Recovery of cardiac function following COVID‐19 – ECHOVID‐19: a prospective longitudinal cohort study. (17th October 2021)

• Record Type: Journal Article
• Authors: Lassen, Mats C.H.; Skaarup, Kristoffer Grundtvig; Lind, Jannie N.; Alhakak, Alia S.; Sengeløv, Morten; Nielsen, Anne B.; Simonsen, Jakob Ø.; Johansen, Niklas D.; Davidovski, Filip S.; Christensen, Jacob; Bundgaard, Henning; Hassager, Christian; Jabbari, Reza; Carlsen, Jørn; Kirk, Ole; Lindholm, Matias G.; Kristiansen, Ole P.; Nielsen, Olav W.; Ulrik, Charlotte S.; Sivapalan, Pradeesh; Gislason, Gunnar; Møgelvang, Rasmus; Jensen, Gorm B.; Schnohr, Peter; Søgaard, Peter; Solomon, Scott D.; Iversen, Kasper; Jensen, Jens U.S.; Schou, Morten; Biering‐Sørensen, Tor
• Is Part Of: European journal of heart failure. Volume 23:Number 11(2021)
• Page Start: 1903
• Page End: 1912
• Publication Date: 2021-10-17
• Subjects: COVID‐19 -- Recovery following COVID‐19 -- Follow‐up -- Strain echocardiography; Heart failure -- Periodicals; Heart Failure -- Periodicals; Insuffisance cardiaque -- Périodiques; Heart failure; Periodicals; 616.129005
• DOI: 10.1002/ejhf.2347
• Languages: English
• ISSNs: 1388-9842

Abstract

Abstract: Aims: The degree of cardiovascular sequelae following COVID‐19 remains unknown. The aim of this study was to investigate whether cardiac function recovers following COVID‐19. Methods and results: A consecutive sample of patients hospitalized with COVID‐19 was prospectively included in this longitudinal study. All patients underwent an echocardiographic examination during hospitalization and 2 months later. All participants were successfully matched 1:1 with COVID‐19‐free controls by age and sex. A total of 91 patients were included (mean age 63 ± 12 years, 59% male). A median of 77 days (interquartile range: 72–92) passed between the two examinations. Right ventricular (RV) function improved following resolution of COVID‐19: tricuspid annular plane systolic excursion (TAPSE) (2.28 ± 0.40 cm vs. 2.11 ± 0.38 cm, P < 0.001) and RV longitudinal strain (RVLS) (25.3 ± 5.5% vs. 19.9 ± 5.8%, P < 0.001). In contrast, left ventricular (LV) systolic function assessed by global longitudinal strain (GLS) did not significantly improve (17.4 ± 2.9% vs. 17.6 ± 3.3%, P = 0.6). N‐terminal pro‐B‐type natriuretic peptide decreased between the two examinations [177.6 (80.3–408.0) ng/L vs. 11.7 (5.7–24.0) ng/L, P < 0.001]. None of the participants had elevated troponins at follow‐up compared to 18 (27.7%) during hospitalization. Recovered COVID‐19 patients had significantly lower GLS (17.4 ± 2.9% vs. 18.8 ± 2.9%, P < 0.001 and adjusted P = 0.004), TAPSE (2.28 ± 0.40 cm vs. 2.67 ± 0.44 cm, P < 0.001 and adjusted P < 0.001), and RVLS (25.3 ± 5.5% vs. 26.6 ± 5.8%, P = 0.50 and adjusted P < 0.001) compared to matched controls. Conclusion: Acute COVID‐19 affected negatively RV function and cardiac biomarkers but recovered following resolution of COVID‐19. In contrast, the observed reduced LV function during acute COVID‐19 did not improve post‐COVID‐19. Compared to the matched controls, both LV and RV function remained impaired. Abstract : Recovered COVID‐19 cases who participated in both rounds of the study. ( Left ) Diagram displaying mean N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) and prevalence of elevated troponins during hospitalization and 2–3 months after. ( Right ) Diagram displaying mean values of tricuspid annular plane systolic excursion (TAPSE), right ventricular longitudinal strain (RVLS), global longitudinal strain (GLS), and left ventricular ejection fraction (LVEF) assessed during hospitalization and median 77 days (interquartile range: 72–92) after. Additionally, reference values based on matched controls are illustrated as well. Dotted lines indicate 95% confidence intervals.