Cardiac Manifestation of COVID-19 Patients and Their Outcome

Abstract

COVID-19, the novel corona virus disease of 2019 pandemic caused by the SARS-CoV-2 virus has imminently threatened all of us having significant morbidity and mortality all around the world. Upper respiratory tract infection, pneumonia, severe acute respiratory distress syndrome, multiorgan failure or even death can be the manifestation of COVID-19.  However, ‘n’ number of cardiac complications including acute myocardial injury, myocarditis, arrhythmia, pericarditis, decompensated heart failure and cardiogenic shock has been described so far. We report the first systematic and comprehensive echocardiographic evaluation of patients requiring hospitalization for COVID-19 infection. It was found that 32% of patients with COVID-19 have normal echocardiography. Out of all unavoidable cardiac complications in covid-19, due to pulmonary parenchymal and vascular disease, Right Ventricular (RV) dilation with or without dysfunction is the most frequent abnormality in patients who earlier had normal heart function. So, one of predictor of mortality in COVID-19 patients might be a RV function evaluation. The right ventricle dysfunction is at high risk in COVID-19 patients just because of its pathophysiological relevance. RV dysfunction is potentially resulting due to cytokines with its negative inotropic effects, directly angiotensin converting enzyme 2-mediated cardiac injury, acute respiratory distress syndrome and pulmonary embolism. They all are increasing preload and provoking RV failure. So, decrease in mortality and improvement in patient outcomes in COVID-19 patients can be achieved by early detection and management of right ventricle dysfunction. There is lack of data from the central India, so the study is being conducted.