ArticleWorld journal of methodology2026
Prognostic impact of right ventricular dilatation and echocardiography use criteria in hospitalized COVID-19 patients.
Article in World journal of methodology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe surge of severe acute respiratory syndrome coronavirus 2 [coronavirus disease 2019 (COVID-19)] infection created unprecedented diagnostic and logistical pressures. Given the established potential for cardiac injury and the critical need to optimize scarce resources, establishing the clinical utility and prognostic value of transthoracic echocardiography (TTE) became imperative.
aimTo evaluate the prognostic predictors and the adherence to appropriate use criteria (AUC) for TTE in a highly affected setting.
methodsWe performed a retrospective cohort study analyzing records from patients with confirmed COVID-19 who underwent TTE. Socio-demographic, biochemical, and echocardiographic parameters were collected. Mortality was the primary outcome. We assessed inter-observer agreement (Kappa statistic) for TTE indications (based on American College of Cardiology Foundation 2011 and American Society of Echocardiography 2020 guidelines) and the determination of clinical impact (a subsequent change in patient management).
resultsTotal 149 patients were analyzed. Median age was 66 years [interquartile range (IQR): 56-73], median hospital stay was 13 days (IQR: 6-23). Overall and intensive care unit mortality rates were 39.6% and 60%, respectively. Elevated biochemical markers (leukocytes, neutrophils, lactate dehydrogenase, and C-reactive protein) were associated with mortality. Crucially, right ventricular (RV) dilatation and/or strain (
conclusionRV pathology is a potent, quantifiable prognostic indicator. While AUC demonstrated high reliability, the significant and frequent changes in management suggest that the current guidelines may possess inherent limitations when addressing the unique, acute prognostic complexities of severe COVID-19 disease.
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