Abstract
The COVID-19 infection, which is caused by the novel coronavirus SARS-CoV-2, has rapidly emerged as a global public health issue. Cardiac complications secondary to this infection are common and associated with mortality. This study aimed to evaluate whether subclinical myocardial dysfunction exists in non-hospitalized mildly symptomatic COVID-19 patients using left ventricular global longitudinal strain (LVGLS). In this cross-sectional, single-center study, data were collected from non-hospitalized mildly symptomatic COVID-19 patients between January 01 and February 01, 2021. Fifty (26 male, 24 female) COVID-19 patients and 50 age- and sex-matched healthy volunteers were included in the study. Apical four-, three-, and two-chamber images were analyzed longitudinally by conventional methods and speckle tracking echocardiography (STE) for left ventricle functions. The mean age of the COVID-19 patients was 39.5 ± 8.96, and 52% of them were male. The most prevalent presenting symptoms were fever [in 34 (68%)], asthenia [in 30 (60%)], loss of appetite [in 21 (42%)], myalgia [in 20 (40%)], and cough [in 13 (26%)]. Plasma levels of C-reactive protein (CRP) were significantly higher in the COVID-19 patients than in the controls (10.84 ± 12.44 vs. 4.50 ± 2.81, p < 0.001). There was no significant difference between the groups in terms of standard echocardiography and Doppler parameters (p > 0.05). Left ventricular longitudinal strain and strain velocity parameters were significantly decreased in COVID-19 patients compared to healthy individuals. LV-GLS values (− 21.72 ± 3.85% vs. − 23.11 ± 4.16%; p = 0.003) were significantly lower in COVID-19 patients compared with the healthy controls. Mildly symptomatic COVID-19 patients also have subclinical myocardial dysfunction similar to hospitalized patients. STE has the potential for detecting subclinical LV systolic dysfunction, and can provide useful information regarding cardiac status in mildly symptomatic COVID-19 population.
Highlights
MethodsThe COVID-19 infection, which is caused by the novel coronavirus SARS-CoV-2, has rapidly emerged as a global public health issue
The diagnosis of COVID-19 was confirmed by real-time polymerase chain reaction (RT-PCR) testing of nasopharyngeal samples
Our study revealed that: (i) left ventricular longitudinal systolic strain and strain rate parameters were significantly reduced in patients with COVID-19 compared to healthy controls; (ii) C-reactive protein (CRP) levels were higher in the COVID-19 group compared to the controls; (iii) conventional echocardiography parameters were similar between COVID-19 and healthy
Summary
MethodsThe COVID-19 infection, which is caused by the novel coronavirus SARS-CoV-2, has rapidly emerged as a global public health issue. As of January 5, 2021, infected patients were present in 222 countries, and there were > 84 million confirmed cases, with more than 1.8 million fatalities [1]. The clinical spectrum of COVID-19 ranges from an asymptomatic form to severe acute respiratory syndrome and even death [2, 3]. The proportion of patients who remained asymptomatic throughout the infection was approximately 20% of all confirmed cases [4]. 80% of symptomatic patients have experienced a mild clinical course, defined as dry cough, sore throat, low-grade fever, or malaise [5]. The clinical manifestations are mainly respiratory, numerous studies have reported that cardiac complications are common (20–25%) and associated with mortality [6, 7]
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