Table 1.
Comparison of clinical characteristics and echocardiographic parameters in the cohort of hospitalized patients with COVID-19 and subgroups with normal vs. abnormal global longitudinal strain (GLS) and myocardial work efficiency (MWE).
| Variables |
Overall cohort
N = 136 |
Normal GLS
N = 44 |
Abnormal GLS
N = 39 |
p-value |
Normal MWE
N = 16 |
Abnormal MWE
N = 59 |
p-value |
|---|---|---|---|---|---|---|---|
| Age, years | 62.4 ± 13.9 | 61.9 ± 13.4 | 63.4 ± 14.4 | 0.614 | 55.2 ± 16.5 | 64.3 ± 13.1 | 0.023 |
| Male | 79 (58%) | 27 (61%) | 22 (56%) | 0.647 | 13 (81%) | 32 (53%) | 0.039 |
| Race | 0.347 | 0.082 | |||||
| White | 34 (25%) | 10 (23%) | 5 (13%) | 3 (19%) | 12 (21%) | ||
| African American | 63 (47%) | 20 (45%) | 23 (61%) | 5 (31%) | 33 (57%) | ||
| Other | 37 (27%) | 14 (32%) | 10 (26%) | 8 (50%) | 13 (22%) | ||
| Body mass index, kg/m2 | 30.0 (26.4–35.8) | 27.8 (25.6–31.3) | 31.4 (26.5–38.4) | 0.017 | 27.7 (25.7–31.8) | 28.7 (25.7–34.5) | 0.544 |
| Comorbidities | |||||||
| Hypertension | 97 (72%) | 29 (66%) | 30 (77%) | 0.269 | 7 (44%) | 46 (78%) | 0.008 |
| Diabetes mellitus | 55 (41%) | 12 (27%) | 20 (51%) | 0.025 | 1 (6%) | 29 (49%) | 0.002 |
| Coronary artery disease | 20 (15%) | 4 (9%) | 8 (21%) | 0.140 | 0 (0%) | 10 (17%) | 0.077 |
| Heart failure | 20 (15%) | 2 (5%) | 12 (31%) | 0.001 | 0 (0%) | 12 (20%) | 0.049 |
| Clinical presentation | |||||||
| Heart rate, beats per min | 99 ± 20 | 97 ± 17 | 103 ± 21 | 0.151 | 95 ± 18 | 100 ± 20 | 0.392 |
| Systolic blood pressure, mmHg | 129 ± 25 | 129 ± 24 | 134 ± 24 | 0.368 | 126 ± 27 | 132 ± 23 | 0.343 |
| Diastolic blood pressure, mmHg | 71 ± 16 | 71 ± 16 | 74 ± 15 | 0.389 | 74 ± 16 | 71 ± 16 | 0.546 |
| Laboratory measurements | |||||||
| White blood cell count, K/cu mm | 6.7 (5.0–9.3) | 6.4 (4.6–8.7) | 6.0 (4.8–8.3) | 0.773 | 6.4 (4.8–9.0) | 6.4 (4.8–9.1) | 0.946 |
| Absolute lymphocyte count, K/cu mm | 0.6 (0.1–1.1) | 0.6 (0.1–1.0) | 0.5 (0.0–1.3) | 0.794 | 0.7 (0.0–1.2) | 0.7 (0.03–1.2) | 0.992 |
| D-dimer, mg/L | 2.0 (0.8–5.3) | 2.0 (0.8–4.6) | 2.2 (0.9–7.3) | 0.433 | 2.0 (0.4–4.7) | 2.2 (0.9–4.5) | 0.213 |
| Interleukin-6, pg/ml | 130 (51–409) | 86 (32–167) | 164 (69–815) | 0.034 | 114 (47–422) | 125 (45–406) | 0.695 |
| CRP, mg/dl | 15.3 (4.9–34.7) | 11.7 (3.3–20.5) | 13.7 (5.1–37.7) | 0.410 | 4.9 (2.3–15.3) | 15 (6.6–34.3) | 0.009 |
| Ferritin, ng/ml | 735 (395–1,424) | 737 (427–1,130) | 800 (402–2,898) | 0.525 | 830 (289–1,677) | 719 (412–1,125) | 0.897 |
| Fibrinogen, mg/dl | 596 (445–703) | 737 (427–1,130) | 800 (402–2,898) | 0.695 | 568 (463–729) | 597 (457–722) | 0.694 |
| Pro-BNP, pg/ml | 422 (157–1,956) | 242 (99–589) | 564 (164–3,992) | 0.044 | 176 (70–385) | 392 (164–2,611) | 0.032 |
| Troponin I, ng/ml | 0.03 (0.03–0.05) | 0.03 (0.03–0.03) | 0.03 (0.03–0.08) | 0.454 | 0.03 (0.03–0.03) | 0.03 (0.03–0.05) | 0.305 |
| Clinical events | |||||||
| Shock | 72 (53%) | 17 (39%) | 23 (59%) | 0.064 | 4 (25%) | 30 (51%) | 0.065 |
| Mechanical ventilation | 86 (63%) | 22 (50%) | 26 (67%) | 0.125 | 5 (31%) | 38 (64%) | 0.017 |
| ARDS | 78 (57%) | 19 (43%) | 25 (64%) | 0.057 | 5 (31%) | 32 (54%) | 0.103 |
| DVT or PE | 31 (23%) | 8 (18%) | 8 (21%) | 0.788 | 3 (19%) | 12 (20%) | 0.888 |
| Death | 25 (19%) | 7 (16%) | 8 (21%) | 0.620 | 2 (12%) | 9 (16%) | 0.764 |
| Echocardiographic parameters | |||||||
| LA volume, ml | 44 (35–71) | 41 (29–45) | 48 (39–95) | 0.046 | 39.5 (28–42) | 47 (39–55) | 0.222 |
| LVEDD, cm | 4.2 (3.7–4.8) | 4.1 (3.8–4.6) | 4.3 (3.4–4.9) | 0.378 | 4.4 (3.8–4.9) | 4.1 (3.5–4.7) | 0.276 |
| LVEF, % | 62 (52–62) | 62 (57–64) | 55 (40–62) | <0.001 | 62 (62–64) | 57 (50–62) | 0.011 |
| Normal LVEF (>50%) | 109 (81%) | 43 (64%) | 24 (36%) | <0.001 | 16 (100%) | 45 (74%) | 0.031 |
| RVEDD, cm | 3.6 ± 0.7 | 3.4 ± 0.6 | 3.6 ± 0.7 | 0.224 | 3.4 ± 0.7 | 3.6 ± 0.6 | 0.225 |
| Normal RV function | 63 (81%) | 22 (85%) | 18 (72%) | 0.274 | 12 (92%) | 24 (73%) | 0.147 |
| TAPSE, cm | 1.8 ± 0.4 | 2.0 ± 0.4 | 1.7 ± 0.4 | 0.005 | 2.1 ± 0.3 | 1.8 ± 0.4 | 0.003 |
| RVSP, mmHg | 37 (30–50) | 37 (29–48) | 34 (32–53) | 0.742 | 31 (30–33) | 37 (29–49) | 0.288 |
| Mean PAP, mmHg | 34 ± 12 | 35 ± 9 | 34 ± 11 | 0.754 | 27 ± 12 | 35 ± 9 | 0.087 |
| Peak TR gradient, mmHg | 31 (25–42) | 32 (25–42) | 31 (25–40) | 0.899 | 29 (25–38) | 31 (24–43) | 0.832 |
| PCWP, mmHg | 14 (10–18) | 13 (9–17) | 12 (9–16) | 0.820 | 12 (10–16) | 15 (12–21) | 0.422 |
| E/E' | 10 (8–13) | 10 (7–12) | 9 (7–13) | 0.665 | 9 (7–11) | 9 (7–13) | 0.561 |
| GLS, % | −16.1 ± 4.3 | −19.2 ± 2.4 | −12.6 ± 3.0 | <0.001 | −19.7 ± 3.1 | −15.5 ± 4.1 | <0.001 |
| MWI, mmHg% | 1,412 ± 425 | 1,579 ± 362 | 1,227 ± 417 | <0.001 | 1,723 ± 399 | 1,331 ± 396 | <0.001 |
| MWE, % | 92 (87–94) | 94 (91–95) | 89 (82–92) | <0.001 | 96 (95–96) | 91 (86–93) | <0.001 |
Categorical variables are presented as number (%) and continuous variables are presented as mean ± standard deviation or median (interquartile range).
CRP, C-reactive protein; Pro-BNP, N-terminal pro-hormone B-type natriuretic peptide; ARDS, acute respiratory distress syndrome; DVT, deep venous thrombosis; PE, pulmonary embolism; LA, left atrium; LVEDD, left ventricular end diastolic diameter; LVEF, left ventricular ejection fraction; GLS, global longitudinal strain; RVEDD, right ventricular end diastolic diameter; TAPSE, tricuspid annular plane systolic excursion; RVSP, right ventricular systolic pressure; PAP, pulmonary artery pressure; TR, tricuspid regurgitation; GLS, global longitudinal strain; MWI, myocardial work index; MWE, myocardial work efficiency.
The bold values represent significant p-values, with significant defined as <0.05.