Limitations
This is a relatively small, single-center study on consecutive patients
hospitalized with severe COVID-19. This limits the generalizability of
the findings discussed. Echocardiograms were ordered at the discretion
of treating physicians and represent roughly 15% of patients treated at
our center, most of whom already had unfavorable clinical course at the
time of the study. This accounts in part for the higher mortality (31%)
seen in our cohort compared to the previous Wuhan echocardiogram report
(6) which reported a 15% mortality in their imaged patients. Given
ongoing efforts to limit the spread of COVID-19, routine echocardiograms
that are unlikely to change patient management were minimized. When
performed, echocardiographic studies were limited to features deemed
most clinically relevant: LV size and function, RV size and function,
significant valvular abnormalities, and presence of pericardial
effusions. Measurements of ventricular strain and LV diastolic function
were not obtained. Nonetheless, this experience represents the largest
and most comprehensive report on echocardiogram features and biochemical
cardiac markers in COVID 19 patients thus far.