Comparisons of echocardiographic findings of COVID-19 patients in intensive care units before and after the omicron variant propagation

Few investigational reports have evaluated the status of cardiovascular manifestations of coronavirus disease 2019 (COVID-19) during the Omicron dominance period. In this study, we aimed to investigate the cardiac function parameters and clinical outcomes of patients with COVID-19 before and after the Omicron variant (OV) propagation.

We retrospectively analyzed the data of 88 adult patients with COVID-19 who underwent clinically indicated standard transthoracic echocardiography (TTE) in intensive care wards. Patient backgrounds and information on laboratory tests, diagnostic imaging (including TTE), cardiovascular complications, and treatment were reviewed from digitalized medical records.

In the raw data, post-OV patients (n = 39) were relatively older, lighter in body weight, had a more frequent history of hypertension, had worse serum creatinine levels, and a lesser frequency of lung involvement and composite events (in-hospital death and extracorporeal membrane oxygenation installation), with more cardiac complications, compared with pre-OV patients (n = 49). Post-OV patients had worse left ventricular diastolic function than that of pre-OV patients, with better right ventricular function. However, in the propensity-matched adjusted data, no differences were found except lung involvement. Cumulative survival probability plots using the Kaplan–Meier method as to composite events revealed better outcome in post-OV patients when compared with pre-OV patients by the log-rank test (p = 0.027). However, this difference was not observed after background adjustment using propensity-matched data (p = 0.256).

Although the frequencies of some clinical events and hemodynamic abnormalities seemed to vary after OV propagation in critically ill patients with COVID-19, these findings disappeared except lung involvement after the background adjustment.