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.