Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct:65:26-35.
doi: 10.1016/j.jcrc.2021.05.010. Epub 2021 May 25.

COVID-19-related echocardiographic patterns of cardiovascular dysfunction in critically ill patients: A systematic review of the current literature

Antonio Messina  1 , Filippo Sanfilippo  2 , Angelo Milani  3 , Lorenzo Calabrò  3 , Katerina Negri  4 , Manuel Ignacio Monge García  5 , Marinella Astuto  6 , Antoine Vieillard-Baron  7 , Maurizio Cecconi  8
Affiliations

COVID-19-related echocardiographic patterns of cardiovascular dysfunction in critically ill patients: A systematic review of the current literature

Antonio Messina et al. J Crit Care. 2021 Oct.

Abstract

Purpose: Coronavirus disease 2019 (COVID-19) infection may trigger a multi-systemic disease involving different organs. There has been growing interest regarding the harmful effects of COVID-19 on the cardiovascular system. This systematic review aims to systematically analyze papers reporting echocardiographic findings in hospitalized COVID-19 subjects.

Materials and methods: We included prospective and retrospective studies reporting echocardiography data in >10 hospitalized adult subjects with COVID-19; from 1st February 2020 to 15th January 2021.

Results: The primary electronic search identified 1120 articles. Twenty-nine studies were finally included, enrolling 3944 subjects. Overall the studies included a median of 68.0% (45.5-100.0) of patients admitted to ICU. Ten studies (34.4%) were retrospective, and 20 (68.9%) single-centred. Overall enrolling 1367 subjects, three studies reported normal echocardiographic findings in 49 ± 18% of cases. Seven studies (24.1%) analyzed the association between echocardiographic findings and mortality, mostly related to right ventricular (RV) dysfunction.

Conclusions: Data regarding the use of echocardiography on hospitalized, predominantly ICU, COVID-19 patients were retrieved from studies with heterogeneous designs, variable sample sizes, and severity scores. Normal echocardiographic findings were reported in about 50% of subjects, with LVEF usually not affected. Overall, RV dysfunction seems more likely associated with increased mortality.

Trial registration: CRD42020218439.

Keywords: COVID-19; Critical care; Diastolic function; Echocardiography; Left ventricle; Right ventricle; Systolic function.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest Conflict of interest for the present study: none declared. Conflict of interest unrelated to the present study in the last 36 months: Dr. Messina received travel expenses and registration for meetings and congresses from Vygon and Edwards. Prof. Cecconi is a consultant for Edwards Lifesciences, LiDCO and Cheetah Medical. Dr. Monge Garcia has received Honoraria and/or Travel Expenses from Edwards Lifesciences and Deltex Medical. He also received supply medical equipment (Doppler probes) in return for carrying out research works for Deltex Medical.

Figures

Fig. 1
Fig. 1
Flow of the studies. * = Not fitting eligibility criteria full text articles excluded a reported in the Supplemental Table S4 in the Supplemental Materials.
See this image and copyright information in PMC

References

    1. Dong E., Du H., Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20(5):533–534. - PMC - PubMed
    1. Grasselli G., Zangrillo A., Zanella A., Antonelli M., Cabrini L., Castelli A., et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA. 2020;323(16):1574–1581. - PMC - PubMed
    1. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–1062. - PMC - PubMed
    1. Gandhi R.T., Lynch J.B., Del Rio C. Mild or moderate Covid-19. N Engl J Med. 2020;383(18):1757–1766. - PubMed
    1. Grasselli G., Tonetti T., Protti A., Langer T., Girardis M., Bellani G., et al. Pathophysiology of COVID-19-associated acute respiratory distress syndrome: a multicentre prospective observational study. Lancet Respir Med. 2020;8(12):1201–1208. - PMC - PubMed

Publication types