Comparison of the hemodynamics of shock in the first versus the second wave of the covid pandemic

Background: Our group has characterized hemodynamic profiles of patients with COVID-19 and shock using echocardiography in the first wave of the pandemic (W1), from 3/20-8/20. A substantial proportion of patients (43%) had preserved ejection fraction (EF) but low cardiac index (CI). This report compares the distribution of patients in these hemodynamic profiles in the second wave (W2), from 9/20-3/21. Methods: In 327 patients with COVID-19 and shock requiring vasopressors who had an echocardiogram, EF was measured using Simpson’s rule and SV by Doppler. Patients were characterized by EF and CI (SV×HR/BSA) and divided into groups with normal or low values using the cutoffs: EF 45%, CI 2.2 L/min/m 2 . Results: There were 155 patients in W1 and 172 in W2. 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% and 83% in W1 and W2 respectively (p=0.07).