Contrast echocardiography in COVID-19 patients
There have not been many studies that have examined the use and safety of ultrasound enhancing agents (UEA) in patients with COVID-19 despite contrast ECHO generally having a higher diagnostic yield when compared with non-contrast ECHO [51,52]. In a retrospective study of 33 patients, including 14 on mechanical ventilation, it was found that 82% of the ECHO studies were technically difficult (with technical difficulty defined as more than two LV myocardial segments not visualized from any acoustic window). However, after administration of a UEA, it was found that adequate LV opacification was achieved in 97% of patients and adequate RV assessment was possible in 91% of patients. Contrast opacification was particularly beneficial in visualization of RV contours. The UEAs used in this study were Definity (perflutren lipid microsphere; Lantheus Medical Imaging, North Billerica, MA) and Optison (perflutren protein type-A microspheres; GE Healthcare, Little Chalfont, United Kingdom). None of the patients in the study experienced any adverse effects related to UEA administration including sustained arrhythmic events, deterioration of respiratory status including endotracheal intubation, cardiac arrest or death[53].