Abstract

Abstract Background and Aims COVID-19 is associated with myocardial injury and in previous studies, patients with right ventricular dysfunction had an increased risk of all-cause death. In the general population, there is evidence that right ventricular strain improves at 6 months after COVID-19, but data about the course of other myocardial performance parameters are limited. Method CARDIO-SCARS in CKD is a currently ongoing observational cohort study that aims to assess the cardiovascular risk in a CKD (stages 3 to 5), dialysis and kidney transplant population following SARS-CoV2 infection, by using clinical evaluation, various techniques and both endothelial dysfunction and myocardial injury biomarkers (ClinicalTrial.gov Identifier NCT05125913). We hereby report the evolution of the main echocardiographic myocardial performance parameters at 6 months from COVID-19 disease. Results Our study included 222 patients (134 in the COVID-19 group and 88 in the control group). In the COVID-19 group, the echocardiography was performed at a mean distance of 2.21±1.9 months after testing positive for SARS-CoV-2. The mean age at baseline was 58.81±15.2 years and 53.41±14.14 years for the COVID-19 group and control group respectively. Atrial fibrillation, heart failure, ischemic heart disease and diabetes were more prevalent in the COVID-19 group. When analyzing the mean absolute difference between baseline and 6 months echocardiographic parameters using a two-sample t-Test, statistically significant results were observed for the left ventricular (LV) ejection fraction (EF), LV Tei Index, right ventricular (RV) Tei Index and RV free wall longitudinal strain (RVFWLS) as follows: Δ LVEF was 0.70±7.97% and -2.44±7.30% (p = 0.005), ΔLV Tei index was -0.04±0.19 and 0.0007± 0.11 (p = 0.024), Δ RV Tei index was -0.04±0.17 and 0.009±0.20 (p = 0.034) and ΔRVFWLS was -1.68±4.36% and -0.32±3.34% (p = 0.039) for the COVID-19 group and the control group respectively. Conclusion Our study is the first to describe the evolution of echocardiographic parameters post-COVID in a CKD population. Despite worse demographic and echocardiographic characteristics at baseline, patients from the COVID-19 group had a better evolution at 6 months, when compared to the control group. Both right and left ventricular myocardial performance indices improved for the COVID-19 patients and worsened for the control group.

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