Abstract
Background COVID-19 interacts at multiple levels with the cardiovascular system. The prognosis of COVID-19 infection is known to be worse for patients with underlying cardiovascular diseases. Furthermore, the virus is responsible for many cardiovascular complications. Myocardial injury may affect up to 20% of the critically ill patients. However, echocardiography's impact on the management of patients affected by COVID-19 remains unknown. Objectives To explore echocardiography's impact on the management of COVID-19 patients. Methods This study was conducted from March 24th to April 14th, 2020, in a single center at Adolphe de Rothschild Foundation Hospital, Paris, France. All consecutive inpatients with laboratory and/or CT COVID-19 diagnosis were included in this study. Patients' characteristics (clinical, biological, and imaging) and treatment change induced by echocardiography were collected and analyzed. Patients with and without treatment change induced by echocardiography were compared. Results A total of 56 echocardiographies in 42 patients with highly suspected or confirmed COVID-19 were included in the final analyses. The median age was 66 (IQR 60.5–74). Echocardiography induced a treatment change in 9 cases (16%). The analyzed clinical data were not associated with any treatment change induced by echocardiography. D-dimer and Troponin levels were the only biological predictors of the induced treatment change. On echocardiography, higher systolic pulmonary arterial pressure and documented cardiac thrombi were associated with treatment changes in these patients. Conclusions Echocardiography may be useful for the management of selected COVID-19 patients, especially those with elevated D-Dimer and Troponin levels, in up to 16% of patients.
Highlights
First seen in Wuhan, China, at the end of 2019, a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), became responsible for a pandemic acute respiratory disease around the world, a term coined by the World Health Organization (WHO) COVID19, “Coronavirus Disease 2019.”At the time of writing, COVID-19 has affected a total of 2,374,141 individuals in 185 countries and resulted in 164,716 deaths worldwide
transthoracic echocardiography (TTE) and TEE were performed on confirmed or highly suspected COVID-19 patients admitted to our institution, by dedicated teams of one cardiologist and one nurse every time
The indications for TTEs were in accordance with the known cardiovascular complications of COVID-19
Summary
First seen in Wuhan, China, at the end of 2019, a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), became responsible for a pandemic acute respiratory disease around the world, a term coined by the World Health Organization (WHO) COVID19, “Coronavirus Disease 2019.”At the time of writing, COVID-19 has affected a total of 2,374,141 individuals in 185 countries and resulted in 164,716 deaths worldwide. At least 20% of severely ill COVID-19 patients experience cardiac injury [5]. Echocardiography’s impact on the management of patients affected by COVID-19 remains unknown. Patients’ characteristics (clinical, biological, and imaging) and treatment change induced by echocardiography were collected and analyzed. Patients with and without treatment change induced by echocardiography were compared. Echocardiography induced a treatment change in 9 cases (16%). E analyzed clinical data were not associated with any treatment change induced by echocardiography. D-dimer and Troponin levels were the only biological predictors of the induced treatment change. Higher systolic pulmonary arterial pressure and documented cardiac thrombi were associated with treatment changes in these patients. Echocardiography may be useful for the management of selected COVID-19 patients, especially those with elevated D-Dimer and Troponin levels, in up to 16% of patients
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