Table 1.
Clinical Characteristics of Patients According to the Presence or Absence of Signs of RHS on the Presenting 12-Lead ECG
| Overall (N = 314) | RHS-ECG |
p Value | ||
|---|---|---|---|---|
| With (n = 34) | Without (n = 280) | |||
| Demographic characteristic | ||||
| Age, yrs | 60 ± 15 | 65 ± 15 | 59 ± 15 | 0.021 |
| Number of patients ≥65 yrs | 117 (37) | 20 (59) | 97 (35) | 0.006 |
| Sex | ||||
| Women | 151 (48) | 19 (56) | 132 (47) | 0.335 |
| Men | 163 (52) | 15 (44) | 148 (53) | |
| Body mass index, kg/m2 | 33 (29−41) | 34 (30−41) | 33 (29−42) | 0.164 |
| Vital signs and oxygenation on admission | ||||
| Mean arterial pressure, mm Hg | 80 (72−88) | 80 (71−91) | 80 (72−88) | 0.525 |
| SPO2:FiO2 ratio | 359 (301−452) | 333 (239−405) | 359 (311−452) | 0.053 |
| Symptoms on admission | ||||
| Chest pain | 64 (20) | 11 (32) | 53 (19) | 0.067 |
| Shortness of breath | 220 (70) | 28 (82) | 192 (69) | 0.098 |
| Cough | 234 (75) | 25 (74) | 209 (75) | 0.888 |
| Comorbid conditions | ||||
| Hypertension | 232 (74) | 25 (74) | 207 (74) | 0.960 |
| Diabetes mellitus | 151(48) | 21 (62) | 130 (46) | 0.091 |
| Coronary artery disease | 47 (15) | 8 (24) | 39 (14) | 0.138 |
| Cerebrovascular disease | 13 (4) | 4 (12) | 9 (3) | 0.019 |
| Atrial fibrillation/flutter | 13 (4) | 3 (9) | 10 (4) | 0.147 |
| Chronic kidney disease | 122 (39) | 17 (50) | 105 (38) | 0.158 |
| Chronic obstructive pulmonary disease | 36 (12) | 10 (29) | 26 (9) | 0.001 |
| Asthma | 45 (14) | 3 (9) | 42 (15) | 0.332 |
| Obstructive sleep apnea | 31 (10) | 3 (9) | 28 (10) | 0.828 |
| Chronic hypoxic respiratory failure | 9 (3) | 2 (6) | 7 (3) | 0.264 |
| Smoking history | 112 (36) | 18 (53) | 94 (34) | 0.026 |
| Immunosuppression | 21 (7) | 2 (6) | 19 (7) | 0.842 |
| Laboratory data | ||||
| Creatinine, mg/dl | 0.9 (0.8−1.2) | 1.1 (0.7−1.3) | 0.9 (0.8−1.1) | 0.425 |
| White blood cell count, K/μl | 5.8 (4.2−7.0) | 6.7 (5.7−8.6) | 5.6 (4.1−6.9) | 0.005 |
| Lymphocyte count, K/μl | 0.9 (0.7−1.2) | 0.8 (0.6−1.3) | 0.9 (0.7−1.2) | 0.812 |
| Hemoglobin, g/dl | 13.0 (12.0−14.5) | 12.5 (11.2−14.1) | 13.1 (12−14.5) | 0.521 |
| Platelet count, K/μl | 197 (158−245) | 173 (157−256) | 197 (163−246) | 0.644 |
| Aspartate aminotransferase, IU/l | 31 (23−52) | 29 (22−74) | 31 (24−52) | 0.131 |
| Alanine aminotransferase, IU/l | 21 (13−38) | 21 (13−44) | 20 (13−35) | 0.769 |
| Total bilirubin, mg/dl | 0.5 (0.4−0.8) | 0.7 (0.4−0.9) | 0.5 (0.4−0.8) | 0.718 |
| Albumin, mg/dl | 3.6 (3.3−3.8) | 3.5 (3.3−3.7) | 3.6 (3.3−3.8) | 0.157 |
| High-sensitivity troponin, ng/l | 10 (5−21) | 21 (12−37) | 9 (4−21) | 0.935 |
| Cardiac injury∗ | 117 (37) | 21 (62) | 96 (34) | 0.002 |
| Brain natriuretic peptide, pg/ml | 36 (18−79) | 77 (36−183) | 32 (16−71) | 0.758 |
| Elevated brain natriuretic peptide† | 94 (39) | 16 (57) | 78 (37) | 0.040 |
| Lactate dehydrogenase, IU/l | 319 (257−415) | 328 (269−450) | 316 (252−395) | 0.157 |
| Ferritin, ng/ml | 331 (159−810) | 409 (237−875) | 329 (155−837) | 0.685 |
| D-dimer, μg/ml | 0.89 (0.49−1.46) | 1.12 (0.48−2.815) | 0.78 (0.49−1.37) | 0.009 |
| ECG characteristics | ||||
| Sinus rhythm | 273 (87) | 32 (94) | 241 (86) | 0.189 |
| Sinus tachycardia | 100 (32) | 12 (35) | 88 (31) | 0.648 |
| Atrial fibrillation/flutter | 9 (3) | 0 (0) | 9 (3) | 0.289 |
| Heart rate | 103 (91−111.75) | 101 (90−107) | 103 (91−112) | 0.677 |
| QRS duration | 84 (78−97.5) | 118 (80−145) | 84 (78−92) | 0.044 |
| QTc duration | 438 (421−461) | 449 (429−493) | 435 (420−457) | <0.001 |
| Any injury pattern | 33 (11) | 4 (12) | 29 (10) | 0.800 |
| Prolonged QTc | 82 (26) | 18 (53) | 64 (23) | <0.001 |
| First-degree AV block | 11 (4) | 1 (3) | 10 (4) | 0.936 |
| Chest imaging findings | ||||
| Normal | 47 (15) | 2 (6) | 45 (16) | 0.099 |
| Unilateral pneumonia | 44 (14) | 4 (12) | 40 (14) | |
| Bilateral pneumonia | 94 (30) | 16 (47) | 78 (28) | |
| Multifocal pneumonia | 129 (41) | 12 (35) | 117 (42) | |
Values are mean ± SD, n (%), and median (interquartile range).
AV = atrioventricular; ECG = electrocardiography; RHS-ECG = new right heart strain patterns on presenting 12-lead electrocardiogram; SPO2/FiO2 = ratio of peripheral capillary oxygen saturation to the fraction of inspired oxygen.
∗
Cardiac injury as defined by a troponin level above the 99th percentile (18 ng/l).
†
Elevated brain natriuretic peptide as defined by a level >50 pg/l.