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Cardiac Involvement in Recovered Patients From COVID-19: A Preliminary 6-Month Follow-Up Study.
Wu, Xiaoyan; Deng, Ke-Qiong; Li, Chenze; Yang, Zhaoxia; Hu, Huijuan; Cai, Huanhuan; Zhang, Chao; He, Tao; Zheng, Fang; Wang, Hairong; Zhang, Xin A; Caillon, Antoine; Yuan, Yufeng; Wang, Xinghuan; Xu, Haibo; Lu, Zhibing.
  • Wu X; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Deng KQ; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Li C; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Yang Z; Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Hu H; Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Cai H; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Zhang C; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • He T; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Zheng F; Department of Clinical Laboratory, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Wang H; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Zhang XA; University of Oklahoma Health Science Center, Oklahoma City, OK, United States.
  • Caillon A; Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada.
  • Yuan Y; Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Wang X; Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Xu H; Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Lu Z; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Front Cardiovasc Med ; 8: 654405, 2021.
Article in English | MEDLINE | ID: covidwho-1247849
Semantic information from SemMedBD (by NLM)
1. Cardiac involvement PROCESS_OF Patients
Subject
Cardiac involvement
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PROCESS_OF
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Patients
2. COVID-19 PROCESS_OF Patients
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3. Heart LOCATION_OF Magnetic Resonance Imaging
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Heart
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4. Heart Injuries PROCESS_OF Patients
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Heart Injuries
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5. Cardiac fibrosis PROCESS_OF Patients
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Cardiac fibrosis
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8. Heart LOCATION_OF Magnetic Resonance Imaging
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Heart
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9. Heart Injuries PROCESS_OF Patients
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10. Cardiac fibrosis PROCESS_OF Patients
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ABSTRACT

Background:

Accumulating evidence has revealed that coronavirus disease 2019 (COVID-19) patients may be complicated with myocardial injury during hospitalization. However, data regarding persistent cardiac involvement in patients who recovered from COVID-19 are limited. Our goal is to further explore the sustained impact of COVID-19 during follow-up, focusing on the cardiac involvement in the recovered patients.

Methods:

In this prospective observational follow-up study, we enrolled a total of 40 COVID-19 patients (20 with and 20 without cardiac injury during hospitalization) who were discharged from Zhongnan Hospital of Wuhan University for more than 6 months, and 27 patients (13 with and 14 without cardiac injury during hospitalization) were finally included in the analysis. Clinical information including self-reported symptoms, medications, laboratory findings, Short Form 36-item scores, 6-min walk test, clinical events, electrocardiogram assessment, echocardiography measurement, and cardiac magnetic resonance imaging was collected and analyzed.

Results:

Among 27 patients finally included, none of patients reported any obvious cardiopulmonary symptoms at the 6-month follow-up. There were no statistically significant differences in terms of the quality of life and exercise capacity between the patients with and without cardiac injury. No significant abnormalities were detected in electrocardiogram manifestations in both groups, except for nonspecific ST-T changes, premature beats, sinus tachycardia/bradycardia, PR interval prolongation, and bundle-branch block. All patients showed normal cardiac structure and function, without any statistical differences between patients with and without cardiac injury by echocardiography. Compared with patients without cardiac injury, patients with cardiac injury exhibited a significantly higher positive proportion in late gadolinium enhancement sequences [7/13 (53.8%) vs. 1/14 (7.1%), p = 0.013], accompanied by the elevation of circulating ST2 level [median (interquartile range) = 16.6 (12.1, 22.5) vs. 12.5 (9.5, 16.7); p = 0.044]. Patients with cardiac injury presented higher levels of aspartate aminotransferase, creatinine, high-sensitivity troponin I, lactate dehydrogenase, and N-terminal pro-B-type natriuretic peptide than those without cardiac injury, although these indexes were within the normal range for all recovered patients at the 6-month follow-up. Among patients with cardiac injury, patients with positive late gadolinium enhancement presented higher cardiac biomarker (high-sensitivity troponin I) and inflammatory factor (high-sensitivity C-reactive protein) on admission than the late gadolinium enhancement-negative subgroup.

Conclusions:

Our preliminary 6-month follow-up study with a limited number of patients revealed persistent cardiac involvement in 29.6% (8/27) of recovered patients from COVID-19 after discharge. Patients with cardiac injury during hospitalization were more prone to develop cardiac fibrosis during their recovery. Among patients with cardiac injury, those with relatively higher cardiac biomarkers and inflammatory factors on admission appeared more likely to have cardiac involvement in the convalescence phase.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Randomized controlled trials Topics: Long Covid Language: English Journal: Front Cardiovasc Med Year: 2021 Document Type: Article Affiliation country: Fcvm.2021.654405

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Randomized controlled trials Topics: Long Covid Language: English Journal: Front Cardiovasc Med Year: 2021 Document Type: Article Affiliation country: Fcvm.2021.654405