Echocardiograms Detail COVID-19’s Effects on the Heart

Harlan M. Krumholz, MD, SM reviewing Szekely Y et al. Circulation 2020 May 29

Right ventricular dilation and left ventricular diastolic impairment seem the most common findings from this small series.

Early on in the COVID-19 pandemic, we realized that the heart could be involved. Information is still emerging about the spectrum of cardiac disease. Investigators have now reported on echocardiographic findings from 100 patients in Israel hospitalized with COVID-19. (Of 112 original consecutive patients, 12 were excluded because of early hospital discharge, death soon after admission, or refusal to participate.) Initial echocardiograms were taken within 24 hours of admission.

The patients’ mean age was 66, and 63% were men. All patients were dyspneic, and 20% had abnormal troponin levels. Of the 100 people, 61 had mild disease, 29 moderate, and 10 severe; 32% had a normal echocardiogram at baseline. The most common abnormality was right ventricular dilation (39%), followed by left ventricular diastolic dysfunction (16%); 10% had left ventricular systolic dysfunction. Patients with higher-grade disease had shorter pulmonary acceleration time. The only echocardiographic parameter associated with worse outcome was left ventricular ejection fraction. In 12 patients with right ventricular dilation, a venous thrombosis was diagnosed in 5.


Szekely Y et al. The spectrum of cardiac manifestations in coronavirus disease 2019 (COVID-19) — A systematic echocardiographic study. Circulation 2020 May 29; [e-pub]. (

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