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Echocardiographic Manifestation in Patients With Omicron Variant of COVID-19

Conditions
COVID-19
Interventions
Other: Echocardiography
Registration Number
NCT05379543
Lead Sponsor
RenJi Hospital
Brief Summary

The cardiovascular scenario associated with omicron, the new variant of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19), remains unclear. We design this observational and prospective study to explore cardiac manifestations in patients with omicron infection by echocardiography.

Detailed Description

COVID-19 affects the cardiovascular system, and the presence of cardiovascular disease (CAD) and risk factors is associated with worse clinical outcomes in infected patients. However, there is a paucity of information regarding the cardiovascular scenario associated with omicron, the new variant of SARS-CoV-2 that causes COVID-19. Thus, we expect to perform this study to explore the echocardiographic manifestations in patients admitted to the hospital with confirmed COVID-19 infection, during the current omicron wave in Shanghai, China.

According to published guidelines, with written consent from eligible patients, participants are grouped into the severely ill group, the critically ill group, the mildly ill group, and the healthy control group. The investigators will review medical records and document detailed sociodemographic characteristics for each participant. Circulating levels of cardiac biomarkers such as B-type natriuretic peptide (BNP) and cardiac troponin (cTnI), inflammatory biomarkers such as interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP), and blood cell counts are measured in the hospital-based laboratory. To study the cardiac manifestations of the patients, echocardiography is performed using a GE Vingmed Ultrasound System (GE Healthcare, Horten, Norway), and morphological and functional parameters of the heart are measured. Clinical outcomes will be censored at the time of data cut-off, and patients after discharge will continue to be interviewed by telephone. Differences in cardiac manifestations and clinical outcomes between the groups are compared by proper statistical tests.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Aged 18-75 years old
  • Half male and half female
  • Admitted to hospital with confirmed omicron infection
  • Able to receive an echocardiographic examination
  • Written informed consents
  • Healthy volunteers, matched for age and gender, are enrolled as the control group
Exclusion Criteria
  • People under the age of 18 years old
  • Inability to lie or maintain posture during the echocardiographic examination

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
ICU-Critically ill groupEchocardiographyPatients requiring transfer to the ICU, and presenting with respiratory failure, septic shock, multiple organ dysfunction, or failure)
Healthy control groupEchocardiographyHealthy volunteers, matched for gender and age, without any signs or evidence of COVID-19 infection
ICU-Severely ill groupEchocardiographyPatients requiring transfer to the intensive care unit (ICU), and presenting with severe symptoms (dyspnea, respiratory rate ≥30/min, blood oxygen saturation ≤93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio \<300, or lung infiltrates \>50% within 24 to 48 hours)
Mildly ill groupEchocardiographyPatients presenting with fever, mild to moderate respiratory symptoms, and with or without imaging presentations of pneumonia
Primary Outcome Measures
NameTimeMethod
Left atrial diameter (cm)Day at the enrollment

Left atrial diameter (LAD) is a morphological parameter, which is measured by echocardiography to assess the size of left atrium.

Left ventricular internal dimension at end-diastole (cm)Day at the enrollment

Left ventricular internal dimension at end-diastole (LVIDd) is a morphological parameter, which is measured by echocardiography to assess the size of left ventricle.

Interventricular septum thickness (mm)Day at the enrollment

Interventricular septum thickness is a morphological parameter, which is measured by echocardiography to assess the presence of ventricular hypertrophy.

Left ventricular ejection fraction (%)Day at the enrollment

Left ventricular ejection fraction (LVEF) is a functional parameter, which is measured by echocardiography to assess ventricular systolic function.

Secondary Outcome Measures
NameTimeMethod
In hospital all-cause mortality (%)Day at the time of data cut-off

To study the clinical outcome in the groups, patients are followed to death or discharge following the echocardiography. The rate of all-cause mortality (death) is calculated as a percentage (%) for the mildly ill group, the severely ill group, and the critically ill group.

The need of invasive mechanical ventilation (%)Day at the time of data cut-off

Since COVID-19 mainly damages the respiratory system, some severely ill and critically ill patients may need the treatment of invasive mechanical ventilation (IMV). The percentage (%) of patients in each group receiving IMV is calculated to assess the clinical consequence of omicron infection.

Trial Locations

Locations (1)

Renji Hospital

🇨🇳

Shanghai, China

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