Noninvasive Assessment of Cardiac Changes in Patients with Coronavirus
Disease-19 (COVID-19) by Bedside Ultrasound
Abstract
PURPOSE: This study was conducted to explore the value of noninvasive
assessment of bedside ultrasound in diagnosing cardiac changes of
COVID-19. METHODS: We performed a retrospective study in 34 patients
with COVID-19 and analyzed their clinical data, biochemistry test
results (creatine kinase-MB [CK-MB], cardiac troponin I [cTnI]
and C-reactive protein [CRP]), and parameters of cardiac ultrasound
(left atrium [LA], left ventricular end-diastolic dimensions
[LVDD], right atrium [RA], right ventricle [RV], main
pulmonary artery [MPA], left ventricular ejection fraction
[LVEF], tricuspid valve [TV], pulmonic valve [PV] and
pulmonary artery systolic pressure [PASP]). We classified the
patients based on their clinical symptoms: mild, moderate, severe, and
critical groups, and compared the parameters. RESULTS: As the disease
progressed, the parameters of both biochemical blood tests and cardiac
ultrasound changed regularly, manifested as enlargement of LA, LVDD, RA,
RV, and MPA and increase of PASP, CRP, CK-MB, and cTnI. Of these
parameters, CRP, LA, LVDD, MPA, and PASP of the severe group were more
notably elevated than those of the mild and the moderate groups
(p<0.05). The critical group increased more markedly in CK-MB,
cTnI, and RA than the other groups (p<0.05), and rose more
sharply in CRP, LA, LVDD, RV, MPA, and PASP than the mild and the
moderate groups (p<0.05). CONCLUSION: As the disease
progressed, the patients had the enlarged heart with expanded pulmonary
arteries and elevated PASP. Bedside ultrasound can be a noninvasive
assessment of the above changes and a guidance of clinical treatment.