The Utility of Hand-held Cardiac and Lung Ultrasound in Predicting Outcomes of Hospitalized Patients with COVID-19

Link to article at PubMed

Can J Cardiol. 2021 Dec 3:S0828-282X(21)00917-X. doi: 10.1016/j.cjca.2021.11.016. Online ahead of print.


BACKGROUND: Strict isolation precautions limit formal echocardiogram use in the setting of COVID-19 infection. Information on the importance of the utilization of a hand-held focused ultrasound for cardiac evaluation in these patients is scarce. This study investigated the utility of a hand-held echocardiogram device in COVID-19 hospitalized patients in diagnosing cardiac pathologies and predicting the composite endpoint of in-hospital death, mechanical ventilation, shock, and acute decompensated heart failure.

METHODS: From April 28th through July 27th, 2020, consecutive patients diagnosed with COVID-19 underwent evaluation using a hand-held ultrasound (Vscan Extend™ with Dual Probe; GE Healthcare) within 48-h of admission. The patients were divided into two groups: 'Normal' and 'Abnormal' (as defined by biventricular systolic dysfunction/enlargement, or moderate/severe valvular regurgitation/stenosis) echocardiogram study.

RESULTS: Among 102 patients, 26 (25.5%) had an abnormal study. They were older, with more co-morbidities, and more severe presenting symptoms, as compared to the group with a normal echocardiogram. The prevalence of the composite outcome among low- and high-risk patients (oxygen saturation <94%) was 3.1% and 27.1%, respectively. Multivariate logistic regression analysis revealed that an abnormal echocardiogram at presentation was independently associated with the composite endpoint (OR 6.19; 95% CI 1.50-25.57, p=0.012).

CONCLUSIONS: An abnormal echocardiogram in COVID-19 infection settings is associated with a higher burden of medical comorbidities and independently predict major adverse endpoints. Hand-held focused echocardiogram can be utilized as an important "rule-out" tool among high-risk COVID-19 patients and should be integrated into their routine admission evaluation. However, its routine utilization among low-risk patients is not recommended.

PMID:34871728 | PMC:PMC8641404 | DOI:10.1016/j.cjca.2021.11.016

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