{"doi":"10.1016/j.echo.2022.12.019","title":"Association of Right Ventricular Dilation on Echocardiogram With In-Hospital Mortality Among Patients Hospitalized With COVID-19 Compared With Bacterial Pneumonia","abstract":"Right ventricular (RV) abnormalities are the most common echocardiographic findings in acute COVID-19.1Szekely Y. Lichter Y. Taieb P. et al.Spectrum of cardiac manifestations in COVID-19: a systematic echocardiographic study.Circulation. 2020; 142: 342-353Crossref PubMed Scopus (381) Google Scholar,2Mahmoud-Elsayed H.M. Moody W.E. Bradlow W.M. et al.Echocardiographic findings in patients with COVID-19 pneumonia.Can J Cardiol. 2020; 36: 1203-1207Abstract Full Text Full Text PDF PubMed Scopus (106) Google Scholar While RV dysfunction is associated with in-hospital mortality in acute COVID-19,3Li Y. Li H. Zhu S. et al.Prognostic value of Right ventricular longitudinal strain in patients with COVID-19.JACC Cardiovasc Imaging. 2020; 13: 2287-2299Crossref PubMed Scopus (288) Google Scholar,4Karagodin I. Carvalho Singulane C. Woodward G.M. et al.Echocardiographic correlates of in-hospital death in patients with acute COVID-19 infection: the World Alliance Societies of Echocardiography (WASE-COVID) study.J Am Soc Echocardiogr. 2021; 34: 819-830Abstract Full Text Full Text PDF PubMed Scopus (42) Google Scholar the prognostic implications of RV dilation alone are less clear. Similarly, little is known about the clinical significance of RV dilation and dysfunction among patients hospitalized with acute COVID-19 compared with other respiratory illnesses, such as bacterial pneumonia. We studied the association of RV dilation and dysfunction with in-hospital mortality in acute COVID-19 compared with bacterial pneumonia. A retrospective cohort study design was utilized to compare 225 consecutive adults admitted for acute COVID-19 between March 2020 and February 2021 at UCSF Health and Zuckerberg San Francisco General Hospital with 257 control hospitalizations for bacterial pneumonia. To be included, all patients had to have a clinically ordered transthoracic echocardiogram (TTE) during hospitalization. COVID-19 was diagnosed by polymerase chain reaction, while cases of bacterial pneumonia were included based on International Classification of Diseases codes. Qualitative measurements of RV size and function were extracted from the echo report of the first TTE performed after admission. We constructed logistic regression models to estimate associations between RV dilation, RV dysfunction, and in-hospital mortality while adjusting for age, sex, body mass index (BMI), medical history, admission estimated glomerular filtration rate, hemoglobin, and presence of mechanical ventilation and used postestimation to estimate adjusted relative risks. Fine and Gray competing-risks regression models treating discharged alive as a competing risk were implemented to estimate the effect of RV dilation on mortality. Individuals in the COVID-19 cohort were younger, and more identified as Hispanic compared with the bacterial pneumonia group (Table 1). Body mass index was higher in the COVID-19 group, and there was a higher prevalence of cancer, chronic obstructive pulmonary disease, and atrial fibrillation in the bacterial pneumonia group. Compared with those hospitalized with bacterial pneumonia, patients with acute COVID-19 were more likely to be managed in the intensive care unit, require mechanical ventilation, be initiated on renal replacement therapy, develop a venous thromboembolism, and have a longer length of stay.Table 1Baseline characteristics of individuals hospitalized with COVID-19 or bacterial pneumonia who underwent a clinically indicated TTEVariableCOVIDBacterial pneumoniaP valueN225257Age, years, mean ± SD62.9 ± 16.7 (n = 225)67.5 ± 17.4 (n = 257).003Sex:.07 Male148 (65.8)148 (57.6) Female77 (34.2)109 (42.4)Race/ethnicity:<.001 Hispanic/Latinx85 (38.1)29 (11.3) Native American/Alaska native3 (1.3)1 (0.4) Non-Hispanic Black/African American22 (9.9)25 (9.7) Non-Hispanic White42 (18.8)110 (42.8) Asian44 (19.7)79 (30.7) Native Hawaiian or Pacific Islander7 (3.1)2 (0.8) Other Non-Hispanic20 (9.0)11 (4.3)BMI, mean ± SD29.4 ± 8.126.7 ± 7.8<.001Hyperte","journal":"Journal of the American Society of Echocardiography","year":2022,"id":284449,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9636,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":962700,"name":"Emily R. Cedarbaum","orcid":null,"position":1,"is_corresponding":false},{"id":701912,"name":"Christopher A. Hill","orcid":"0000-0003-3302-3658","position":2,"is_corresponding":false},{"id":808283,"name":"Sithu Win","orcid":"0000-0001-5767-0900","position":3,"is_corresponding":false},{"id":272434,"name":"Nisha I. Parikh","orcid":"0000-0002-4531-9897","position":4,"is_corresponding":false},{"id":346891,"name":"Priscilla Y. Hsue","orcid":"0000-0002-3427-6043","position":5,"is_corresponding":false},{"id":618495,"name":"Matthew S. Durstenfeld","orcid":"0000-0002-7612-3352","position":6,"is_corresponding":false},{"id":805567,"name":"Kaiwen Sun","orcid":"0000-0001-6527-5476","position":0,"is_corresponding":true}],"reference_count":7,"raw_metadata":null,"created_at":"2026-07-19T00:29:36.828109Z","pmid":"36592874","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}