Clinical Features in Patients with Acute Pulmonary Edema with Confirmed Coronavirus Disease 2019 (COVID-19): Comparison with Those without Acute Pulmonary Edema

Bong Gun Song, Jiseong Hong, Se Hun Kim, Joo Wook Sung, Ji Yeon Kim, Cheil Kim, Sun Hee Ji, Eun Joo Lee, Jeong-Yeop Song, Won Woong Lee, Ki Hong Park, Chang Suk Noh, Jeong Hyun Yoo, Seung Hwa Lee, Doyeong Han, Chanseon Yoo, Hong Joong Kim, Eun Ok Cho, Kyung Ae Choi, Wonseon Shin, Eunjin Hwang and Ji-Eun Kim

Division of Cardiology, Cardiac and Vascular Center, Seongnam Citizens Medical Center, Korea Department of Medicine, Cardiac and Vascular Center, Division of COVID-19 TASK FORCE, Seongnam Citizens Medical Center, Korea Division of Radiology, Seongnam Citizens Medical Center, Korea

^*Correspondance to: Bong Gun Song 

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Abstract:

Background: Although poor clinical outcomes have been reported for Coronavirus Disease 2019 (COVID-19), comprehensive data regarding Acute Pulmonary Edema (APE) concomitant with patients with COVID-19 are scarce. This study investigated the clinical features and outcomes of APE in patients with COVID-19. Methods: Of 50 patients enrolled from a COVID-19 registry database, 5 patients presented with APE (APE group) and 45 did not (Non-APE [NAPE] group). Results: Most clinical presentations and in-hospital courses were different between the groups. The APE group was older (P=0.001) and had higher prevalence of underlying diabetes (P=0.005), hypertension (P=0.005), coronary artery disease (P=0.001), stroke/transient ischemic attack (P=0.001) and chronic renal failure (P=0.002). The APE group had significantly higher prevalence of sputum (P=0.002), higher body temperature (P=0.004) and shock (P=0.002). The APE group had significantly higher prevalence of ST depression (P=0.023) and T-wave inversion (P=0.045). The APE group had significantly higher levels of high sensitivity-C Reactive Protein (hs-CRP) (P=0.007), Erythrocyte Sedimentation Rate (ESR) (P=0.001) and procalciton in (P=0.001). The APE group had significantly higher prevalence of bilateral involvement (P=0.002) and multi-lobal involvement (P=0.001) of Ground Glass Opacities (GGO). The APE group required more frequent use of inotropics (P=0.002), ventilator (P=0.001), Angiotensin-converting enzyme inhibitors (P=0.001), diuretics (P=0.001), and antibiotics (P=0.001). The APE group had significantly higher in-hospital mortality (P=0.002). Conclusion: Our study demonstrated that the APE group had higher in-hospital mortality than the NAPE group. A meticulous diagnostic and therapeutic approach should be considered for elderly patients with COVID-19 having diabetes, hypertension, coronary artery disease, chronic renal failure, stroke, and ST depression and T-wave inversion, bilateral, multi-lobal involvement of GGO and high levels of ESR, hs-CRP and procalcitonin at the time of admission.

Keywords:

Coronavirus Disease 2019 (COVID-19); Cardiovascular complications; Acute pulmonary edema; Acute heart failure; Covid-19; Covid; Corona Virus

Cite the Article:

Song BG, Hong J, Kim SH, Sung JW, Kim JY, Kim C, et al. Clinical Features in Patients with Acute Pulmonary Edema with Confirmed Coronavirus Disease 2019 (COVID-19): Comparison with Those without Acute Pulmonary Edema. Ann Clin Case Rep. 2020; 5: 1842..