Limited tablet cardiac ultrasound was found to represent an effective alternative to standard platform imaging for the screening of coronavirus disease 2019 (COVID-19) related cardiac conditions, according to a study published in the Journal of the American Society of Echocardiography.
The time and effort required to perform comprehensive echocardiogram in patients with COVID-19 poses a significant risk for health care workers. Here, researchers sought to assess whether a handheld ultrasound platform used for a bedside limited echocardiogram in their patients may be a safer alternative.
In this retrospective single center observational study conducted at Hartford Hospital, Connecticut, 90 consecutive inpatients (mean age, 67±14 years; 64% men; body mass index, 32±10 kg/m) with known or suspected COVID-19 infection were scanned according to laboratory COVID-19 guidelines using a limited 11-20 clip protocol on a tablet sonograph. The primary assessment was length of study time. Factors that were recorded included length of exam, exam indication, presence or absence of pericardial effusion, and presence or absence of wall motion abnormalities. A total of 90 patients without COVID-19 and treated in an intensive care unit who had comprehensive echocardiograms performed in the same time period as the test group were used as control individuals.
Echocardiographies were performed using a handheld device, and all were deemed diagnostic and gave satisfactory information for the clinical care team.
Although there were no immediate requests for supplementary imaging due to inadequate studies, 8% of the patients with COVID-19 underwent repeat imaging. In the control group, 12% of the patients had repeat imaging. The average imaging time using handheld devices was 5.4±1.9 min compared with 24±6.8 min using regular echocardiograms (P <.001). The total time spent in the patient’s room was 42±5.5 min with traditional echocardiograms vs12±2.2 min with handheld devices, and the time to disinfect devices was 30±3.5 min vs 4±0.9 min, respectively.
Limitations of the study include its single center setup, retrospective nature, small sample size, reader bias, and the inability to perform a validation study comparing tablet based and comprehensive echocardiograms on the same patients.
“A limited protocol performed with handheld ultrasound provides adequate diagnostic information of the major cardiac complications of COVID-19 infection while decreasing sonographer exposure and simplifying decontamination,” noted the study authors.
McMahon SR, DeFrancis G, Schwartz S, Duvall WL, Arora B, Silverman DI. Tablet based limited echocardiogram to reduce sonographer scan and decontamination time during the COVID-19 pandemic (published online May 11, 2020). J Am Soc Echocardiogr. doi.org/10.1016/j.echo.2020.05.005