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- Title
Global evaluation of echocardiography in patients with COVID-19.
- Authors
Dweck, Marc R; Bularga, Anda; Hahn, Rebecca T; Bing, Rong; Lee, Kuan Ken; Chapman, Andrew R; White, Audrey; Salvo, Giovanni Di; Sade, Leyla Elif; Pearce, Keith; Newby, David E; Popescu, Bogdan A; Donal, Erwan; Cosyns, Bernard; Edvardsen, Thor; Mills, Nicholas L; Haugaa, Kristina
- Abstract
Aims To describe the cardiac abnormalities in patients with COVID-19 and identify the characteristics of patients who would benefit most from echocardiography. Methods and results In a prospective international survey, we captured echocardiography findings in patients with presumed or confirmed COVID-19 between 3 and 20 April 2020. Patient characteristics, indications, findings, and impact of echocardiography on management were recorded. Multivariable logistic regression identified predictors of echocardiographic abnormalities. A total of 1216 patients [62 (52–71) years, 70% male] from 69 countries across six continents were included. Overall, 667 (55%) patients had an abnormal echocardiogram. Left and right ventricular abnormalities were reported in 479 (39%) and 397 (33%) patients, respectively, with evidence of new myocardial infarction in 36 (3%), myocarditis in 35 (3%), and takotsubo cardiomyopathy in 19 (2%). Severe cardiac disease (severe ventricular dysfunction or tamponade) was observed in 182 (15%) patients. In those without pre-existing cardiac disease (n = 901), the echocardiogram was abnormal in 46%, and 13% had severe disease. Independent predictors of left and right ventricular abnormalities were distinct, including elevated natriuretic peptides [adjusted odds ratio (OR) 2.96, 95% confidence interval (CI) 1.75–5.05) and cardiac troponin (OR 1.69, 95% CI 1.13–2.53) for the former, and severity of COVID-19 symptoms (OR 3.19, 95% CI 1.73–6.10) for the latter. Echocardiography changed management in 33% of patients. Conclusion In this global survey, cardiac abnormalities were observed in half of all COVID-19 patients undergoing echocardiography. Abnormalities were often unheralded or severe, and imaging changed management in one-third of patients.
- Subjects
HEART disease diagnosis; CONFIDENCE intervals; ECHOCARDIOGRAPHY; INTERNATIONAL relations; LONGITUDINAL method; POPULATION geography; MULTIPLE regression analysis; ODDS ratio; COVID-19
- Publication
European Heart Journal - Cardiovascular Imaging, 2020, Vol 21, Issue 9, p949
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jeaa178