Objectives To describe the use of echocardiography in patients hospitalised with suspected coronavirus infection and to assess its impact on clinical management. Methods 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. Results 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. Conclusions Echocardiograms performed on hospitalised patients with coronavirus infection were often technically limited, and their findings altered patient management in a minority of patients. Deidentified patient data are available in a password-protected RedCap database and as deidentified studies within a clinical imaging server, accessible by the authors. These data can be made available upon reasonable request.

中文翻译：

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疑似冠状病毒感染的超声心动图：适应症、局限性和对临床管理的影响

目的 描述超声心动图在疑似冠状病毒感染住院患者中的应用，并评估其对临床管理的影响。方法 我们研究了来自一个学术中心疑似冠状病毒感染住院患者的前瞻性登记的 79 名成年人。超声心动图适应症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。为每位患者评估研究类型（有限或完整）。主要结局指标是超声心动图相关的临床管理变化，定义为重症监护转移、药物变化、通气参数改变或超声心动图 24 小时内的后续心脏手术。比较了冠状病毒阳性和冠状病毒阴性的患者组。评估了超声心动图结果与冠状病毒死亡率之间的关系。结果 56 名患者为冠状病毒阳性，23 名患者为冠状病毒阴性且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% 对 26%，p=0.001）。与胸痛、晕厥或临床心力衰竭（23% 对 44%）相比，冠状病毒感染患者的超声心动图指征经常恶化低氧血症（43% 对 4%）。在冠状病毒阳性患者中，超声心动图改变管理的频率较低（18% 对 48%，p=0.01）。在冠状病毒阳性患者中，56 人中有 14 人（25.0%）在住院期间死亡。那些死亡更频繁的人进行超声心动图评估临床恶化（71% 对 24%）并且右心室收缩压升高（37 毫米汞柱对 25 毫米汞柱），但其他参数与幸存者相似。结论 对冠状病毒感染住院患者进行的超声心动图通常在技术上受到限制，他们的发现改变了少数患者的患者管理。去标识化的患者数据可在受密码保护的 RedCap 数据库中获得，并作为临床成像服务器中的去标识化研究，作者可以访问。可应合理要求提供这些数据。他们的发现改变了少数患者的患者管理。去标识化的患者数据可在受密码保护的 RedCap 数据库中获得，并作为临床成像服务器中的去标识化研究，作者可以访问。可应合理要求提供这些数据。他们的发现改变了少数患者的患者管理。去标识化的患者数据可在受密码保护的 RedCap 数据库中获得，并作为临床成像服务器中的去标识化研究，作者可以访问。可应合理要求提供这些数据。