Left Ventricular Global Longitudinal Strain as a Predictor for Poor Outcomes in Patients Hospitalized for COVID-19 Infection

Abstract

BACKGROUND Establishing a correlation between left ventricular global longitudinal strain (LV-GLS) with transthoracic echocardiography (TTE), and the severity and outcomes of patients infected with COVID-19 offers several advantages in patient care and management. This study aims to explore the utility of measuring the LV-GLS to predict outcomes in hospitalized patients infected with COVID-19. METHODS This was a retrospective cohort study of COVID-19 patients in a tertiary care center who had a TTE with GLS measurements from April 2021 to May 2021. Comparisons between parameters of left ventricular function (GLS and LVEF) were performed using the t-test or Mann-Whitney U test for continuous variables and the χ2 test or Fisher exact test for categorical variables. Kaplan-Meier survival analysis was used to estimate mortality and length of hospital stay. Log-rank test was used to assess the association of GLS on in-hospital mortality. RESULTS A total of 124 participants were included in the study. 73.2% (90/123) had a decreased GLS; average GLS was -19.2% [-27.6 to -4.7]. A significant model was created using GLS as a main factor with pre-selected co-variates with a Wald χ2 (2, N = 121) = 7.932 (p = .020). Co-variates were average GLS magnitude (HR = 0.897 [95% CI 0.808 to 0.997], p = .0.043) and presence of severe complications (HR = 2.630 [95% CI of 1.087 to 6.362], p = 0.032). CONCLUSION A model considering severe complications showed that among patients admitted for COVID-19 an abnormal average global longitudinal strain predicts increased in-hospital mortality.