Echocardiographic findings in hospitalized patients with COVID-19

ABSTRACT

Introduction: Data on echocardiographic findings in COVID-19 patients is limited. Atrial arrhythmias (AA) are common in COVID-19 but their impact on echocardiographic phenotypes is not well studied. We aimed to assess transthoracic echocardiographic (TTE) findings in adult hospitalized patients with COVID-19 undergoing TTE, and compare patients with new-onset or history of AA to patients with normal sinus rhythm (NSR). Methods: We studied TTE findings in adult patients who were admitted to one tertiary care and five community hospitals in Michigan with PCR-proven SARS-CoV-2 infection from 3/1/2021 to 12/1/2020, and stratified them into three groups Group 1 (NSR), group 2 (new-onset AA including atrial fibrillation and atrial flutter), and group 3 (history of AA). Results: Among 6927 (5522 in group 1, 626 in group 2, 779 in group 3) hospitalized patients (mean age 65.4 ± 17.1 years, 50.7 % females) 115 patients underwent TTE (Table). Group 2 and 3 patients were significantly older, more commonly males, Whites, smokers, and more frequently had diabetes mellitus, hypertension, heart failure, history of coronary artery disease, and cerebrovascular accident compared to group 1 (p≤0.05 for all). The most common TTE abnormalities were valvular abnormalities (40.9%), RV dilation (29.6% of patients), elevated PASP (16.5%), reduced LV ejection fraction (13.9%), pericardial effusion (9.6%), and LV dilation (6.1%) with no significant difference in the prevalence of these echocardiographic abnormalities between the 3 groups. Conclusions: TTE abnormalities are common in hospitalized COVID-19 patients with valvular abnormalities, RV dilation, and PASP elevation being the most common. Current or prior history of atrial arrhythmias did not increase the prevalence of echocardiographic abnormalities. Clinicians should have a low threshold to obtain echocardiogram in hospitalized COVID-19 patients if clinically indicated even in the absence of AA.