Subclinical LV and RV Dysfunction in Patients Recovered From COVID-19

Abstract

Cardiac injury is reported acutely in hospitalised COVID-19 patients, however sustained impairment in recovered patients is unclear. We evaluated cardiac involvement in patients who had recovered from acute COVID-19 infection but had ongoing symptoms, using echocardiography (TTE). Forty-two patients with recovered COVID-19 were followed up at a median time from infection of 112 [109] days and were compared to age and gender-matched healthy controls. Traditional TTE parameters left ventricular (LV), 2D global longitudinal strain (GLS), and right ventricular (RV) free wall strain were measured. Among COVID patients, 10 (23.8%) were hypertensive, 6 (14.3%) diabetic, 2 (4.8%) had atrial fibrillation and 1 (2.4%) a history of IHD. LV wall thickness was significantly higher in the COVID-19 group (Table). LV volumes and LVEF were similar to controls; however, LV GLS was significantly worse in the COVID-19 cohort (p=0.002, Table). Similarly, RV volumes and traditional function parameters (FAC, TAPSE, S’ velocity) were similar, but RV free wall strain (RVFWS, p=0.009) and RV global strain (p=0.015) were reduced. On univariant analysis, COVID-19 infection, sex, admission to ICU, LV volume and mass and RV area were associated with LV GLS. On multivariant analysis, COVID-19 infection was the only independent determinant of LV GLS (β=0.269, p=0.008). Prior COVID-19 infection was the only independent determinant of reduced LV GLS, suggesting persisting subclinical cardiac injury even in recovered patients with ongoing symptoms.Tabled 1ParametersControlsCOVID-19p valuePW ED (mm)8.12±1.648.76±1.560.029IVS ED (mm)8.17±1.829.17±1.890.002LVEDVI (ml/m2)47.10±10.8946.70±17.280.867LVESVI (ml/m2)19.25±5.1418.91±9.210.782LVEF (%)59.40±5.2760.19±5.430.427LV GLS (%)-19.86±1.90-18.33±2.430.002TAPSE (mm)22.41±3.7721.48±4.650.300RVS' (cm/s)11.51±1.6011.93±2.090.359RV FAC (%)40.81±6.7039.79±7.980.352RVFWS (%)-27.32±4.56-24.05±5.890.009 Open table in a new tab