Echocardiographic Assessment in Patients Recovered from Acute COVID-19 Illness
Coronavirus (COVID-19) infections have spread rapidly worldwide and posed an immense public health problem. COVID-19 infection can affect the cardiovascular system both acutely and in patients followed up some period after COVID-19 infection. The aim of this study was to evaluate left ventricular (L...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/10/8/349 |
| _version_ | 1827729579227217920 |
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| author | Luke Stefani Paula Brown Monica Gerges Peter Emerson Aaisha Ferkh Kristina Kairaitis Nicole Gilroy Mikhail Altman Liza Thomas |
| author_facet | Luke Stefani Paula Brown Monica Gerges Peter Emerson Aaisha Ferkh Kristina Kairaitis Nicole Gilroy Mikhail Altman Liza Thomas |
| author_sort | Luke Stefani |
| collection | DOAJ |
| description | Coronavirus (COVID-19) infections have spread rapidly worldwide and posed an immense public health problem. COVID-19 infection can affect the cardiovascular system both acutely and in patients followed up some period after COVID-19 infection. The aim of this study was to evaluate left ventricular (LV) and right ventricular (RV) function by echocardiography in COVID-19 recovered patients (hospitalized and non-hospitalized). Forty-two patients who recovered from COVID-19 but had ongoing symptoms were included in this retrospective observational cross-sectional study. Patients were followed-up at a median time of 112 days from confirmed COVID-19 diagnosis and a comprehensive echocardiogram was performed. COVID-19 patients were age- and sex-matched to healthy controls. Traditional TTE parameters and advanced echocardiographic parameters including two-dimensional LV global longitudinal strain (GLS) and RV free wall strain (FWS) were measured. LV volumes and LV ejection fraction were similar in COVID-19 patients and controls; however, LV GLS was significantly worse in the COVID-19 group (<i>p</i> = 0.002). Similarly, RV volumes and traditional RV function parameters were similar, but RV FWS (<i>p</i> = 0.009) and RV global strain (<i>p</i> = 0.015) were reduced. Alterations in LV and RV strain were observed in both hospitalized and non-hospitalized patients. In the subset of COVID-19 patients without any co-morbidities (<i>n</i> = 30), LV GLS remained reduced compared to controls. According to multivariate analysis, COVID-19 infection was the only independent determinant of reduced LV GLS (<i>p</i> = 0.012), while COVID-19 infection, diastolic blood pressure, and RV fractional area change were determinants of RV FWS. In this observational study, prior COVID-19 infection demonstrated LV dysfunction in patients with persistent symptoms. Abnormal LV strain was evident in both hospitalized and non-hospitalized patients, suggesting that these changes are independent of the severity of COVID-19 infection at presentation. The use of LV GLS in COVID-19 patients could have potential clinical utility to support the indication for cardiac magnetic resonance imaging in patients with possible COVID-19 related myocarditis. Future longitudinal studies are needed to evaluate its correlation with adverse cardiovascular events. |
| first_indexed | 2024-03-10T23:51:40Z |
| format | Article |
| id | doaj.art-a84001ebc96b4db5a927051f79d975e4 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-10T23:51:40Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-a84001ebc96b4db5a927051f79d975e42023-11-19T01:38:30ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-08-0110834910.3390/jcdd10080349Echocardiographic Assessment in Patients Recovered from Acute COVID-19 IllnessLuke Stefani0Paula Brown1Monica Gerges2Peter Emerson3Aaisha Ferkh4Kristina Kairaitis5Nicole Gilroy6Mikhail Altman7Liza Thomas8Westmead Clinical School, Westmead Hospital, University of Sydney, Westmead 2145, AustraliaCardiology Department, Westmead Hospital, Westmead 2145, AustraliaCardiology Department, Westmead Hospital, Westmead 2145, AustraliaWestmead Clinical School, Westmead Hospital, University of Sydney, Westmead 2145, AustraliaWestmead Clinical School, Westmead Hospital, University of Sydney, Westmead 2145, AustraliaWestmead Clinical School, Westmead Hospital, University of Sydney, Westmead 2145, AustraliaWestmead Clinical School, Westmead Hospital, University of Sydney, Westmead 2145, AustraliaWestmead Clinical School, Westmead Hospital, University of Sydney, Westmead 2145, AustraliaWestmead Clinical School, Westmead Hospital, University of Sydney, Westmead 2145, AustraliaCoronavirus (COVID-19) infections have spread rapidly worldwide and posed an immense public health problem. COVID-19 infection can affect the cardiovascular system both acutely and in patients followed up some period after COVID-19 infection. The aim of this study was to evaluate left ventricular (LV) and right ventricular (RV) function by echocardiography in COVID-19 recovered patients (hospitalized and non-hospitalized). Forty-two patients who recovered from COVID-19 but had ongoing symptoms were included in this retrospective observational cross-sectional study. Patients were followed-up at a median time of 112 days from confirmed COVID-19 diagnosis and a comprehensive echocardiogram was performed. COVID-19 patients were age- and sex-matched to healthy controls. Traditional TTE parameters and advanced echocardiographic parameters including two-dimensional LV global longitudinal strain (GLS) and RV free wall strain (FWS) were measured. LV volumes and LV ejection fraction were similar in COVID-19 patients and controls; however, LV GLS was significantly worse in the COVID-19 group (<i>p</i> = 0.002). Similarly, RV volumes and traditional RV function parameters were similar, but RV FWS (<i>p</i> = 0.009) and RV global strain (<i>p</i> = 0.015) were reduced. Alterations in LV and RV strain were observed in both hospitalized and non-hospitalized patients. In the subset of COVID-19 patients without any co-morbidities (<i>n</i> = 30), LV GLS remained reduced compared to controls. According to multivariate analysis, COVID-19 infection was the only independent determinant of reduced LV GLS (<i>p</i> = 0.012), while COVID-19 infection, diastolic blood pressure, and RV fractional area change were determinants of RV FWS. In this observational study, prior COVID-19 infection demonstrated LV dysfunction in patients with persistent symptoms. Abnormal LV strain was evident in both hospitalized and non-hospitalized patients, suggesting that these changes are independent of the severity of COVID-19 infection at presentation. The use of LV GLS in COVID-19 patients could have potential clinical utility to support the indication for cardiac magnetic resonance imaging in patients with possible COVID-19 related myocarditis. Future longitudinal studies are needed to evaluate its correlation with adverse cardiovascular events.https://www.mdpi.com/2308-3425/10/8/349COVID-19echocardiographyGLSRV free wall strain |
| spellingShingle | Luke Stefani Paula Brown Monica Gerges Peter Emerson Aaisha Ferkh Kristina Kairaitis Nicole Gilroy Mikhail Altman Liza Thomas Echocardiographic Assessment in Patients Recovered from Acute COVID-19 Illness Journal of Cardiovascular Development and Disease COVID-19 echocardiography GLS RV free wall strain |
| title | Echocardiographic Assessment in Patients Recovered from Acute COVID-19 Illness |
| title_full | Echocardiographic Assessment in Patients Recovered from Acute COVID-19 Illness |
| title_fullStr | Echocardiographic Assessment in Patients Recovered from Acute COVID-19 Illness |
| title_full_unstemmed | Echocardiographic Assessment in Patients Recovered from Acute COVID-19 Illness |
| title_short | Echocardiographic Assessment in Patients Recovered from Acute COVID-19 Illness |
| title_sort | echocardiographic assessment in patients recovered from acute covid 19 illness |
| topic | COVID-19 echocardiography GLS RV free wall strain |
| url | https://www.mdpi.com/2308-3425/10/8/349 |
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