Results
A total of 45 patients were included in the study, the mean age of these patients was 61.4 ± 12.2 years (range 28-81). Males and females were equally represented in our data (M=23, F=22). Hispanic race constituted 47% of the patient population ( n=21) followed by African Americans 27%(n=12), Caucasians 20%(n=9) and other races 6%( n=3). Hypertension in 29 (64%) and diabetes mellitus in 25 patients ( 55%) were the most common co morbidities associated with COVID-19 infection followed by congestive heart failure(CHF) in 11 patients (24%),Coronary artery disease (CAD)  in 9 patients (20%) and valvular heart disease in 3 patients (7%). Eight patients (18%) had of myocardial injury suggested by elevated troponin (n=44) and BNP was found to be elevated in 14 patients (35.8 %) (n=39) patients. Among other inflammatory biomarkers, majority 93 % (n=29) had elevated LDH and 87.8 % (n=33) had elevated ferritin. Similarly 88 % (n=27) had elevated D-dimer suggesting that they might be in a prothrombotic state. This laboratory data and echocardiographic findings are summarized in table1.
A total of 14 patients had left ventricular dysfunction (31%), 7 of these patients had mild dysfunction with left ventricular ejection fraction (LVEF) 41-50%, 2 had moderate dysfunction (LVEF 30-40%) and 5 patients had severe LV dysfunction (LVEF<30%). LV thrombus was not seen in any patients. Regional wall motion abnormality was seen in two patients; one patients presenting with AMI and another with takotsubo cardiomyopathy. Rest of the patients with low EF had global hypokinesis. None of the patients had pericardial effusion or severe valvulopathy secondary to COVID-19 infection. We found 6 patients with right ventricular (RV) dilatation and 5 patients with reduced RVEF. Pressure and volume overload, as demonstrated by flattening of interventricular septum (IVS) in diastole and systole, was seen in 3 of our patients. In one patient RV thrombus was visualized, which was confirmed on  computed tomography angiography (CTA) of the chest. Pulmonary   pressure (calculated using tricuspid regurgitation jet and right atrial pressure) was found to be elevated in 10 patients (24%) in the study population.