COVID-19, while primarily recognized for its pulmonary and systemic manifestations, afflicts the cardiovascular system through various abnormalities. Notably, right ventricular (RV) involvement leading to dysfunction and failure is a manifestation seen in up to 20% of severe COVID patients. RV severity correlates with overall COVID severity, serving as a prognostic marker. Data review reveals that RV failure was largely underdiagnosed, particularly early on in the pandemic. The therapy approach for RV failure in patients with COVID should focus on supporting overall RV perfusion pressure, maintaining sinus rhythm, optimizing RV loading conditions and contractility, and addressing anticoagulation and thrombus-related conditions. Beyond medical therapy, cardiac and pulmonary support should be utilized and introduced in a graded, stair-step approach of aggressiveness based on clinical need. This approach is best managed with a care team and defined protocols. Effective devices include right ventricular assistance devices (RVAD), Oxy-RVAD, veno-venous extracorporeal membrane oxygenation, and Impella (Abiomed) devices.
Slepian, Marvin M.D.
"COVID-19 Induced Right Ventricular Failure and Right Ventricular Assist Device Support,"
Journal of Shock and Hemodynamics: Vol. 1(2)
Available at: https://digitalcommons.library.tmc.edu/josh/vol1/iss2/14