Table 5.
Analysis of COVID‐19 patients according to myocardial injury (high‐sensitivity troponin T >99% upper limit of normal/>14 ng/L)
| Baseline characteristics | No myocardial injury (n = 44, 69%) | Myocardial injury (n = 20, 31%) | P‐value |
|---|---|---|---|
| Age (years) | 50 ± 16 | 70 ± 17 | <0.001 |
| Female sex | 11 (25) | 9 (45) | 0.11 |
| BMI (kg/m2) | 26.8 ± 4.5 | 27.8 ± 5.3 | 0.45 |
| Systolic blood pressure (mmHg) | 124 ± 17 | 131 ± 14 | 0.14 |
| Diastolic blood pressure (mmHg) | 76 ± 12 | 76 ± 11 | 0.88 |
| Severe disease according to WHO | 29 (66) | 15 (75) | 0.47 |
| Dyspnoea | 25 (57) | 13 (65) | 0.54 |
| Peripheral oedema | 4 (9) | 2 (10) | 0.91 |
| Length of hospitalization (days) | 9 (5–14) | 13 (9–21) | 0.016 |
| Medical history | |||
| Arterial hypertension | 14 (32) | 14 (70) | 0.004 |
| Atrial fibrillation | 2 (5) | 6 (30) | 0.009 |
| Coronary artery disease | 3 (7) | 5 (25) | 0.096 |
| Myocardial infarction | 1 (2) | 2 (10) | 0.23 |
| Diabetes mellitus type 2 | 2 (5) | 7 (35) | 0.003 |
| Chronic obstructive pulmonary disease | 3 (7) | 4 (20) | 0.19 |
| Chronic kidney disease ≥G4 (KDIGO) | 0 | 0 | 1.00 |
| Cardiovascular medications | |||
| ACE inhibitors | 2 (5) | 5 (25) | 0.026 |
| ARBs | 4 (9) | 4 (20) | 0.24 |
| Beta‐blockers | 7 (16) | 11 (55) | 0.001 |
| Diuretics | 0 | 8 (40) | <0.001 |
| Blood parameters | |||
| Sodium (mmol/L) | 138 ± 3 | 136 ± 3 | 0.017 |
| Potassium (mmol/L) | 3.8 ± 0.4 | 3.8 ± 0.4 | 0.86 |
| eGFR (mL/min) | 102.9 ± 20.2 | 74.4 ± 21.6 | <0.001 |
| hsTnT (ng/L) | 6 (5–8) | 22 (16–29) | <0.001 |
| NT‐proBNP (ng/L) | 97 (33–191) | 538 (234–2414) | <0.001 |
| CRP (mg/L) | 24 (7–84) | 32 (9–92) | 0.45 |
| Haemoglobin (g/dL) | 13.0 ± 1.7 | 11.4 ± 2.3 | 0.002 |
| Leucocytes (/nL) | 7.0 ± 3.1 | 8.0 ± 3.2 | 0.23 |
| Thrombocytes (/nL) | 273 ± 127 | 293 ± 94 | 0.54 |
| Resting ECG parameters | |||
| Sinus rhythm | 44 (100) | 14 (70) | 0.001 |
| Atrial fibrillation | 0 | 4 (20) | 0.008 |
| Heart rate (bpm) | 75 ± 13 | 77 ± 17 | 0.61 |
| QRS interval (ms) | 98 ± 9 | 106 ± 26 | 0.23 |
| QTc (ms) | 428 ± 23 | 440 ± 34 | 0.085 |
| QTc ≥440 ms | 13 (30) | 10 (50) | 0.11 |
| Echocardiographic parameters | |||
| LV ejection fraction (%) | 66 ± 3 | 63 ± 4 | 0.013 |
| Global longitudinal strain (%) | −16.6 ± 6.4 | −15.5 ± 3.0 | 0.53 |
| HFA‐PEFF score (points) | 1 (0–3) | 5 (3–6) | <0.001 |
| H2FPEF score (points) | 1 (0–2) | 3 (1–7) | <0.001 |
| LV wall thickness (mm) | 10.2 ± 1.5 | 11.3 ± 1.6 | 0.007 |
| LV mass index (g/m2) | 92 ± 23 | 108 ± 35 | 0.031 |
| Relative wall thickness | 0.41 ± 0.09 | 0.45 ± 0.07 | 0.061 |
| Left atrial volume index (mL/m2) | 20.6 ± 6.9 | 27.9 ± 15.5 | 0.055 |
| Mitral E/A ratio | 1.2 ± 0.5 | 0.8 ± 0.3 | 0.004 |
| Diastolic dysfunction | 12 (27) | 15 (75) | <0.001 |
| Grade 1 (E/A < 1 + E/e′ mean <10) | 10 (23) | 9 (45) | 0.071 |
| Grade 2 (E/A ≥ 1 + E/e′ mean 10–14) | 2 (5) | 2 (10) | 0.58 |
| Grade 3 (E/A >= 1 + E/e′ mean >14) | 0 | 4 (20) | 0.008 |
| RV dysfunction (TAPSE <18 mm and/or RV S′ <0.10 m/s) | 0 | 6 (30) | 0.001 |
| Septal e′ (cm/s) | 9.4 ± 2.7 | 7.2 ± 2.5 | 0.004 |
| Lateral e′ (cm/s) | 12.1 ± 3.2 | 9.4 ± 3.6 | 0.004 |
| TR velocity (m/s) | 2.28 ± 0.27 | 2.59 ± 0.57 | 0.030 |
| Pulmonary artery systolic pressure (mmHg) | 26 ± 5 | 31 ± 11 | 0.028 |
Normal distributed variables are presented as mean ± standard deviation, non‐parametric variables as median (interquartile range), and nominal variables as n (%).
ACE, angiotensin‐converting enzyme; ARB, angiotensin receptor blocker; BMI, body mass index; CRP, C‐reactive protein; e′, mitral annulus early diastolic velocity; E/A, early filling velocity (E) and late filling velocity (A) ratio through the mitral annulus; ECG, electrocardiogram; eGFR, estimated glomerular filtration rate; hsTnT, high‐sensitivity troponin T; LV, left ventricular; NT‐proBNP, N‐terminal pro B‐type natriuretic peptide; RV, right ventricular; RV S′, right ventricular systolic excursion velocity; TAPSE, tricuspid annular plane systolic excursion, TR, tricuspid regurgitation; WHO, World Health Organization.