Left and right ventricular longitudinal strains are associated with poor outcome in COVID-19: a systematic review and meta-analysis

• Published in: Journal of intensive care Vol. 9; no. 1; p. 9
• Main Authors: Wibowo, Arief, Pranata, Raymond, Astuti, Astri, Tiksnadi, Badai Bhatara, Martanto, Erwan, Martha, Januar Wibawa, Purnomowati, Augustine, Akbar, Mohammad Rizki
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.01.2021; BioMed Central; BMC
• Subjects: Analysis; Asymptomatic; Cardiovascular disease; Coronaviruses; COVID-19; Diabetes; Disease transmission; Echocardiography; Health aspects; Heart failure; Hypertension; Longitudinal strain; Medical research; Medicine, Experimental; Meta-analysis; Mortality; Respiratory distress syndrome; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Systematic review; Ventricle; COVID-19; Longitudinal strain; SARS-CoV-2; Echocardiography; Ventricle
• ISSN: 2052-0492; 2052-0492
• DOI: 10.1186/s40560-020-00519-3

This systematic review and meta-analysis aimed to assess whether ventricular longitudinal strain can be used as a prognostication tool in patients with coronavirus disease 2019 (COVID-19). Systematic literature searches of PubMed, Embase, and EuropePMC databases were performed on 16 November 2020. Left ventricular global longitudinal strain (LV-GLS) refers to LV contraction measurement using the speckle tracking-based method refers to the mean of strain values of the RV free wall (three segments) measured using echocardiography. The main outcome was poor outcome, defined as a composite of mortality and severe COVID-19. Seven studies comprising of 612 patients were included in meta-analysis. Six studies have mortality as their outcome, and 1 study has severity as their outcome. Patients with poor outcome have lower LV-GLS (SMD 1.15 (0.57, 1.72), p < 0.001; I 70.4%). Each 1% decrease in LV-GLS was associated with 1.4x increased risk of poor outcome (OR 1.37 (1.12, 1.67), p = 0.002; I 48.8%). Patients with poor outcome have lower RV-LS (SMD 1.18 (0.91, 1.45), p < 0.001; I 0%). Each 1% decrease in RV-LS was associated with 1.3x increased risk of poor outcome (OR 1.25 (1.15, 1.35), p < 0.001; I 11.8%). Subgroup analysis showed that for every 1% decrease in LV-GLS and RV-LS is increased mortality with OR of 1.30 (1.12, 1.50) and OR of 1.24 (1.14, 1.35), respectively. This study shows that lower LV-GLS and RV-LS measurements were associated with poor outcome in patients with COVID-19. PROSPERO CRD42020221144.