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Table 1 Characteristics, presentation and outcome of ventilated patients with COVID-19 and flu-related ARDS

From: Cardiovascular phenotypes in ventilated patients with COVID-19 acute respiratory distress syndrome

 COVID-19 (n = 18)Flu (n = 23)p value
Patients’ characteristics
 Age, years70 (57–75)58 (49–64)0.006
 Male (%)12 (67)12 (52)0.524
 BMI, kg/m229 (26–32)29 (25–34)0.519
 Hypertension (%)11 (61)10 (43)0.350
 Diabetes mellitus (%)4 (22)3 (13)0.679
 Time from illness onset to ICU admission, days11 (7–13)5 (4–10)0.017
 Time from illness onset to intubation, days12 (8–15)6 (4–10)0.002
 Time from illness onset to echocardiography, days14 (9–17)13 (6–17)0.001
 SAPS II34 (30–38)43 (32–54)0.015
 SOFA score4 (2–4)6 (4–9)< 0.001
Clinical presentation and treatment
 ECG changes* (%)1 (5%)3 (13%)0.618
 Documented coinfection (%)3 (17)9 (39)0.171
 Septic shock (%)0 (%)10 (43)
 Vasopressor support (%)2 (11)10 (43)0.038
 Prone position (%)10 (56)14 (61)1.000
 Neuromuscular blockers (%)17 (94%)12 (52%)0.005
Biology on admission
 Troponin I (ng/L)73 (51–94)53 (37–66)0.020
 Lactate, mmol/L1.17 (0.89–1.57)1.51 (1.02–2.54)0.143
 Creatinine, μmol/L58 (42–87)88 (59–160)0.021
 Prothombine time, %87 (78–96)87 (71–101)0.979
 AST, U/L55 (27–71)107 (46–203)0.020
 ALT, U/L37 (27–65)45 (27–115)0.527
 CPK, U/L72 (34–103)419 (180–2456)< 0.001
 White blood cell count, G/L7.98 (6.61–11.25)5.96 (4.02–8.05)0.003
 Lymphocyte count, G/L0,78 (0.55–1.05)0.75 (0.47–1.13)0.770
 Eosinophils count, G/L0.02 (0.02–0.09)0.01 (0.00–0.01)0.094
 Platelet count, G/L318 (218–425)172 (153–225)< 0.001
 Hemoglobin, g/dl11.2 (10.2–12.3)13.1 (11.6–14.2)0.007
Respiratory parameters
 PaO2/FiO2130 (81–217)70 (62–100)< 0.001
 Arterial pH7.35 (7.29–7.45)7.32 (7.23–7.41)0.121
 PaCO2, mmHg44 (33–51)47 (36–60)0.430
 RR, breaths/min24 (22–27)25 (24–28)0.139
 Tidal volume, mL/kg5.2 (4.5–6.2)5.3 (4.0–6.1)0.885
 PEEP, cmH2O10 (8–12)10 (8–12)0.476
 Plateau pressure, cmH2O23 (20–26)28 (20–28)0.144
 Driving pressure, cmH2O12 (10–15)18 (17–18)0.001
 Respiratory-system compliance**, mL/cmH2O38 (31–45)23 (22–27)0.001
Hemodynamic parameters
 Heart rate, bpm90 (72–109)105 (69–118)0.494
 Mean arterial blood pressure, mmHg102 (85–110)78 (71–94)< 0.001
 CVP, mmHg9 (7–10)11 (9–14)0.058
Cardiovascular phenotypes
 ACP (%)3 (17)11 (48)0.051
 Severe ACP (%)1 (5)8 (35)0.054
 LV failure3*** (17)14 (61)0.009
 Hypovolemia2 (11)1 (4)0.573
 Hyperkinesia6 (33)7 (30)1.00
 Normal hemodynamic profile8 (44)5 (22)0.179
Echocardiographic indices
 Cardiac index**** (L/min/m2)3.1 (2.5–4.2)2.5 (2.0–3.0)0.034
 RVEDA/LVEDA0.55 (0.37–0.60)0.70 (0.54–0.80)0.021
 RVFAC, %46 (35–50)33 (24–39)0.002
 TAPSE, mm25 (23–29)18 (16–22)< 0.001
 Tricuspid S′, cm/s16.0 (15.0–20.5)12.2 (11.0–13.4)0.005
 TR peak velocity, m/s3.2 (2.9–3.6)2.9 (2.4–3.2)0.113
 IVC diameter, mm22 (19–26)22 (21–24)0.762
 LVEF (%)52 (44–61)44 (28–59)0.265
 LVOT VTI, cm22 (18–25)18 (13–24)0.106
 Mitral E/E′ ratio7.3 (6.5–10.9)7.8 (6.1–10.6)0.730
Outcome
 ICU mortality***** (%)1 (6)9 (39)0.025
  1. Abbreviations: BMI body mass index, SAPSII Simplified Acute Physiology Score, SOFA Sepsis Organ Failure Assessment, AST aspartate aminotransferase, ALT alanine aminotransferase, CPK creatinine phosphokinase, RR respiratory rate, PEEP positive end-expiratory pressure, CVP central venous pressure, ACP acute cor pulmonale, LV left ventricle, RVEDA right ventricular end-diastolic area, LVEDA left ventricular end-diastolic area, RVFAC right ventricular fractional area change, TAPSE tricuspid annular plane systolic excursion, TR tricuspid regurgitation, IVC inferior vena cava, LVEF left ventricular ejection fraction, LVOT left ventricular outflow tract, VTI velocity-time integral, ICU intensive care unit
  2. *One patient had anterior negative T-wave in the COVID-19 group; 2 patients had inferior negative T-wave, and 1 patient had anterior negative T-wave in the flu group [2]
  3. **Calculated as the tidal volume divided by the driving pressure (difference between the inspiratory plateau pressure and positive end-expiratory pressure)
  4. ***One patient was diagnosed with a Tako-tsubo syndrome during transesophageal echocardiography examination performed shortly after tracheal intubation, after 6 days of high-flow nasal cannula; full recovery of left ventricular systolic function was documented under mechanical ventilation 10 days later
  5. ****Measured using the Doppler method applied at the left ventricular outflow tract
  6. *****As per April 24, with still 6 patients hospitalized in the intensive care unit, 5 of them being invasively ventilated