Hemodynamic Characteristics of Patients with Myocardial Injury and Cardiogenic Shock Caused by Severe COVID-19-Related Pneumonia

Figures & data

Table 1 The General Information of the Patients

Patient ID	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16
Gender	Male	Female	Male	Male	Male	Male	Female	Male	Female	Female	Male	Female	Female	Male	Male	Male
Age	67	78	71	65	64	64	56	66	91	42	63	60	60	65	76	79
BMI	20.5	22.8	26.7	24.2	31.2	22.8	26.2	26.7	27.2	27.5	24.8	28.9	25.2	24.2	25.4	26.6
Past history	HTN, T2DM	T2DM, CHD	CHD	HTN, CHD	HTN	HTN, CHD	HTN, T2DM	Non	HTN, T2DM, CHD	Non	HTN, CHD	HTN, CHD	HTN, T2DM	HTN, CRF, T2DM	HTN, T2DM	HTN, T2DM
T (°C)	36.9	37.1	39	36.9	39	38.5	36.2	37.5	36.9	36.3	39.8	36.5	37	38	38	39
HR (times/min)	120	83	118	85	85	90	110	104	94	103	92	98	76	78	74	80
SBP (mmHg)	125	128	151	156	165	130	143	126	139	99	132	120	168	128	130	152
DBP (mmHg)	86	80	66	75	73	76	92	70	60	61	82	65	74	65	80	84
RR (times/min)	21	21	36	12	15	30	25	32	20	20	22	20	30	20	20	22
PO2 (mmHg)	68	65	70	55	90	54	52	48	98	86	105	85	78	68	108	68
P/F (mmHg)	172	156	255	273	230	250	263	120	483	412	320	420	430	180	280	256
Na (mmol/L)	143.4	137.6	143.6	134.3	134.3	137.5	130.9	141	137	136.9	142.6	140.2	134.8	138.1	139.2	141.5
K (mmol/L)	4.8	3.19	4.97	5.16	3.86	4.51	3.91	3.77	4.85	4.96	3.62	4.74	4.68	4.53	4.01	4.41
TBIL (mmol/L)	15.4	7.4	11.4	16.8	20.3	12.3	33.8	6.4	16.9	11.4	8.4	7.7	14	7.8	7.6	12.7
Cr (umol/L)	68.5	66.3	89.3	89.3	73	92.5	91.9	88.2	74.2	66.9	114.4	79.9	64.5	55.9	57.9	72
Bun (mmol/L)	4.64	4.91	5.76	5.12	3.69	7.88	12.1	10.91	10.71	4.31	11.02	4.9	5.58	3.99	2.25	4.97
LDH (U/L)	391	188	221	380	319	407	209	332	295	160	393	150	339	459	221	386
CRP (mg/L)	17.27	9.53	0.84	65.14	79.91	103.31	144.36	45.24	5.61	5.11	2.91	0.82	25.65	3.86	3.25	6.84
Glu (mmol/L)	5.62	13.59	5.6	5.73	5.88	6.18	8.82	8.58	7.85	5.74	8.65	5.03	18.88	5.77	4.85	12.8
TP (g/L)	67.2	43.9	60.3	65.1	56.4	56.8	65.7	59.2	70.1	72.3	67.4	74.8	70.8	68	68.2	70.1
ALB (g/L)	27.6	18.1	37.2	28.1	24.6	25	33.1	29.8	42.2	41.5	30.5	36	30.9	40.6	31.6	35.2
Pre-ALB (g/L)	248.8	121.4	408.2	145.6	84.8	59.6	93.4	124.9	139.1	295.7	368.9	466.6	137.1	354.8	237.1	255.8
Hct (%)	43.1	33.7	38.4	37.5	34.7	32.8	23.4	23.1	38.8	41.1	35.7	44.9	41.7	38.8	32.4	38
WBC (X10^9)	7.39	10.98	5.16	8.76	6.44	5.08	14.03	7.36	10.44	8.11	17.5	9.48	3.6	5.25	3.48	5.08
Hgb (g/L)	127	142	116	170	146	133	117	135	125	154	137	128	126	133	138	132
Lym (X10^9)	1.05	0.63	1.72	1.18	0.75	0.64	0.59	0.19	1.67	3.14	1.89	2.24	0.55	1.29	0.91	1.02
PLT (X10^9)	294	276	170	156	538	120	224	339	289	353	339	416	213	154	324	370
ARW (mm)	37	40	35	31	30	38	27	33	34	28	34	33	34	30	38	33
LA (mm)	35	37	30	33	38	37	36	36	39	51	37	36	39	38	37	36
LV (mm)	46	50	46	43	43	43	45	47	48	45	43	47	48	43	43	47
IVS (mm)	10	11	11	10	10	11	10	10	11	10	12	9	11	10	11	10
RA (mm)	39	38	34	36	33	34	37	44	30	31	41	44	30	34	33	43
RV (mm)	37	43	35	36	29	29	36	40	41	31	38	40	31	36	32	42
MPAW (mm)	28	26	22	22	21	25	29	29	26	21	26	25	26	29	28	30
LVEF (%)	65	66	66	60	65	63	62	57	65	68	68	57	65	65	63	57
LVDF	3	2	3	2	3	2	2	3	3	3	3	3	3	3	3	2
Length of stay (days)	34	61	30	42	42	43	50	21	8	19	12	15	14	12	10	17
Survival at discharge	No	Yes	No	No	No	No	No	No	No	No	No	No	No	No	No	No
Cause of death	CGS, MODS	Non	CGS, MODS	CGS	CGS, MODS	CGS, MODS	CGS	CGS, MODS	CGS	CGS	CGS	CGS	CGS	CGS	CGS	CGS

Abbreviations: BMI, Body mass index; T, Temperature; HR, Heart rate; SBP, Systolic blood pressure; DBP, Diastolic blood pressure; RR, Respiratory rate; PO2, Oxygen partial pressure; P/F, Oxygen partial pressure/Fraction of inhaled oxygen; Na, Sodium concentration; K, Potassium concentration; TBIL, Total bilirubin; Cr, Creatinine; Bun, Blood urea nitrogen; LDH, Lactate dehydrogenase; CPR, C reaction protein; Glu, Glucose; TP, Total protein; ALB, Albumin; pre-ALB, Pre albumin; Hct, Hematocrit; WBC, White blood cell; Hgb, Hemoglobin; Lym, lymphocyte; PLT, Platelet; T2DM, Type 2 diabetes mellitus; CHD, Chronic heart disease; CRF, Chronic renal failure; HTN, Hypertension; CGS, Cardiogenic shock; MODS, Multiple organ dysfunction syndrome; LA, Left atrium; LV, Left ventricular; IVS, Interventricular septum; RA, Right atrium; RV, Right ventricular; LVEF, Left ventricular ejection fraction; LVDF, Left ventricular diastolic function; MPAW, Main pulmonary artery width; ARW, Aortic root width.

Figure 1 Patients recruitment flow-chart.

Table 2 Time to Myocardial Injury and Hemodynamic Instability After Admission

Patient ID	Time to Myocardial Injury After Admission	Time from Myocardial Injury to Hemodynamic Instability	On Admission				When Hemodynamics Was Unstable
			hsTNT (ng/mL)	Myo (ng/mL)	CK-MB (ng/mL)	BNP (pg/mL)	hsTNT (ng/mL)	Myo (ng/mL)	CK-MB (ng/mL)	BNP (pg/mL)
1	7	14	11.4	37.4	5.1	120	135.9	210	12	432
2	6	13	6.1	166.3	0.8	18.6	75.1	34.9	2.8	150.1
3	12	11	3.8	41.5	0.8	98	3414.7	1016.9	32.7	171.3
4	25	9	19.5	147.4	0.9	140.4	59.9	346.4	3.5	102.1
5	3	9	29.3	47	5	33.6	76.2	92.8	18	171
6	16	22	6.1	59.6	2.3	41.7	336.8	34.2	1.6	195.6
7	16	37	16.6	99.1	1.2	98.7	1133	1200	25	464.9
8	4	4	7.5	37.8	0.4	27.5	45.3	37.8	0.4	427.5
9	5	25	4.4	26.6	0.2	98.5	553.2	1200	27.7	1826.6
10	5	40	18.8	38	0.2	29.3	70.3	162	0.7	300
11	18	6	6.1	290.4	1.6	229.7	200.2	1500	8	720.1
12	13	2	25	193	1.6	145	1958.4	1200+	18.4	420
13	26	5	13.7	95.5	0.6	152	69.8	62	1.2	187
14	3	6	8.2	59.1	0.6	30.4	10,759	1200+	6.4	2048.4
15	27	5	22.3	89.5	1.2	60.8	313	117	0.9	315
16	9	25	10.5	142.8	3.4	98	229.8	75.8	6.9	251.6

Abbreviations: hsTNT, High sensitivity troponin T; Myo, Myoglobin; CK-MB, Creatine kinase-MB; BNP, Brain natriuretic peptide.

Table 3 Parameters Monitored by PiCCO When Hemodynamics Was Unstable

Numbers	HR	pArt-M	CO	SVI	CI	GEF	dPmx	GEDI	SVRI	ELWI	PVPI
1	65	78	3.01	26	1.69	12	1716	1050	2976	17.2	2.2
2	74	85	3.67	28	1.06	17	1333	773	3067	13.6	2.4
3	66	84	4.01	34	2.25	16	1611	791	2782	16	2.7
4	74	85	3.67	28	2.06	17	1333	773	3067	13.6	2.4
5	90	76	6.83	43	3.9	20	1955	824	1403	19.7	3.5
6	79	66	5.69	40	3.19	30	1336	730	1516	9.5	1.8
7	106	93	7.1	38	3.98	30	2000	730	1766	9.5	1.8
8	115	86	7.41	36	4.15	22	1506	787	1552	15.6	2.8
9	82	64	7.62	49	4.09	16	1560	1362	1137	17.1	1.8
10	69	91	7.7	60	4.13	17	1183	1714	1659	21.2	1.9
11	124	76	6.09	27	3.41	22	1564	787	1659	15.6	2.8
12	61	98	8.36	46	4.49	20	1595	1357	1640	12.1	1.3
13	66	84	4.01	34	2.25	16	1611	791	2782	16	2.7
14	68	69	4.66	39	2.66	23	1928	756	1929	14.9	2.9
15	96	79	7.04	43	4.2	20	2204	894	1839	18.3	2.8
16	71	85	4.57	44	2.91	20	1997	729	2102	10.1	2.1

Abbreviations: HR, Heart rate; pArt-M, Mean artery pressure; CO, Cardiac output; SVI, Stroke volume index; CI, Cardiac index; GEF, General ejection fraction; dpmx, dp/dt maximum; GEDI, General end diastolic volume index; SVRI, Systemic vascular resistance index; ELWI, Extravascular lung water index; PVPI, Pulmonary vascular permeability index.

Table 4 The Arterial Blood Gas Analyses of Patients by GEM Premier 3500 at Hemodynamics Unstable

Patient Number	PH	PCO2 mmHg	PO2 mmHg	FIO2%	P/F mmHg	LAC mmol/L	HCT%	HCO3- mmol/L	BE Mmol/L	SO2%	THbc g/L	A-aDO2 mmHg	pAO2 mmHg	RI
1	7.43	38	86	50	172	1.3	32	25.2	0.8	97	128	218	308	2.4
2	7.46	46	112	65	173	1.3	37	22.7	5.9	98	115	270	372	2.6
3	7.49	35	67	45	149	1.8	35	26.7	3.4	95	78	210	277	3.1
4	7.52	45	64	41	156	1.6	34	36.7	3.8	94	105	178	239	2.9
5	7.32	56	131	80	164	2.6	29	28.9	2.8	99	118	365	499	2.7
6	7.36	53	106	70	151	3.9	29	29.9	4.5	98	119	331	434	3.2
7	7.46	43	73	50	146	3.5	37	30.6	6.1	95	115	233	304	3.3
8	7.55	37	81	45	180	2	31	22.4	5.4	97	96	194	275	2.4
9	7.55	39	85	45	189	2.1	31	24.1	6.8	98	96	187	272	2.2
10	7.5	48	131	50	262	2	37	27.4	4.2	99	115	170	298	1.3
11	7.49	44	98	50	196	1.2	29	23.5	5.2	98	90	204	302	2.1
12	7.53	39	80	70	114	1.9	34	22.6	4.9	97	105	374	452	4.8
13	7.44	37	104	60	173	1.8	29	25.1	0.9	98	120	278	382	2.7
14	7.4	46	151	55	274	1.2	33	28.5	3.7	99	71	170	302	1.3
15	7.4	46	137	50	274	1.2	33	28.5	3.7	99	71	170	302	1.3
16	7.42	30	177	65	273	1.8	34	19.5	−5	100	74	341	576	1.5

Abbreviations: PCO2, CO2 partial pressure; PO2, Oxygen partial pressure; FIO2, Fraction of inspired oxygen; P/F, Oxygen partial pressure/ Fraction of inspired oxygen; LAC, Lactic acid; HCT, Hematocrit; HCO3-, Bicarbonate ion; BE, Base excess; SO2, Oxygen saturation; THbc, Total hemoglobin concentration; A-aDO2, Alveolar arterial oxygen differential pressure; pAO2, Alveolar oxygen partial pressure; RI, Respiratory index.