Echocardiography in COVID-19 Pandemic

Barosi, Alberto; Bergamaschi, Luca; Cusmano, I; Gasperetti, Alessio; Schiavone, Marco; Gherbesi, Elisa

doi:10.1016/j.ccep.2021.10.007

Cited by 3 publications

(5 citation statements)

References 71 publications

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“…There is some literature investigating ultrasound for the diagnosis, monitoring, and prognosis of COVID-19 illness, mostly comprised of case-series or retrospective studies with small samples, and not based on POCUS findings. 17,20,32 While specific studies have explored the role of POC lung ultrasound in the monitoring and prognosis of COVID-19 disease, [42][43][44] there are no studies that we are aware of linking findings on ED POCUS to COVID-19 severity and prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…If a patient were to develop a pulmonary embolus as a complication of COVID‐19, presence of right ventricular (RV) dilation may help identify this, particularly if the embolism is hemodynamically significant 17,19 . If COVID‐19 resulted in myocardial injury, echocardiography could also capture images of left ventricular (LV) dysfunction, such as a newly depressed ejection fraction 17,20 . Currently, evidence is limited on the prevalence and importance of cardiac findings using POCUS on COVID‐19 patients in the ED, and much of the current evidence was obtained in intensive care units 21,22 …”

Section: Introductionmentioning

confidence: 99%

“…17,19 If COVID-19 resulted in myocardial injury, echocardiography could also capture images of left ventricular (LV) dysfunction, such as a newly depressed ejection fraction. 17,20 Currently, evidence is limited on the prevalence and importance of cardiac findings using POCUS on COVID-19 patients in the ED, and much of the current evidence was obtained in intensive care units. 21,22 We sought to determine the importance of both lung and cardiac POCUS to predict COVID-19 disease course and severity in ED patients.…”

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confidence: 99%

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Emergency Department Point‐of‐Care Echocardiography and Lung Ultrasound in Predicting COVID‐19 Severity

Baloescu

Weingart

Moore

2023

J of Ultrasound Medicine

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Objectives-We sought to determine if point-of-care ultrasound (POCUS) performed on patients with COVID-19 in the emergency department (ED) can help predict disease course, severity, or identify complications.Methods-This was a retrospective cohort study of adult ED patients who tested positive for COVID-19 at hospital admission or within 2 weeks of presentation and received heart or lung POCUS. Clips were reviewed for presence of decreased left ventricular ejection fraction (LVEF), right ventricular dilation, presence of B-lines, and pleural line abnormalities. Patients with worsening hypoxemic respiratory failure or shock requiring higher level of care and patients who expired were considered to have developed severe COVID-19. Regression analysis was performed to determine if there was a correlation between ED POCUS findings and development of severe COVID-19.Results-A total of 155 patients met study criteria; 148 patients had documented cardiac views and 116 patients had documented lung views (113 with both). Mean age was 66.5 years old (AE18.6) and 53% of subjects were female. Subjects with decreased LVEF that was not previously documented had increased odds of having severe COVID during their hospitalization compared to those with old or no dysfunction (OR 5.66, 95% CI: 1.55-19.95, P = .08). The presence of pleural line abnormalities was also predictive for development of severe COVID (OR 2.68, 95% CI: 1.04-6.92, P = .04).Conclusion-POCUS findings of previously unidentified decreased LVEF and pleural line abnormalities in patients with COVID-19 evaluated in the ED were correlated to a more severe clinical course and worse prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Emergency Department Point‐of‐Care Echocardiography and Lung Ultrasound in Predicting COVID‐19 Severity

Baloescu

Weingart

Moore

2023

J of Ultrasound Medicine

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“…One study ( 6 ) showed that nearly one third of critically ill COVID-19 patients manifested with aberrant systolic function in either left or right ventricle during the inital echocardiographic assessment, with left ventricular systolic dysfuntion resembling as septic cardiomyopathy and right ventricular systolic dysfunction associated with pressure overload attributed to positive pressure ventilation, hypercapnia and pulmonary embolism. An additional study ( 8 ) revealed that COVID-19 infection led to a diverse array of cardiac conditions, including acute myocardial infarction, Takotsubo cardiomyopathy, myocarditis, arrhythmogenic and thrombotic manifestations, as well as potential drug-related effects. Nearly 80% of patients exhibited localized left ventricular wall motion abnormalities, while approximately 60% of patients had a left ventricular ejection fraction lower than 50%.…”

Section: Introductionmentioning

confidence: 99%

“…Nearly 80% of patients exhibited localized left ventricular wall motion abnormalities, while approximately 60% of patients had a left ventricular ejection fraction lower than 50%. ( 8 ) While some COVID-19 patients may not initially exhibit cardiac symptoms, a more thorough echocardiographic analysis, including speckle tracing and deformation patterns, revealed that the majority of COVID-19 patients displayed anomalous left ventricular deformation, particularly in the basal segments, indicative of a basal “Takotsubo-like syndrome” ( 9 ). Changes were recorded even in patients with mild to moderate disease.…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic Findings of Covid-19 Patients in Canton Sarajevo During the Third Wave of the Covid-19 Pandemic

Sljivo,

Brigic,

Abdulkhaliq

et al. 2023

Mater Sociomed

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Background: Increasing evidence indicates that COVID-19 may result in cardiac issues in certain individuals, such as myocarditis, arrhythmias, and heart failure. Ongoing research on echocardiographic manifestations is still limited.Objective: To investigate the incidence and patterns of left and right ventricular dysfunction in COVID-19 patients. Methods: This study retrospectively observed COVID-19 patients admitted to the Clinical Center of University of Sarajevo during the third wave, with a particular focus on cardiac evaluations.Results. Our patients, predominantely male 155 (72.4%), with a mean age of 66.2±11.4, having hypertension 86 (40.1%), diabetes mellitus 61 (28.5%), hyperlipidemia 144 (67.3%), were active smokers 87 (40.6%), had family history of cardiovascular diseases 123 (57.5%) and were COVID-19 positive 95 (44.4%), presented because of chest pain 78 (36.4%), dyspnea 103 (48.1%), palpitations 67 (31.3%), fatigue 106 (49.5%) and peripheral oedema 30 (14.0%). COVID-19 patients reported much higher symptoms of dyspnea (65 (68.4%) vs 38 (31.9%)) and fatigue (73 (76.8%) vs 33 (27.7%)) than COVID-19 negative patients. On the initial laboratory report, COVID-19 patients had a significantly (p<0.05) higher mean score of C-reactive protein (24.0±4.8 vs. 6.0±2.1), D-dimer (1.6±2.5 vs 0.8±0.6), ALT (94.8±17.2 vs 36.5±19.9) and creatinine (128.0±80.8 vs. 93.4±40.1) when compared to COVID-19 negative patients. COVID-19 patients had enlarged left atrium diametes (31.6±5.6 vs 27.5±5.3), enlarged left ventricular diameter both in systole (27.9±18.1 vs 23.3±16.3) and diastole (39.3±24.1 vs 34.9±22.7), reduced left ventricular ejection fraction (53.5±9.2 vs 59.8±4.3) and elevated right ventricular systolic pressure (37.0±16.4 vs 35.1±8.6). Conclusion. COVID-19 patients had enlarged left atrium, enlarged systolic and diastolic left ventricular diameter, reduced left ventricular ejection fraction and elevated right ventricular systolic pressure.

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The Long-Term Cardiovascular Impact of COVID-19: Pathophysiology, Clinical Manifestations, and Management

Mukkawar,

Reddy,

Rathod

et al. 2024

Cureus

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The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has resulted in a substantial global health crisis, with effects extending far beyond the acute phase of infection. This review aims to provide a comprehensive overview of the long-term cardiovascular impact of COVID-19, focusing on the pathophysiology, clinical manifestations, diagnostic approaches, management strategies, and future research directions. SARS-CoV-2 induces cardiovascular complications through mechanisms such as inflammation, endothelial dysfunction, and direct myocardial injury, leading to conditions like myocarditis, heart failure, arrhythmias, and thromboembolic events. These long-term effects, collectively called "long COVID" or post-acute sequelae of SARS-CoV-2 infection (PASC), present significant challenges for healthcare systems and patient management. Diagnostic approaches include imaging techniques and laboratory tests to identify and monitor cardiovascular complications. Management strategies emphasize a holistic approach, incorporating pharmacological treatments and lifestyle modifications. Special attention is required for vulnerable populations, including those with pre-existing cardiovascular conditions. Ongoing research is essential to understand the full spectrum of long-term cardiovascular impacts and to develop effective treatments. This review highlights the critical need for continued vigilance, multidisciplinary care, and research to address the cardiovascular sequelae of COVID-19 and improve long-term health outcomes for survivors.

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Echocardiography in COVID-19 Pandemic

Cited by 3 publications

References 71 publications

Emergency Department Point‐of‐Care Echocardiography and Lung Ultrasound in Predicting COVID‐19 Severity

Emergency Department Point‐of‐Care Echocardiography and Lung Ultrasound in Predicting COVID‐19 Severity

Echocardiographic Findings of Covid-19 Patients in Canton Sarajevo During the Third Wave of the Covid-19 Pandemic

The Long-Term Cardiovascular Impact of COVID-19: Pathophysiology, Clinical Manifestations, and Management

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