ABSTRACT
Background Cardiac problems are frequent (20 to 25%) with COVID-19 and are associated with cardiac complications and in-hospital mortality. Existing research on the echocardiographic examination of COVID-19 focuses mostly on hospitalized patients with severe symptoms and in the acute phase of the disease, leaving out of the spotlight non-hospitalized individuals with mild symptoms. In this study, we wanted to determine the long-term influence of both severe and non-severe COVID-19 on echocardiographic changes. Methods This prospective cohort study was conducted during Iran's third COVID-19 wave in November 2020 among healthcare workers with a history of COVID-19 but otherwise healthy. Initially, a total of 100 patients underwent the primary echocardiographic examination 6 to 8 weeks following COVID-19 onset, and 6 months after the COVID-19 diagnosis, 64 subjects underwent the secondary echocardiographic evaluations. Based on clinical or radiological evidence, individuals were categorized into two groups of non-severe and severe COVID-19. Results Of 64 participants, 42 (65.6%) were women. The patients ' mean age was 40.4±8.1 years. In the non-severe COVID-19 group, among left ventricular (LV) echocardiographic indices, stroke volume index and ejection fraction increased significantly (24.7±4.1 cc/m2 vs. 29.7±7.0 cc/m2, p-value<0.001 and 61.9% [59.8-64.5] vs. 63.8% [58.2-68.9], p-value=0.029, respectively). Among right ventricular indices, free-wall global longitudinal strain decreased significantly in the secondary echocardiogram: (-32.3±4.6% vs. -28.8±5.8%, p-value=0.002). In the severe COVID-19 group, from LV echocardiographic indices, global longitudinal strain increased significantly over the follow-up period (-20% [-21.4- -19] vs. -23.9% [-25.3--21.9], p-value=0.004) and from RV indices, the fractional area change showed a significant decrease (47.2% [42.3-52.2] vs. 36.4% [31.1-45], p-value=0.002). Conclusion Although some patterns of significant change were seen among echocardiographic indices, COVID-19, regardless of severity, did not lead to cardiac impairment in an otherwise healthy population. The current results may not present the outcomes of older adults or with a history of cardiac problems against COVID-19.
Subject(s)
Cardiac Complexes, Premature , Ventricular Dysfunction, Left , COVID-19 , Stroke , Heart DiseasesABSTRACT
Background: Cardiovascular complications are frequently reported among patients with pulmonary coronavirus disease 2019 (COVID-19) infection. Echocardiography has been immensely implemented for diagnosing cardiovascular involvements. We aimed to evaluate the changes in echocardiographic parameters in health care workers infected with COVID-19 during follow-up. Methods: This prospective study was conducted during Iran’s third COVID-19 wave in November 2020 among health care workers who were infected with COVID-19 but otherwise healthy. A total of 100 patients underwent echocardiographic examination six to eight weeks following recovery, an early follow-up. Six months after the COVID-19 diagnosis, as the late follow-up, 63 subjects underwent echocardiographic evaluations. Moreover, based on clinical and radiological evidence, individuals were categorized into two groups of non-severe and severe COVID-19. Results: The participants’ mean age was 40.4±8.1 years. In the non-severe COVID-19 group, Right Ventricle Free-Wall Global Longitudinal Strain (RVFWGLS) significantly decreased in the follow-up echocardiogram (-32.3±4.6% vs. -28.8±5.8%, p-value=0.002). RV Fraction Area Change (RV-FAC) (46.6% [43.6-53] vs. 39.7% [25-43] , p-value <0.001) and, Tricuspid Annular Plane Systolic Excursion (TAPSE) (21 mm [19-24] vs. 23 mm [20-25], p-value=0.09) did not show a significant change. In the severe COVID-19 group in late echocardiogram, RVFWGLS showed no statistically significant change (-28.3%±3.5 vs. -28.6%±5.1, p-value=0.79). The RV-FAC (47.2% [42.3-52.2] vs. 36.4% [31.1-45], p-value=0.002) showed a significant decrease, and TAPSE (22.5 mm [19.1-24.2] vs. 23 mm [21-25], p-value= 0.55) was comparable. Conclusion: Although LV and RV functions did not vary significantly over time in our entire cohort, different patterns of changes were discovered according to baseline function.