Abstract
Background: Although severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may cause an acute multiorgan syndrome (coronavirus disease 2019 (COVID-19)), data are emerging on mid- and long-term sequelae of COVID-19 pneumonia. Since no study has hitherto investigated the role of both cardiac and pulmonary ultrasound techniques in detecting such sequelae, this study aimed at evaluating these simple diagnostic tools to appraise the cardiopulmonary involvement after COVID-19 pneumonia. Methods: Twenty-nine patients fully recovered from COVID-19 pneumonia were considered at our centre. On admission, all patients underwent 12-lead electrocardiogram (ECG) and transthoracic echocardiography (TTE) evaluation. Compression ultrasound (CUS) and lung ultrasound (LUS) were also performed. Finally, in each patient, pathological findings detected on LUS were correlated with the pulmonary involvement occurring after COVID-19 pneumonia, as assessed on thoracic computed tomography (CT). Results: Out of 29 patients (mean age 70 ± 10 years; males 69%), prior cardiovascular and pulmonary comorbidities were recorded in 22 (76%). Twenty-seven patients (93%) were in sinus rhythm and two (7%) in atrial fibrillation. Persistence of ECG abnormalities from the acute phase was common, and nonspecific repolarisation abnormalities (93%) reflected the high prevalence of pericardial involvement on TTE (86%). Likewise, pleural abnormalities were frequently observed (66%). TTE signs of left and right ventricular dysfunction were reported in two patients, and values of systolic pulmonary artery pressure were abnormal in 16 (55%, despite the absence of prior comorbidities in 44% of them). Regarding LUS evaluation, most patients displayed abnormal values of diaphragmatic thickness and excursion (93%), which correlated well with the high prevalence (76%) of pathological findings on CT scan. CUS ruled out deep vein thrombosis in all patients. Conclusions: Data on cardiopulmonary involvement after COVID-19 pneumonia are scarce. In our study, simple diagnostic tools (TTE and LUS) proved clinically useful for the detection of cardiopulmonary complications after COVID-19 pneumonia.
Highlights
The aim of this study was to evaluate echocardiographic (transthoracic echocardiography (TTE)) features, possibly related to electrocardiographic (ECG) abnormalities, in patients with previous COVID-19 pneumonia and to elucidate possible cardiovascular involvement; using compression ultrasound (CUS) and lung ultrasound (LUS), we explored the presence of deep venous thrombosis (DVT) and/or lung abnormalities related to COVID-19 pneumonia
In the setting of an ongoing prospective registry, patients affected by COVID-19 were consecutively considered at our Department of Medicine and Cardiopulmonary Rehabilitation of the Maugeri Care and Research Institute of Tradate-Varese, Italy [8,9,10]
Twenty-one patients had a history of hypertension (72%), while 20 (69%), 8 (28%) and 9 (31%) suffered from diabetes mellitus (DM), obesity and chronic obstructive pulmonary disease (COPD), respectively (Table 1)
Summary
Since the initial outbreak in Wuhan, China, in December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and its related syndrome (coronavirus disease 2019 (COVID-19)) have spread further afield, leading to a globalised pandemic and a significant disruption of our daily lives [1]. the virus is well known to lead to a variety of multiorgan clinical manifestations during the acute phase [1,2,3,4,5], preliminary clinical [6] and radiological [7] data have recently reported mid-term cardiopulmonary sequelae in fully recovered patients.no study has hitherto focused attention on the combined role of different ultrasound techniques in assessing cardiac or pulmonary involvement after recovery fromCOVID-19 pneumonia.the aim of this study was to evaluate echocardiographic (transthoracic echocardiography (TTE)) features, possibly related to electrocardiographic (ECG) abnormalities, in patients with previous COVID-19 pneumonia and to elucidate possible cardiovascular involvement; using compression ultrasound (CUS) and lung ultrasound (LUS), we explored the presence of deep venous thrombosis (DVT) and/or lung abnormalities related to COVID-19 pneumonia. Since the initial outbreak in Wuhan, China, in December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and its related syndrome (coronavirus disease 2019 (COVID-19)) have spread further afield, leading to a globalised pandemic and a significant disruption of our daily lives [1]. The virus is well known to lead to a variety of multiorgan clinical manifestations during the acute phase [1,2,3,4,5], preliminary clinical [6] and radiological [7] data have recently reported mid-term cardiopulmonary sequelae in fully recovered patients. No study has hitherto focused attention on the combined role of different ultrasound techniques in assessing cardiac or pulmonary involvement after recovery from.
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