EC-10, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Open Heart. 2021 Aug;8(2). doi: 10.1136/openhrt-2021-001702.
To describe the use of echocardiography in patients hospitalised with suspected coronavirus infection and to assess its impact on clinical management.
We studied 79 adults from a prospective registry of inpatients with suspected coronavirus infection at a single academic centre. Echocardiographic indications included abnormal biomarkers, shock, cardiac symptoms, arrhythmia, worsening hypoxaemia or clinical deterioration. Study type (limited or complete) was assessed for each patient. The primary outcome measure was echocardiography-related change in clinical management, defined as intensive care transfer, medication changes, altered ventilation parameters or subsequent cardiac procedures within 24 hours of echocardiography. Coronavirus-positive versus coronavirus-negative patient groups were compared. The relationship between echocardiographic findings and coronavirus mortality was assessed.
56 patients were coronavirus-positive and 23 patients were coronavirus-negative with symptoms attributed to other diagnoses. Coronavirus-positive patients more often received limited echocardiograms (70% vs 26%, p=0.001). The echocardiographic indication for coronavirus-infected patients was frequently worsening hypoxaemia (43% vs 4%) versus chest pain, syncope or clinical heart failure (23% vs 44%). Echocardiography changed management less frequently in coronavirus-positive patients (18% vs 48%, p=0.01). Among coronavirus-positive patients, 14 of 56 (25.0%) died during hospitalisation. Those who died more often had echocardiography to evaluate clinical deterioration (71% vs 24%) and had elevated right ventricular systolic pressures (37 mm Hg vs 25 mm Hg), but other parameters were similar to survivors.
Echocardiograms performed on hospitalised patients with coronavirus infection were often technically limited, and their findings altered patient management in a minority of patients.
描述疑似冠状病毒感染住院患者中超声心动图的应用，并评估其对临床管理的影响。
我们研究了一家学术中心疑似冠状病毒感染住院患者前瞻性登记处的 79 名成年人。超声心动图的适应证包括异常生物标志物、休克、心脏症状、心律失常、低氧血症恶化或临床恶化。评估了每位患者的研究类型（有限或完整）。主要观察指标是超声心动图相关的临床管理变化，定义为在超声心动图后 24 小时内转入重症监护病房、药物改变、通气参数改变或随后进行心脏手术。比较了冠状病毒阳性和冠状病毒阴性患者组。评估了超声心动图结果与冠状病毒死亡率之间的关系。
56 名患者冠状病毒阳性，23 名患者冠状病毒阴性，症状归因于其他诊断。冠状病毒阳性患者更常接受有限的超声心动图（70% vs 26%，p=0.001）。冠状病毒感染患者进行超声心动图的指征通常是低氧血症恶化（43% vs 4%），而不是胸痛、晕厥或临床心力衰竭（23% vs 44%）。冠状病毒阳性患者的管理改变较少（18% vs 48%，p=0.01）。在冠状病毒阳性患者中，56 例中有 14 例（25.0%）在住院期间死亡。死亡患者更常因评估临床恶化而进行超声心动图检查（71% vs 24%），且右心室收缩压升高（37 毫米汞柱 vs 25 毫米汞柱），但其他参数与幸存者相似。
对冠状病毒感染住院患者进行的超声心动图检查通常技术上受限，且其检查结果仅改变少数患者的治疗。
