New Report Published Compares Hemodynamics of Cardiac Shock in COVID19 Patients   
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New Report Published Compares Hemodynamics of Cardiac Shock in COVID19 Patients

What You Need to Know

A new report by cardiologists from the Heart & Vascular Hospital at Hackensack University Medical Center that compares the hemodynamics of cardiac shock in patients with COVID-19 during the first versus the second wave of the COVID-19 pandemic was published in JACC: Journal of the American College of Cardiology.1

During the first wave of the pandemic, a substantial proportion of patients with COVID-19 -- 43 percent  -- had shock and a low cardiac output but with a preserved ejection fraction suggesting underfilling of the left ventricle.

The proportion of these patients was smaller in the second phase of the pandemic – 29 percent.

The Hackensack Meridian cardiologists characterized the hemodynamic profiles of patients with COVID-19 and shock, using echocardiography in the first wave of the pandemic; March 2020 to August 2020. 

The report compares the distribution of patients using these hemodynamic profiles determined echocardiographically to the second wave of the pandemic; September 2020 to March 2021.

Study Methods

In 327 patients with COVID-19 and cardiac shock requiring vasopressors who had an echocardiogram, ejection fraction and stroke volume were measured.


There were 155 patients in wave one and 172 in wave two. Mean age: 66.9±12.6 vs 63.9±12.9, EF 59.9±12.8 vs 56.4±9.3; CI 2.4±0.9 vs 2.7±0.9, all p=NS. Hospital mortality was 77 percent and 83 percent in wave one and wave two respectively (p=0.07). A smaller proportion of patients in wave two with a preserved EF had a low CI (45/153, 29%) than in wave one (55/128, 43%) (p=0.03). Mean PEEP did not differ in the preserved EF low CI group between W1 and W2 (11.3 vs 11.6 cmH2O, p=0.8).  This result suggests that fluid therapy may have been more aggressive in wave 2 than wave 1 resulting in higher cardiac output.

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