- Cardiac complications of COVID – 19 have been described on the basis of elevated troponin and clinical findings.
- No detailed evaluation of cardiac function by echocardiography has been described to identify the specific functional impairments that occur in patients with COVID – 19 hospital admission.
- To identify the frequency and types of echocardiographic findings in patients with COVID – 19 infection.
- Consecutive echocardiograms were performed within 24 hrs. on admission for 100 adult pts admitted with COVID – 19 diagnosed by assay positive respiratory samples for SARS-CoV-2 virus.
- Echocardiograms were repeated for patients with clinical deterioration defined as death, respiratory, hemodynamic or cardiac deterioration.
- Symptoms on admission were most commonly respiratory followed by fever, chest pain and fatigue.
- Seventy-two percent of pts had comorbidities: In order of frequency – Hypertension, diabetes, obesity and coronary artery disease.
- Lab markers of disease were: Troponin I (20%), CRP (87%), BNP (30%) and D-dimer (58%).
- Baseline echo cardiac parameters
- Normal LVEF – 90% of pts
- Normal LV filling pressures – 80%
- RV dilatation – 39%
- Baseline echo was normal in 32% of patients.
- In (20%) pts with clinical deterioration
- RV dilatation and dysfunction were present in 12/20 (60%) pts.
- DVT present in 5/12 (42%) of pts with RV failure
- LV dysfunction – 5 pts.
- Baseline Echo normal in 1/3.
- LVEF is not usually impaired.
- LV dysfunction present in 10% patients
- Clinical deterioration seen in 20% of patients.
- Clinical deterioration most commonly associated with reduced right heart function in which case an echo can be important for patient management.
- The authors recommend echocardiograms only for deteriorating conditions, not as a routine, but this recommendation is directed at staff protection and the concern about cleaning equipment between cases for overall patient and staff safety.
- This study again emphasizes the importance of assessing heart function by echocardiography and the significance of RV dysfunction in the cardiac deterioration of severe COVID – 19 disease.