Abstract 15841: Echocardiographic Parameters Are Correlated With Initial Infection Severity in Long-Term Post Covid-19 Patients

Abstract

Introduction: COVID-19 acutely affects the cardiovascular system leading to various cardiac complications. Major concerns are on the less understood long-term cardiovascular consequences of COVID-19. Hypothesis: Post COVID-19 cardiac dysfunctions could be long lasting and vary by severity of initial infection. Methods: This is an on-going prospective observational study from a multidisciplinary Post COVID-19 Research Clinic. Inclusion criteria included both RT-PCR confirmed and recovered COVID-19 patients and control subjects. After IRB approval and informed consents, 83 participants received serial transthoracic echocardiography at 3, 6 or >12 months after initial infection. Pearson’s correlation coefficients, Fisher's exact test and one-way ANOVA was conducted to examine the association between variables, across follow-up time and severity of initial infection. Results: Proximal RVOT diastolic diameter was significantly larger at >12 months’ compared to earlier time points post COVID-19 (2.92±0.55 cm at 3 months, 2.81±0.57 cm at 6 months and 3.15±0.52 cm at >12 months). The posterior wall was significantly thicker in post COVID-19 patients with moderate or severe infection compared to patients with mild infection. The left atrium diameter was significantly larger as the initial infection severity increased. Pulmonary artery acceleration time was significantly shorter as initial infection severity increased indicating higher pulmonary arterial pressure although no significant relationship was found with follow-up time. There were no left ventricular ejection fraction, E/E’ (index of diastolic function) or valvular abnormality differences by either follow-up time or severity. Furthermore, 77% patients with severe infection had grade 1 diastolic dysfunction compared to mild (28.57%) or moderate (33.33%) patients. Conclusions: Long-term echocardiographic follow-up showed increased RV size after COVID-19 over time. Posterior wall thickness, left atrium size and pulmonary artery acceleration time, and diastolic dysfunction were correlated with initial infection severity in long-term post COVID-19 patients suggestive of possible structural changes in recovered patients from COVID-19.