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This study aims to better understand how heart ultrasound scans were used during the first wave of the pandemic and to see how best to use them during subsequent waves of COVID-19 and any future pandemics.

STUDY BACKGROUND

As well as the widely documented respiratory problems of people suffering with COVID-19, emerging evidence suggests that there is also direct damage to the heart in some patients. We also know that patients with underlying heart disease are at significantly increased risk of complications. Monitoring of cardiac function is therefore important to guide treatment of and recovery from Covid-19. 

Echocardiography (heart ultrasound scanning) is both safe and can be performed anywhere, making it the most commonly used heart imaging technique. Scans can be performed at the hospital bedside as well as in community clinics or care homes and are assessed by trained individuals who make measurements and interpret the findings. Ultrasound equipment potentially used on COVID-19 patients ranges from larger high-end machines with multiple cutting edge features, to smaller laptop style systems, to single cameras which are plugged into smartphones and used with an app to view the heart. 

It is not well understood how echocardiography was used in UK NHS hospitals during the first surge of the coronavirus pandemic. Data from this period may help to optimise the use of echocardiography in future surges and pandemics.

 STUDY OBJECTIVES

By investigating how echocardiography was used to assess patients in real world practice, and whether traditional or more novel biomarkers were useful to predict outcomes, the investigators will try to establish the optimal use of echocardiography for patient management. Ultimately, the aim is to develop systems for remote automated analysis and reporting to maintain quality, and simplify delivery, of echocardiography within the NHS during future pandemics. 

STUDY RECRUITMENT

Echocardiogram images, associated measurements, clinical parameters and patient outcomes will be collected retrospectively from patients already seen at the three participating sites (Oxford University Hospitals NHS Foundation Trust, Royal Papworth NHS Foundation Trust, St George’s University Hospital NHS Foundation Trust). Data from Covid-19 patients during their admission, and any echocardiograms they had in the two year period before the pandemic will be collected. Data from a matched cohort of patients without Covid-19 will be collected from the same timeframe, to act as a control group. 

RESEARCH FUNDING

This research is funded by the COVID-19 Research Response Fund of the Medical Sciences Division, University of Oxford, UK.

STUDY APPROVAL

This research has been approved by the UK Health Research Authority (reference 19/HRA/2068/AM03).

CLEAR-UK