Cardiovascular Research Center, 391934Alborz University of Medical Sciences, Karaj, Iran.
Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, 12228Yale University School of Medicine, New Haven, CT, USA.
J Intensive Care Med. 2021 Apr;36(4):500-508. doi: 10.1177/0885066620981015. Epub 2020 Dec 22.
The available information on the echocardiographic features of cardiac injury related to the novel coronavirus disease 2019 (COVID-19) and their prognostic value are scattered in the different literature. Therefore, the aim of this study was to investigate the echocardiographic features of cardiac injury related to COVID-19 and their prognostic value.
Published studies were identified through searching PubMed, Embase (Elsevier), and Google scholar databases. The search was performed using the different combinations of the keywords "echocard*," "cardiac ultrasound," "TTE," "TEE," "transtho*," or "transeso*" with "COVID-19," "sars-COV-2," "novel corona, or "2019-nCOV." Two researchers independently screened the titles and abstracts and full texts of articles to identify studies that evaluated the echocardiographic features of cardiac injury related to COVID-19 and/or their prognostic values.
Of 783 articles retrieved from the initial search, 11 (8 cohort and 3 cross-sectional studies) met our eligibility criteria. Rates of echocardiographic abnormalities in COVID-19 patients varied across different studies as follow: RV dilatation from 15.0% to 48.9%; RV dysfunction from 3.6% to 40%; and LV dysfunction 5.4% to 40.0%. Overall, the RV abnormalities were more common than LV abnormalities. The majority of the studies showed that there was a significant association between RV abnormalities and the severe forms and death of COVID-19.
The available evidence suggests that RV dilatation and dysfunction may be the most prominent echocardiographic abnormality in symptomatic patients with COVID-19, especially in those with more severe or deteriorating forms of the disease. Also, RV dysfunction should be considered as a poor prognostic factor in COVID-19 patients.
与新型冠状病毒病 2019（COVID-19）相关的心脏损伤的超声心动图特征及其预后价值的相关信息分散在不同的文献中。因此，本研究旨在探讨与 COVID-19 相关的心脏损伤的超声心动图特征及其预后价值。
通过检索 PubMed、Embase（Elsevier）和 Google Scholar 数据库，确定已发表的研究。使用“echocard*”、“cardiac ultrasound”、“TTE”、“TEE”、“transtho*”或“transeso*”与“COVID-19”、“sars-COV-2”、“novel corona”或“2019-nCOV”的不同组合，对文章的标题和摘要以及全文进行筛选，以确定评估与 COVID-19 相关的心脏损伤的超声心动图特征及其预后价值的研究。
从最初的搜索中检索到 783 篇文章，其中 11 篇（8 项队列研究和 3 项横断面研究）符合我们的入选标准。COVID-19 患者的超声心动图异常率在不同研究中有所不同，如下所示：RV 扩张率为 15.0%至 48.9%；RV 功能障碍为 3.6%至 40%；LV 功能障碍为 5.4%至 40.0%。总体而言，RV 异常比 LV 异常更为常见。大多数研究表明，RV 异常与 COVID-19 的严重形式和死亡之间存在显著关联。
现有证据表明，RV 扩张和功能障碍可能是 COVID-19 有症状患者中最突出的超声心动图异常，尤其是在疾病更为严重或恶化的患者中。此外，RV 功能障碍应被视为 COVID-19 患者的不良预后因素。
