A study on echocardiography findings in severe COVID-19 pneumonia patients


  • Karthik Adiga B. Department of Pulmonary Medicine, Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Shashi B. L. Department of Pulmonary Medicine, Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Deepa A. S. Department of Pulmonary Medicine, Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India




COVID-19, Echocardiography, Inflammatory markers


Background: Whilst the COVID-19 predominantly affects the respiratory tract, it is also observed to cause a wide range of cardiac complications. Accordingly, the ECHO findings range from specific regional wall motion abnormalities to different degrees of global cardiac dysfunction. Thus, there is a need to better understand the interactions between COVID-19 and the cardiac functions.

Methods: In this retrospective observational study, 86 subjects admitted with severe COVID-19 pneumonia were considered. Those with pre-existing heart-diseases were excluded. The ECHO parameters were assessed as right heart or left heart abnormalities; they were correlated with Inflammatory markers.

Results: Right heart abnormality was the most common finding (51.1%). 23% had combined right and left heart abnormalities, 4.6% had left heart abnormality, rest 21% had a normal 2D-ECHO findings. 55.8% had evidence of pulmonary hypertension. RV dilatation and dysfunction is associated with a pro-thrombotic, inflammatory state reflected by elevation of CRP and D-dimer levels; however, these ECHO findings did not correlate with increase in marker levels (p=0.227, >0.05).

Conclusions: RV dysfunction is more common than LV dysfunction among COVID-19 patients. 2D-ECHO findings may serve as a useful guide in optimization and modification of treatment strategies in critically ill COVID-19 patients, but are not independent predictors of mortality (p=0.09, >0.05).



Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, Bi Z, Zhao Y. Prevalence and impact of cardiovascular metabolic disease on COVID-19 in China. Clin Res Cardiol. 2020;109:531-8.

Bangalore S, Sharma MHA, Slotwiner A, Yatskar L, Harari R, Shah B et al. ST-segment elevation in patients with COVID-19-a case series. N Engl J Med. 2020;382(25):2478-80.

Hu H, Ma F, Wei X, Fang Y. Coronavirus fulminant myocarditis saved with glucocorticoid and human immunoglobulin. Eur Heart J. 2020;42(2):206.

Meyer P, Degrauwe S, Delden CV, Ghadri JR, Templin C. Typical takotsubo syndrome triggered by SARS-CoV-2 infection. Eur Heart J. 2020;41:1860.

Barman HA, Atici A, Tekin EA, Baycan OF, Alici G, Meric BK et al. Echocardiographic features of patients with COVID-19 infection: a cross-sectional study. Int J Cardiovasc Imaging. 2020;37(3):825-34.

Grasselli G, Tonetti T, Protti A, Langer T, Girardis M, Bellani G et al. Pathophysiology of COVID-19-associated acute respiratory distress syndrome: amulticentre prospective observational study. Lancet Respir Med. 2020;8(12):1201-8.

Guo T, Fan Y, Chen M, Wu X, Zhang L, He T et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(7):811-8.

Ishigami J, KouM, Ding N,Matsushita K. Cardiovascular disease and coronavirus disease 2019: epidemiology, management, and prevention. Curr Epidemiol Rep. 2021:1-8.

Knight DS, Kotecha T, Razvi Y, Chacko L, Brown JT, Jeetley PS et al. COVID-19: myocardial injury in survivors. Circulation. 2020;142(11):1120-2.

Martin L, Derwall M, Al Zoubi S, Zechendorf E, Reuter DA, Thiemermann C et al. The septic heart: current understanding of molecular mechanisms and clinical implications. Chest. 2018;155(2):427-37.

Messina A, Sanfilippo F, Milani A, Calabrò L, Negri K, Monge García MI. COVID-19-related echocardiographic patterns of cardiovascular dysfunction in critically ill patients: A systematic review of the current literature. J Crit Care. 2021;65:26-35.

Mahmoud-Elsayed HM, Moody WE, Bradlow WM, Khan-Kheil AM, Senior J, Hudsmith LE, Steeds RP. Echocardiographic findings in patients with COVID-19 pneumonia. Can J Cardiol. 2020;36;1203-7.






Original Research Articles