Comparison between myocardial function assessed by echocardiography during hospitalization for COVID-19 and at 4 months follow-up

Abstract

In patients hospitalized for corona virus infectious disease 19 (COVID-19) it is currently unknown whether myocardial function changes after recovery and whether this is related to elevated cardiac biomarkers. In this single center, prospective cohort study we consecutively enrolled hospitalized COVID-19 patients between 1 April and 12 May 2020. All patients underwent transthoracic echocardiography (TTE) evaluation during hospitalization and at a median of 131 days (IQR; 116–136) follow-up. Of the 51 patients included at baseline, 40 (age: 62 years (IQR; 54–68), 78% male) were available for follow-up TTE. At baseline, 68% of the patients had a normal TTE, regarding left ventricular (LV) and right ventricular (RV) volumes and function, compared to 83% at follow-up (p = 0.07). Median LV ejection fraction (60% vs. 58%, p = 0.54) and tricuspid annular plane systolic excursion (23 vs 22 mm, p = 0.18) were comparable between hospitalization and follow-up, but a significantly lower RV diameter (39 vs. 34 mm, p = 0.002) and trend towards better global longitudinal strain (GLS) (− 18.5% vs − 19.1%, p = 0.07) was found at follow-up. Subgroup analysis showed no relation between patients with and without elevated TroponinT and/or NT-proBNP during hospitalization and myocardial function at follow-up. Although there were no significant differences in individual myocardial function parameters at 4 months follow-up compared to hospitalisation for COVID-19, there was an overall trend towards normalization in myocardial function, predominantly due to a higher rate of normal GLS at follow-up.

High Levels of Sedentary Time in Patients with COVID-19 after Hospitalisation

“…Post-hospitalised patients with COVID-19 were invited for a single visit to objectively assess their PA patterns (i.e., moderate-to-vigorous PA (MVPA), light-intensity PA (LIPA), sedentary time and sitting bouts) and sleep duration. The study was part of a larger trial assessing the long-term outcomes after COVID-19 hospitalisation [13,14]. COVID-19 diagnosis was confirmed by polymerase chain reaction (PCR) testing of a nasopharyngeal sample and/or a non-enhanced low-dose CT thorax.…”

Serial Left and Right Ventricular Strain Analysis in Patients Recovered from COVID-19

“…strain analysis, of individuals recovered from COVID-19 have emerged. [9][10][11][12][13][14][15] Most of these studies compare inpatient echocardiogram findings at the time of COVID-19 infection to echocardiograms obtained 1 to 4 months into recovery, with many suggesting residual subclinical cardiac dysfunction based on strain analysis. 9,[12][13][14] However, comparison to pre-COVID-19 cardiac status is imperative.…”

Myocardial function in COVID-19 patients after hospital discharge: a descriptive study comparing the first and second ‘wave’ patients

“…In our study, no differences in LV and RV function between first and second wave patients could be demonstrated, even though “first wave patients” were significantly more critically ill. Cardiac evaluation during hospitalization was not performed and potentially, cardiac dysfunction could be present during hospitalization and restored at time of out-patient follow-up. Van den Heuvel et al reported a trend towards normalization in myocardial function 4 months post-discharge in patients during the first wave [ 18 ]. They reported no relation between troponin T levels during hospitalization and cardiac function at 4 months follow-up.…”

“…Therefore, in the second wave, due to increased awareness and earlier presentation to the hospital, admitted patients were less severely affected in comparison to the first wave. Several studies have compared patient characteristics and clinical outcomes between the first and second wave, however few studies have compared cardiac sequelae of COVID-19 infection between these two waves [ 17 , 18 ].…”