Table 2.
Electrocardiographic and Echocardiographic Characteristics of Patients With Versus Without Cardiac Injury and COVID-19
| Overall (N = 305) | Myocardial Injury (n = 190) | No Myocardial Injury (n = 115) | p Value | |
|---|---|---|---|---|
| Electrocardiogram at presentation | ||||
| Sinus rhythm | 261/305 (85.6) | 156 (82.1) | 105 (91.3) | 0.03 |
| Atrial fibrillation or flutter | 37/305 (12.1) | 28 (14.7) | 9 (7.8) | 0.07 |
| ST-segment elevations | 20/305 (6.6) | 19 (10.0) | 1 (0.9) | 0.002 |
| ST-segment depressions | 21/305 (10.5) | 20 (10.5) | 1 (0.9) | 0.001 |
| ST-segment elevations or depressions | 30/305 (9.8) | 28 (14.7) | 2 (1.7) | <0.0001 |
| Regional∗ | 22/305 (7.2) | 21 (11.1) | 1 (0.9) | 0.001 |
| Diffuse | 8/305 (2.6) | 7 (3.7) | 1 (0.9) | |
| T-wave inversions | 86/305 (28.2) | 57 (30.0) | 29 (25.2) | 0.37 |
| Q-waves | 41/305 (13.4) | 28 (14.7) | 13 (11.3) | 0.39 |
| New ECG ischemic changes during hospitalization† | 62/305 (20.3) | 59 (31.1) | 3 (2.6) | <0.0001 |
| Conduction disturbances | 49/305 (16.1) | 39 (20.5) | 10 (8.7) | 0.006 |
| Low voltage | 29/305 (9.5) | 23 (12.2) | 6 (5.2) | 0.04 |
| Echocardiographic characteristics | ||||
| Ejection fraction, % | 60 (47.5–65) | 58 (42–65) | 61 (58–65) | 0.0003 |
| ≥50 | 228 (74.8) | 124 (65.3) | 104 (90.4) | <0.0001 |
| 40–49 | 37 (12.1) | 27 (14.2) | 10 (8.7) | |
| <40 | 40 (13.1) | 39 (20.5) | 1 (0.9) | |
| LV internal diastolic diameter, cm | 4.5 (4–5) | 4.6 (4.1–5.1) | 4.4 (4.0–4.9) | 0.32 |
| LV internal systolic diameter, cm | 3.1 (2.7–3.8) | 3.2 (2.7–4.0) | 3.0 (2.8–3.6) | 0.08 |
| LV end-diastolic volume, ml | 101 (76–124) | 108 (76–131) | 94 (77–113) | 0.009 |
| LV end-systolic volume, ml | 40 (30–58) | 44 (30–71) | 36 (29–45) | 0.004 |
| Septal wall thickness, cm | 1.1 (0.9–1.2) | 1.1 (1.0–1.3) | 1.0 (0.9–1.2) | 0.0001 |
| Posterior wall thickness, cm | 1.0 (0.9–1.2) | 1.0 (0.9–1.2) | 0.9 (0.8–1.0) | 0.0001 |
| Stroke volume, ml | 54 (43–67) | 53 (40–69) | 55 (45–66) | 0.44 |
| Left atrial volume, ml | 50 (39–71.3) | 60 (40–78) | 46 (38–61) | 0.0005 |
| Diastolic function | ||||
| Normal | 99/194 (51.0) | 55 (49.1) | 44 (53.7) | 0.001 |
| Grade I dysfunction | 68/194 (35.1) | 32 (28.6) | 36 (43.9) | |
| Grade II dysfunction | 18/194 (9.3) | 16 (14.3) | 2 (2.4) | |
| Grade III dysfunction | 9/194 (4.6) | 9 (8.0) | 0 (0.0) | |
| Moderate or severe aortic regurgitation | 10/296 (3.4) | 10 (5.4) | 0 (0.0) | 0.10 |
| Moderate or severe aortic stenosis | 7/296 (2.4) | 7 (3.8) | 0 (0.0) | 0.24 |
| Moderate or severe mitral regurgitation | 23/294 (7.8) | 17 (9.4) | 6 (5.3) | 0.23 |
| Moderate or severe tricuspid regurgitation | 33/300 (11.0) | 27 (14.5) | 6 (5.3) | 0.006 |
| Pulmonary artery systolic pressure, mm Hg | 36 (28–46) | 36 (28–47) | 36 (28–44) | 0.46 |
| LV wall motion abnormalities | 50/305 (16.4) | 45 (23.7) | 5 (4.4) | <0.0001 |
| Apical | 28/50 (56.0) | 27 (60.0) | 1 (20.0) | |
| Mid | 40/50 (80.0) | 37 (82.2) | 3 (60.0) | |
| Basal | 33/50 (66.0) | 29 (64.4) | 4 (80.0) | |
| LV global dysfunction | 45/305 (14.8) | 35 (18.4) | 9 (7.8) | 0.01 |
| LV thrombus | 4/276 (1.5) | 4 (2.4) | 0 (0.0) | 0.11 |
| RV size | ||||
| Normal | 239/299 (79.9) | 141 (75.4) | 97 (87.4) | 0.07 |
| Mild dilatation | 35/299 (11.7) | 25 (13.3) | 10 (9.0) | |
| Moderate dilatation | 18/299 (6.0) | 15 (8.0) | 3 (2.7) | |
| Severe dilatation | 7/299 (2.3) | 6 (3.2) | 1 (0.9) | |
| RV function | ||||
| Normal | 236/298 (79.2) | 136 (73.1) | 100 (89.3) | 0.004 |
| Mildly abnormal | 37/298 (12.4) | 27 (14.5) | 10 (8.9) | |
| Moderately abnormal | 21/298 (7.1) | 19 (10.2) | 2 (1.8) | |
| Severely abnormal | 4/298 (1.3) | 4 (2.2) | 0 (0.0) | |
| RV s′ | 12 (10–15) | 12 (9.5–15) | 12.3 (11–14.5) | 0.54 |
| Pericardial effusion | ||||
| None or minimal | 280/302 (92.7) | 169 (89.4) | 111 (98.2) | 0.02 |
| Small | 13/302 (4.3) | 13 (6.8) | 0 (0.0) | |
| Moderate | 6/302 (2.0) | 4 (2.1) | 2 (1.8) | |
| Large | 3/302 (1.0) | 3 (1.6) | 0 (0.0) | |
| Inferior vena cave size, cm | 1.8 (1.4–2.1) | 1.8 (1.4–2.1) | 1.7 (1.3–2.0) | 0.14 |
| Any major echocardiographic abnormality‡ | 145/305 (47.5) | 120 (63.2) | 25 (21.7) | <0.0001 |
Values are n/N (%) or median (interquartile range) as appropriate.
COVID-19 = coronavirus disease-2019; ECG = electrocardiographic; LV = left ventricular; RV = right ventricular.
∗
Defined as ST-segment elevations or deviations occurring in a coronary artery distribution territory, including reciprocal ST-segment changes.
†
Defined as the composite of ST-segment elevations, depressions, or T-wave inversions.
‡
Defined as the composite of wall motion abnormalities, global LV dysfunction, grade II or III diastolic dysfunction, RV dysfunction or pericardial effusions.