Association of Higher Body Mass Index and Diastolic Dysfunction in Patients Non-Hospitalized with COVID-19: A Post-COVID-19 Echocardiography Study

Abstract

Background: The studies reported an association between body mass index (BMI) and diastolic function in metabolically healthy individuals. The relationship between the BMI and diastolic dysfunction (DD) of those who are metabolically healthy who recovered from COVID-19 without hospitalization and who have effort dyspnea has not been adequately studied yet. In this study, we aimed to characterize the association between BMI and diastolic function in an uncomplicated group with preserved ejection fraction. Materials and Methods: The study included 50 (17 males and 33 females) patients (PG) and 50 (20 males and 30 females) healthy control subjects (CG). Transthoracic echocardiogram was performed in all patients. Results: There was no significant difference between the groups in terms of age (p=0.101), gender (p=0.534), and BMI (p=0.070). C-reactive protein (CRP) (p=0.005) and D-dimer (p=0.009) were significantly higher in the PG. Grade 1 DD was significantly higher in PG (p<0.001). When controlling for the effect of age in the PG, a significant negative correlation was found between BMI and E/A ratio (r=-0.452; p=0.001), while this significance was not detected in the CG (r=0.122; p=0.404). The area under the ROC curve of BMI for the detection of DD was 0.806 (p<0.001; 95% CI (0.716-0.896)). The optimal cut-off score for BMI was 28.91, and its sensitivity and specificity for the diagnosis of DD were 39.3% and 93.1%, respectively. According to the binary logistic regression analysis, the sensitivity of BMI related to the diagnosis of DD was 50.0% and the specificity was 88.9%. Conclusions: These early abnormalities in cardiac function may have important implications for explaining the DD that is associated with increased cardiopulmonary morbidity caused by higher BMI.