Prognostic Value of TAPSE/sPAP Ratio, RV S′ Velocity, and RV S′/sPAP Ratio in Hospitalized Patients with COVID-19: A Retrospective Echocardiographic Analysis

Aim: This study aimed to evaluate the association between the tricuspid annular plane systolic excursion (TAPSE) systolic pulmonary artery pressure (sPAP) ratio, right ventricular (RV) S′ velocity, RV S′/sPAP ratio and, adverse clinical outcomes in hospitalized COVID-19 patients.Materials and Methods: A retrospective cohort of 100 adult patients hospitalized with laboratory-confirmed COVID-19 who underwent transthoracic echocardiography (TTE) was analyzed. Patients were classified into two groups according to clinical outcomes: adverse outcome (ICU admission, mechanical ventilation, ARDS, or in-hospital mortality) and favorable outcome. Echocardiographic parameters (TAPSE, sPAP, RV S′, TAPSE/sPAP, and RV S′/sPAP) were compared between groups, and receiver operating characteristic (ROC) curve analysis was performed to assess discriminative performance in this exploratory analysis.Results:Thirty-two patients experienced adverse outcomes. The TAPSE/sPAP ratio (0.44 ± 0.18 vs. 0.55 ± 0.22, p = 0.006), RV S′ velocity (9.17 ± 2.1 cm/s vs. 10.54 ± 2.1 cm/s, p = 0.004), and RV S′/sPAP ratio (0.28 ± 0.10 vs. 0.33 ± 0.08, p = 0.008) were significantly lower in the adverse outcome group. ROC analysis showed fair discriminative performance for TAPSE/sPAP, RV S′, and RV S′/sPAP with AUCs of 0.686, 0.691, and 0.753, respectively.Conclusion:TAPSE/sPAP, RV S′, and RV S′/sPAP are non-invasive echocardiographic markers associated with adverse outcomes in hospitalized COVID-19 patients. Their combined use may contribute to early risk stratification in an exploratory, hypothesis-generating context.