly more likely than those who didn’t have one to be admitted to the intensive care unit, where they stayed on average about twice as long (23 vs. 12.4 days). They stayed in the hospital almost three times as long (29.5 vs. 10.6 days) and required mechanical ventilation to help with breathing for about twice as many days (21 vs. 10.9 days).
They were more frequently diagnosed with acute respiratory distress syndrome, which causes low blood oxygen, and had a significantly higher chance of dying in the hospital.
“Patients who underwent TTE had worse outcomes compared with the patients without TTE,” the researchers wrote.
Those with PH had a significantly higher chance of dying compared with those without PH (80% vs. 43.8%). After adjusting for age, sex, race, body mass index (a measure of body fat), it was found that having PH increased the chances of dying by 8.9 times.
“We demonstrated the independent association of PH and mortality from COVID-19 infection,” the researchers wrote. “Interestingly, other surrogate markers of disease severity based on hospital course … were not worse in those with PH.”