key: cord-1001375-xtpi69q6
authors: Churchill, Timothy W.; Bertrand, Philippe B.; Bernard, Samuel; Namasivayam, Mayooran; Churchill, Jessica; Crousillat, Daniela; Davis, Esther F.; Hung, Judy; Picard, Michael H.
title: Echocardiographic Features of COVID-19 Illness and Association with Cardiac Biomarkers
date: 2020-05-28
journal: J Am Soc Echocardiogr
DOI: 10.1016/j.echo.2020.05.028
sha: a81d2e2107ebf7967bdd1b185eec40833120c714
doc_id: 1001375
cord_uid: xtpi69q6

nan

Echocardiography remains an essential diagnostic tool in this climate, particularly with emerging data that myocardial injury appears to be associated with adverse prognosis [2] and that echocardiography may add important prognostic information [3, 4] . We present our institutional experience with echocardiography in the current pandemic with the goal of assessing the prevalence and reversibility of left ventricular (LV) dysfunction.

Requests for echocardiograms in COVID-19 patients were screened for appropriateness by echocardiography laboratory physicians; all performed studies (n=125 patients over 49 days, all hospitalized) were included in this report. Studies were performed on standard (EPIQ, Philips

Healthcare, Andover MA), laptop-sized (Vivid-I, GE Healthcare, Milwaukee WI), or tablet machines (Lumify, Philips Healthcare). Echocardiographic measurements were made according to society guidelines [5] . Echocardiographic data were extracted from the clinical report and clinical information from the medical record.

Average patient age was 64±15 years, and 50 (40%) were women. The most common comorbidities included hypertension (60%), diabetes mellitus (41%), and obesity (50%, BMI We describe here our initial experience with echocardiography during the COVID-19 pandemic and highlight two important findings. First, LV dysfunction was common, affecting 26% overall and 48% of those with troponin≥50ng/L. Second, while follow-up echocardiograms were limited, resolution of LV dysfunction was noted in 9/11 cases and in 8/9 with troponin ≥50ng/L. We acknowledge the screening process of echocardiogram requests creates important selection bias, and we do not suggest that these findings apply across all COVID-19 patients.

Prospective studies, and correlation of echocardiographic data with disease severity, biomarkers, and clinical outcomes, will be required to understand the range of cardiovascular involvement in COVID-19. The presence or absence of left ventricular (LV) dysfunction, defined by LVEF < 50% or regional wall motion abnormalities, is shown in the group of patients with high-sensitivity troponin < 50ng/L (left panel, n=43) and ≥ 50ng/L (right panel, n=50). Of the 24 patients with some form of LV dysfunction in the elevated troponin group, 9 underwent follow-up echocardiography, with the majority (8/9) demonstrating resolution of LV abnormalities with the exception of one patient with previously-documented LV dysfunction.

Coronavirus Disease 2019 (COVID-19) and Cardiovascular Disease. Circulation

Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol

Prognostic Value of Right Ventricular Longitudinal Strain in Patients with COVID-19

Right Ventricular Dilation in Hospitalized Patients with COVID-19 Infection

Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging