Cardiac Muscle Injury and Echocardiographic Plus Electrocardiographic Findings in Patients With 2019 Novel Coronavirus (COVID-19): A Retrospective Cohort Study

BackgroundMyocardial injury has been described in coronavirus-2019 (COVID-19). Few studies have reported cardiovascular imaging data with transthoracic echocardiography (TTE) and electrocardiographic (ECG) findings in COVID-19 patients and their correlation with mortality.MethodsWe conducted a retrospective cohort study that included COVID-19 patients from March 2020 through February 2021 who had TTE and ECG during hospital admission. Myocardial injury was defined by elevated high-sensitivity troponin T > 20 ng/L. Bivariate analysis was used to compare patients with myocardial injury and those without. Multivariate logistic regression analysis was performed to identify the variables associated with mortality.ResultsA total of 438 patients were included. The mean age was 62.1 ± 14.9 years, and 58.9% were male. A total of 149 patients died, with a mortality rate of 34%. A total of 260 patients (59.4%) had myocardial injury. The average left ventricular ejection fraction was 59.8 ± 11.2%, with 30 patients (6.8 %) having an ejection fraction of <40%. Patients with myocardial injury had higher mortality than those without (P-value < 0.05, Chi-square test). A multiple regression analysis model indicated that age, race/ethnicity, the development of acute respiratory distress syndrome (ARDS), shock, the need for vasopressors, mechanical ventilation, and hemodialysis were the significant variables associated with mortality.ConclusionCOVID-19 patients with myocardial injury had higher mortality than those without. Age, race/ethnicity, ARDS, shock, the need for vasopressors, mechanical ventilation, and hemodialysis were the clinical variables associated with mortality. TEE and ECG variables studied were not significantly associated with mortality.