We hypothesize that recovered COVID-19 patients suffer long term cardiovascular and pulmonary complications, which can be detected by point of care ultrasound. The goal is to comprehensively delineate the long term cardiovascular and pulmonary ultrasound findings in recovered COVID-19 patients, identify risks factors for prolonged heart/lung injury, evaluate long term effects of applied treatment, and assess late medication/vaccine side effects in COVID-19 patients.
Aim 1: To examine the long term cardiac involvements of recovered COVID-19 patients at 3, 6,
12 months after being discharged from the hospital or symptom resolution with
electrocardiogram (ECG) and echocardiography. 12 lead ECG will be obtained for all patients.
Transthoracic echocardiography will be performed using GE Vivid E9 ultrasound system to
measure left ventricular (LV) dimensions, LV volumes and LV ejection fraction (EF), wall
thickness, LV mass, and LV remodeling index. LV diastolic function will be characterized by
maximum velocities of mitral inflow E and A waves, E/A ratio, E/E' ratio (maximum myocardial
velocities (E') of the lateral mitral annulus), isovolumetric relaxation time, tricuspid
regurgitation velocity, and left atrial volumes. Right-ventricular function will be assessed
by tricuspid annular plane systolic excursion (TAPSE), pulmonary acceleration time, and by
estimation of systolic pulmonary artery pressure. We will evaluate mitral, aortic, tricuspid
and pulmonic valvular stenosis and regurgitation. In addition, speckle tracking
echocardiography will be used to detect subclinical impairment of myocardium in patients who
have grossly normal LVEF. Lastly, inferior vena cava will be measured to assess patients'
volume status.
Aim 2: To evaluate long term pulmonary involvements of recovered COVID-19 patients at 3, 6,
12 months after being discharged from the hospital or symptom resolution with pulse oximetry,
bedside spirometry and lung ultrasound. Pulse oximetry, bedside spirometry, and lung
ultrasonography (LUS) will be performed for all patients. The pathological LUS features for
every zone will be reported as: (1) normal appearance (A lines, < 3 B lines), (2) pathologic
B lines (≥3 B lines), (3) confluent B lines, (4) thickening of the pleura with pleural line
irregularities (subpleural consolidation < 1 cm), (5) consolidation (≥ 1 cm), (6) pleural
effusion. The LUS score, used as a correlate of loss of lung tissue aeration, as well as a
normalized LUS score corrected for the number of examined zone, will be calculated in every
patient.
Aim 3: To diagnose long term vascular involvements of recovered COVID-19 patients at 3, 6, 12
months after being discharged from the hospital or symptom resolution with vascular
ultrasound. A trained physician or sonographer will use high resolution gray-scale imaging,
color Doppler ultrasound and spectral analysis with pulse wave Doppler to examine bilateral
upper/lower extremity venous and arterial systems and carotid arteries for thrombosis,
atheroma, and stenosis.
Diagnostic Test: Point of care ultrasound including echocardiography, lung ultrasound, vascular ultrasound
Point of care ultrasound including echocardiography, lung ultrasound, vascular ultrasound, ECG, pulse oximetry, blood draw, spirometry
Other Name: ECG, pulse oximetry, blood draw, spirometry
Inclusion Criteria:
- >18 years of age
- Consent to participate in this research
- Confirmed SARS-CoV-2 infection by RT-PCR or serological tests.
Exclusion Criteria:
- Refusal to participate in this research
University of Louisville Health
Louisville, Kentucky, United States
Investigator: Jiapeng Huang, MD, PhD
Contact: 502-852-8157
jiapeng.huang@louisville.edu
Investigator: Jiapeng Huang, Md, PhD
Jiapeng Huang, MD, PhD
5028528157
jiapeng.huang@louisville.edu
Jiapeng Huang, MD, PhD, Principal Investigator
University of Louisville