The 2019 novel coronavirus, or severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that results in coronavirus disease-2019 (COVID-19), has been declared a pandemic and is severely affecting the provision of healthcare services all over the world.1 Healthcare workers are at higher risk since this virus is very easily spread, especially through the kind of close contact involved in the performance of echocardiographic studies. The virus carries relatively high mortality and morbidity risk, particularly for certain populations (the elderly, the chronically ill, the immunocompromised and, possibly, pregnant women).2 Given the risk of cardiovascular complications in the setting of COVID-19, including pre-existing cardiac disease, acute cardiac injury, and drug-related myocardial damage,3 echocardiographic services will likely be required in the care of patients with suspected or confirmed COVID-19. Consequently, echo providers will be exposed to SARS-CoV-2.
Sonographers, nurses, advance practice providers and physicians have a duty to care for patients and are at the frontlines in the battle against disease. We are at high risk, particularly when we participate in the care of patients who are suspected or confirmed to have highly contagious diseases. While dedication to patient care is at the heart of our profession, we also have a duty to care for ourselves and our loved ones and to protect all of our patients by preventing the spread of disease. This means reducing our own risk while practicing judicious use of personal protective equipment (PPE).
ASE is committed to the health, safety and wellbeing of our members and the patients we serve. This document is provided to the ASE community as a service to help guide the practice of echocardiography in this challenging time. It represents input from a variety of echocardiography practitioners and institutions who have experience with the COVID-19, or have been actively and thoughtfully preparing for it. The circumstances surrounding the outbreak are, of course, extremely dynamic, and this statement’s recommendations are subject to change. We direct echocardiography practitioners to the Centers for Disease Control (CDC) website for the latest updates and recommendations.4
This statement addresses triaging and decision pathways for handling echocardiographic requests, as well as indications and recommended procedures to be followed for an echocardiographic assessment of cardiovascular function in suspected or confirmed COVID-19 cases. In addition, we list measures recommended to be used in the echo lab for prevention of disease spread.