ABSTRACT
BACKGROUND: This study aimed to investigate the cardiac manifestations of coronavirus disease 2019 (COVID-19). METHODS: From February to March 2020, we prospectively and retrospectively enrolled consecutive patients diagnosed with COVID-19. Patient's data such as the demographic characteristics, symptoms, vital signs, laboratory and radiologic findings, electrocardiographic, and echocardiographic data, including the global longitudinal strain (GLS) of both ventricles, were obtained. RESULTS: Forty patients (median age, 58 years; 50% men) were enrolled in the initial analysis. Patients were classified into severe and nonsevere groups based on the current guidelines. The 13 patients in the severe group were significantly older, had a greater prevalence of bilateral pneumonia and leukocytosis, and higher aspartate transaminase levels than patients in the nonsevere group. Patients in the severe group had a slightly lower left ventricular ejection fraction (LVEF) than those in the nonsevere group (median [interquartile range], 61.0% [58.5%, 62.3%] vs. 66.7% [60.6%, 69.8%], P = 0.015). In a subgroup of 34 patients in whom GLS could be analyzed, patients in the severe group had a significantly impaired left ventricular GLS (LVGLS) than those in the nonsevere group (-18.1% [-18.8%, -17.1%] vs. -21.7% [-22.9%, -19.9%], P = 0.001). There were no significant differences in total wall (RVGLStotal, -19.3% [-23.9%, -18.4%] vs. -24.3% [-26.0%, -22.6%], P = 0.060) and free wall (RVGLSfw, -22.7% [-27.2%, -18.6%] vs. -28.8% [-30.4%, -24.1%], P = 0.066) right ventricle GLS (RVGLS). CONCLUSION: Patients with severe COVID-19 had lower LVEF and LVGLS. RVGLS was not different between patients with severe and nonsevere COVID-19.
Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Heart Diseases/diagnosis , Heart Diseases/virology , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Adult , Aged , Betacoronavirus , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Echocardiography , Electrocardiography , Female , Heart/physiopathology , Heart Ventricles , Hospitalization , Humans , Male , Middle Aged , Observer Variation , Pandemics , Prospective Studies , Reproducibility of Results , Retrospective Studies , SARS-CoV-2 , Ventricular Dysfunction, Left/diagnosis , Ventricular Dysfunction, Left/virology , Ventricular Function, LeftABSTRACT
OBJECTIVES: The aim of this study was to elucidate patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clearance in the natural course of asymptomatic coronavirus disease 2019 (COVID-19). METHODS: Consecutive patients with non-severe COVID-19 were included retrospectively. Asymptomatic patients with a normal body temperature and no evidence of pneumonia throughout the disease course were assigned to the asymptomatic group. The reverse transcription PCR (RT-PCR) assay was repeated every two to five days after the first follow-up RT-PCR assay. Negative conversion was defined as two consecutive negative RT-PCR assay results within a 24-h interval. Rebound of the cycle threshold (Ct) value was defined as negative from the single RT-PCR assay and positive from the following assay. RESULTS: Among a total of 396 patients identified (median age 42.5 years (interquartile range (IQR) 25.0-55.0 years), 35.6% male), 68 (17.2%) were assigned to the asymptomatic group and 328 (82.8%) to the symptomatic group. The time until negative conversion was significantly shorter in the asymptomatic group than in the symptomatic group: median 14.5 days (IQR 11.0-21.0 days) and 18.0 days (IQR 15.0-22.0 days), respectively (p = 0.001). Rebound of Ct values was observed in 78 patients (19.7%). CONCLUSIONS: Time until negative conversion is shorter in asymptomatic COVID-19 than in symptomatic COVID-19. Rebound of Ct values is not uncommon.