Correlation of Echocardiographic Abnormalities with Severe and Critically Ill Coronavirus Disease 2019 Confirmed Patient's Mortality at Cipto Mangunkusumo General Hospital

Background: The mortality rate of COVID-19 patients in Indonesia is high with manifestations of cardiac complications. Echocardiographic evaluation can help identify cardiac functional and structural disorders associated with patient mortality. Therefore, this study aims to determine the relationship between echocardiographic abnormalities and mortality in severe and critical COVID-19 patients. Methods: Data on severe and critical COVID-19 patients at Cipto Mangunkusumo General Hospital were taken based on medical records and then analyzed by displaying descriptive tables, while bivariate and multivariate analyses were carried out with chi-square and logistic regression respectively. Results: Among the total 83 patients, 48 ​​or 57.8% died, while the most common functional abnormality found on echocardiography was mPAP in 51 or 68%, and the most structural disturbance was left ventricular concentric remodeling in 48 or 58%. The chi-square analysis results of echocardiographic variables namely TAPSE with RR = 7.292, Right Ventricular Systolic Pressure (RVSP) 10.208, mean Pulmonary Artery Pressure (mPAP) 1.440, Pulmonary Acceleration Time (PAT) 2.357, and Right Atrial Pressure (RAP) 3.403 had a significant relationship with mortality. Meanwhile, LVEF, E/e' and CO have no significant relationship. Based on the multivariate analysis, variables independently associated with mortality were RVSP and RAP. Conclusion: Echocardiographic abnormalities associated with mortality in severe and critical COVID-19 patients are TAPSE, RVSP, mPAP, PAT and RAP estimation.