Novel COVID-19 pandemic presented primarily as a severe acute respiratory distress syndrome however, in addition to respiratory features there were many with cardiovascular presentations, not ‘typical’ of COVID-19 that caused confusion in diagnosis and management in frontline units.
A case-series was undertaken in a large London Hospital to describe cardiovascular manifestations and outcomes (discharge vs death) of all patients with a laboratory-confirmed SARS-CoV-2 infection, admitted from March-May 2020.Results
In this cohort (n=855) there were 295 deaths (standardised mortality 345 per thousand admissions). Patients who had died were older; age 72.2 (SD 16.3) vs 64.8 (18.7) years, p<0.001, had similar length of stay - 12.3 (SD 9.7) vs 11.9 (SD 11.7) days. Almost 50% had pre-existing hypertension, ischaemic heart disease, or atrial fibrillation, 45% had radiographic changes. Ventilatory support was required in 20% of the group who were discharged versus 44% in those who died. Patients who were male, older, with palpitations, or pulmonary infiltrates and raised inflammatory markers were more likely to die. Following recovery, over 50% had abnormal findings on echocardiography.
Therefore follow up should include a repeat echocardiogram and cardio-pulmonary assessment to explore long term sequelae.
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