Adverse right ventricular remodeling in severe obstetric patients with COVID-19
Keywords:
right ventricular remodeling, COVID-19 infections, echocardiography.Abstract
Introduction: COVID-19 has led to an increased incidence of right ventricular remodeling in severe obstetric patients.
Objective: To identify the diagnostic elements that influenced the occurrence of right ventricular remodeling in severe obstetric patients with COVID-19.
Methods: A descriptive, cross-sectional, single-center study was performed in 53 severe obstetric patients with COVID-19.
Results: The most significant average echocardiographic values were TAPSE (15.4mm), right ventricular end-diastolic diameter (31.3mm) and RV/LV ratio (0.75). An increase in troponins (39.5 ng/L), CPK (338.4 U/L) and CK-MB (51.3 U/L) was observed on admission to the intensive care units, and greater ventricular dilatation and dysfunction were observed in pregnant women with high dímero D (84.6% and 76.9% respectively). AHT (32.07%) was the predominant obstetric risk factor, while patients with bronchial asthma (77.7%) and obesity (69.2%) presented greater dilatation and ventricular dysfunction, respectively. LV ejection fraction constituted the only factor associated with patient survival (p = 0.01).
Conclusions: In severe obstetric patients due to COVID-19 decreased TAPSE values and RV dilatation were the main echocardiographic features found. In addition, there was a considerable increase in troponin, CPK and CK-MB values. Greater right ventricular dilatation and dysfunction were recorded in asthmatic and obese women, respectively, with elevated D-dimer values. LV ejection fraction was the only independent factor related to survival in these patients.
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