Prior left ventricular systolic dysfunction is an independent predictor of in-hospital mortality in patients with COVID-19

Abstract

Objectives: This study aims to examine the effect of left ventricular systolic dysfunction (LVSD) on in-hospital mortality in patients hospitalized for novel coronavirus disease 2019 (COVID-19). Patients and methods: Between June 2020 and December 2020, a total of 847 patients (423 males, 424 females; median age: 68 years; range, 58 to 77 years) who had echocardiography and had positive real-time reverse transcriptase-polymerase chain reaction were retrospectively analyzed. A left ventricular ejection fraction (LVEF%) of <50% was defined as LVSD. Results: In 138 patients, LVEF was <50% and in 709 patients LVEF was >50% (non-LVSD). Of the patients with LVSD, 89 had mid-range LVEF (40 to 49%), and 49 had reduced LVEF (LVEF <40%). Intensive care unit admission (p<0.001), myocardial injury (p<0.001), and mechanical ventilation (p<0.001) were more frequent in patients with LVSD, and LVSD was found to significantly increase the risk of and in-hospital mortality (odds ratio=2.57, 95% confidence interval, 1.43-4.60, p=0.002). Among patients with LVSD, no significant difference was observed in terms of in-hospital mortality between patients with mid-range LVEF and patients with reduced LVEF. Conclusion: Our study results showed that LVSD significantly increased the risk of in-hospital mortality in patients hospitalized for COVID-19. In addition, an increased risk of in-hospital mortality was present in both the mid-range LVEF and the reduced LVEF group, separately.