Echocardiography in Confirmed and Highly Suspected Symptomatic COVID-19 Patients and Its Impact on Treatment Change

Table 1

Clinical and imaging characteristics of the patients included.

Characteristics	All TTE/TEE patients (n = 56)	According to treatment change		value
		TTE/TEE patients with treatment change induced by the TTE N = 9 (16%)	TTE/TEE patients without treatment change induced by the TTE N = 47 (84%)
Age, median (IQR), y	66 (60.5–74)	64 (59–74)	67 (62–74)	0.78
Female, N(%)	18 (32.1)	3 (33.3)	15 (31.9)	0.93
COVID-19 diagnosis, N(%); [1] positive nasopharyngeal swab; [2] typical chest CT scan; [3] atypical pneumonia on CT scan	[1]: 4 (7.1); [1 + 2]: 25 (44.6); [2]: 22 (39.3); [3]: 5 (8.9)	[1]: 0; [1 + 2]: 5 (55.6); [2]: 3 (33.3); [3]: 1 (11.1)	[1]: 4 (8.5); [1 + 2]: 20 (42.6); [2]: 19 (40.4); [3]: 4 (8.5)	0.75
Inaugural symptoms^$, N(%)	Neuro.: 16 (28.6); Resp.: 35 (62.5); Viral: 3 (5.3); COVID typical: 2 (3.6)	Neuro.: 2 (22.2); Resp.: 6 (66.7); Viral: 1 (11.1); COVID typical: 0	Neuro.: 14 (29.8); Resp.: 29 (61.7); Viral: 2 (4.3); COVID typical: 2 (4.3)	0.75
Symptoms’ severity, N(%); [1] no need for oxygen; [2] need for oxygen therapy; [3] intubated	[1]: 9 (16.1); [2]: 14 (25); [3]: 33 (58.9)	[1]: 0; [2]: 3 (33.3); 3 : 6 (66.7)	[1]: 9 (19.1); [2]: 11 (23.4); [2]: 27 (57.5)	0.35
Body area, median (IQR), m^2	1.895 (1.83–1.97)	1.92 (1.83–2.06)	1.89 (1.83–1.97)	0.35
BMI, median (IQR), Kg/m^2	28.7 (25.30–30.15)	29.6 (29.1–31.3)	28.1 (24.8–29.8)	0.08
Diabetes, N(%)	24 (43.6)	3 (33.3)	21 (45.7)	0.50
Hypertension, N(%)	35 (63.6)	7 (77.8)	18 (60.9)	0.34
Smoking, N(%)	4 (7.7%)	0	4 (8.9)	0.41
Alcohol, N(%)	4 (7.8)	0	4 (9.1)	0.41
Known cardiovascular disease, N(%)	16 (28.6)	2 (22.2)	14 (29.8)	0.65
Evolution^#, N(%); 1 discharge (home or rehabilitation); 2 deceased; 3 still in hospital at the time of writing	1 : 20 (35.7); 2 : 5 (8.9); 3 : 31 (55.4)	1 : 1 (11.1); 2 : 1 (11.1); 3 : 7 (77.8)	1 : 19 (40.4); 2 : 4 (8.5); 3 : 24 (51.1)	0.24
Patients with TTE/TEE, N(%)	TTE: 50 (87.5); TTE + TEE: 5 (10.7); TEE: 1 (1.8)	TTE: 7 (77.8); TTE + TEE: 2 (22.2); TEE: 0	TTE: 42 (89.4); TTE + TEE: 4 (8.5); TEE: 1 (2.1)	0.44
Indications for TTE/TEE, N(%); 1 pulmonary embolism: suspicion or evaluation/pulmonary pressures; 2 left ventricular filling pressures; 3 troponin T hs elevation; 4 exclude infectious endocarditis; 5 left ventricular systolic function/hemodynamic; 6 ischemic stroke: seek cardiac source of embolism; 7 other (valvular prosthesis, renal embolism, etc.)	1 : 9 (16.1); 1 + 2+5 : 6 (10.7); 1 + 4+6 : 1 (1.8); 1 + 5+6 : 1 (1.8); 2 : 6 (10.7); 1 + 2+5 + 7 : 1 (1.8); 3 : 2 (3.6); 4 : 4 (7.14); 5 : 11 (19.6); 1 + 5 : 2 (3.6); 6 : 8 (14.3); 6 + 7 : 1 (1.8); 7 : 4 (7.14)	1 : 0; 1 + 2+5: (11.1); 1 + 4+6 : 0; 1 + 5+6 : 1 (11.1); 2 : 3 (33.3); 1 + 2+5 + 7 : 0; 3 : 1 (11.1); 4 : 0; 5 : 2 (22.2); 1 + 5 : 0; 6 : 1 (11.1); 6 + 7 : 0; 7 : 0	1 : 9 (19.15); 1 + 2+5 : 5 (10.6); 1 + 4+6 : 1 (2.1); 1 + 5+6 : 0; 2 : 3 (6.4); 1 + 2+5 + 7 : 1 (2.1); 3 : 1 (2.1); 4 : 4 (8.5); 5 : 9 (19.15); 1 + 5 : 2 (4.3); 6 : 7 (14.9); 6 + 7 : 1 (2.1); 7 : 4 (8.5)	0.18
CT/TEE documented PE, N(%)	Yes: 10 (17.9); No: 16 (28.6); Not assessed: 30 (53.5)	Yes: 2 (22.2); No: 3 (33.3); Not assessed: 4 (44.4)	Yes: 8 (17.0); No: 13 (27.7); Not assessed: 26 (55.3)	0.83
LVEF on TTE	>50%: 51 (91.1); 40–50%: 5 (8.9)	>50%: 8 (88.9); 40–50%: 1 (11.1)	>50%: 43 (91.5); 40–50%: 4 (8.5)	NS
LVEF on TTE, median (IQR), (%)	62 (60–70)	64 (52–76)	62 (60–70)	0.90
E/A (transmitral flow), median (IQR)	0.8 (0.7–1)	0.75 (0.6–1.0)	0.8 (0.8–0.9)	0.50
E/Ea on TTE, median (IQR)	8.8 (6.5–11.8)	8.5 (6.7–10.4)	8.9 (6.5–11.8)	0.83
Systolic PAP, median (IQR), mmHg	38 (31–43)	40 (38–55)	36 (30–43)	0.0549
Pericardial effusion, N(%)	2 (3.6)	0	2 (4.3)	0.53
Cardiac thrombus (TTE or TEE), N(%)	3 (5.4)	3 (33.3)	0	≤0.001

IQR: interquartile range; y: years, CT: computed tomography; PE: pulmonary embolism; PAPs: echocardiographic systolic pulmonary arterial pressure. ^$Inaugural symptoms: Neuro.: neurological; Resp.: respiratory; Viral: nonspecific viral syndrome; COVID: typical signs and symptoms of COVID-19. ^#Evolution: 1 discharge (to home or rehabilitation); 2 deceased; 3 still in hospital on 17/04/2020 (at the date of writing this manuscript). None of the patients had LVEF <40% in this study.