Acute cor pulmonale in Covid-19 related acute respiratory distress syndrome

Excerpt

Right ventricle (RV) dysfunction is a frequent complication of acute respiratory distress syndrome (ARDS). Its more severe presentation, acute cor pulmonale (ACP), is defined at echocardiography as a dilated RV (end-diastolic RV/left ventricle area ratio > 0.6) associated with the presence of septal dyskinesia. The prevalence of ACP in non-Covid-19 related ARDS (NC-ARDS) has been evaluated to be 22% [95% confidence interval (CI) 19–25%] during the first 72 h of protective mechanical ventilation [1]. A clinical risk score has been proposed to select NC-ARDS patients at risk of ACP, including four variables: pneumonia as a cause of ARDS, elevated driving pressure, severe hypoxemia and severe hypercapnia [1]. RV dysfunction has been also reported in the setting of COVID-19-related ARDS (C-ARDS) [2], but the prevalence of ACP and the validity of ACP risk score in C-ARDS patients are still unknown. We performed an observational study in the medical ICU of Henri Mondor University Hospital (Créteil, France), from March 9th 2020 to March 9th 2021 to assess the prevalence and predictors of ACP in C-ARDS. …