Normalized Cardiac Structure and Function in COVID-19 Survivors Late After Recovery

Gao, Yiping; Zhou, Wei; Huang, Pei-Na; Liu, Hongyun; Bi, Xiaojun; Zhu, Ying; Sun, Jie; Tang, Qinghua; Li, Li; Zhang, Jun; Sun, Ruiying; Cheng, Xingwang; Liu, Yani; Deng, Yansha

doi:10.3389/fcvm.2021.756790

Cited by 8 publications

(25 citation statements)

References 33 publications

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“…We and others have found a normal LV function in the first few months after hospitalization 15–17,28 . Gao et al found no structural or functional cardiac pathology 12 months after COVID‐19 compared to matched controls 29 . In the current study, we found no significant changes in any of the echocardiographic parameters from 3 to 12 months, and the proportion of patients with LV and RV dysfunction was similar at both visits.…”

Section: Discussionsupporting

confidence: 47%

“…[15][16][17]28 Gao et al found no structural or functional cardiac pathology 12 months after COVID-19 compared to matched controls. 29 In the current study, we found no significant changes in any of the echocardiographic parameters from 3 to 12 months, and the proportion of patients with LV and RV dysfunction was similar at both visits. Although we did not have pre-COVID echocardiographic data on the participants, these findings suggest that there is limited long-term cardiac remodeling and progressive dysfunction after hospitalization for COVID-19, and that cardiac recovery from the acute disease predominantly occurs within the first 3 months.…”

Section: Discussionmentioning

confidence: 90%

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Changes in cardiac structure and function from 3 to 12 months after hospitalization for COVID‐19

Øvrebotten

Myhre

Grimsmo³

et al. 2022

Clinical Cardiology

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Background Cardiac function may be impaired during and early after hospitalization for COVID‐19, but little is known about the progression of cardiac dysfunction and the association with postacute COVID syndrome (PACS). Methods In a multicenter prospective cohort study, patients who had been hospitalized with COVID‐19 were enrolled and comprehensive echocardiography was performed 3 and 12 months after discharge. Twenty‐four‐hour electrocardiogram (ECG) was performed at 3 and 12 months in patients with arrhythmias at 3 months. Results In total, 182 participants attended the 3 and 12 months visits (age 58 ± 14 years, 59% male, body mass index 28.2 ± 4.2 kg/m 2 ). Of these, 35 (20%) had severe COVID‐19 (treatment in the intensive care unit) and 74 (52%) had self‐reported dyspnea at 3 months. From 3 to 12 months there were no significant overall changes in any measures of left or right ventricle (LV; RV) structure and function ( p > .05 for all), including RV strain (from 26.2 ± 3.9% to 26.5 ± 3.1%, p = .29) and LV global longitudinal strain (from 19.2 ± 2.3% to 19.3 ± 2.3%, p = .64). Changes in echocardiographic parameters from 3 to 12 months did not differ by COVID‐19 severity or by the presence of persistent dyspnea ( p > .05 for all). Among patients with arrhythmia at 3 months, there was no significant change in arrhythmia burden to 12 months. Conclusion Following COVID‐19, cardiac structure and function remained unchanged from 3 to 12 months after the index hospitalization, irrespective of COVID‐19 severity and presence of persistent dyspnea. These results suggest that progression of cardiac dysfunction after COVID‐19 is rare and unlikely to play an important role in PACS.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 90%

Changes in cardiac structure and function from 3 to 12 months after hospitalization for COVID‐19

Øvrebotten

Myhre

Grimsmo³

et al. 2022

Clinical Cardiology

View full text Add to dashboard Cite

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“…Besides, we included risk factor-matched controls to minimize the influence of cardiovascular risk factors on CMR characteristics, considering that some patients with COVID-19 had hypertension, diabetes, or hyperlipidemia. Age, sex, and cardiovascular risk factors (hypertension, diabetes, and hyperlipidemia) were matched between risk factor-matched controls and patients with COVID-19 as described in previous studies by Puntmann et al ( 17 ) and Gao et al ( 18 ). Comparisons were made with cardiovascular risk factor-matched patients (risk factor-matched controls; n = 21), who were examined in our institution before 2020.…”

Section: Methodsmentioning

confidence: 99%

Cardiac involvement in patients 1 year after recovery from moderate and severe COVID-19 infections

Qiao

Zhao²,

Lu³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundSome patients suffered persistent cardiac symptoms after hospital discharge following COVID-19 infection, including chest tightness, chest pain, and palpitation. However, the cardiac involvement in these patients remains unknown. The purpose of this study was to investigate the effect of COVID-19 infection on the cardiovascular system after 1 year of recovery in patients hospitalized with persistent cardiac symptoms.Materials and methodsIn this prospective observational study, a total of 32 patients who had COVID-19 (11 diagnosed as severe COVID-19 and 21 as moderate) with persistent cardiac symptoms after hospital discharge were enrolled. Contrast-enhanced cardiovascular magnetic resonance (CMR) imaging was performed on all patients. Comparisons were made with age- and sex-matched healthy controls (n = 13), and age-, sex- and risk factor-matched controls (n = 21). Further analysis was made between the severe and moderate COVID-19 cohorts.ResultsThe mean time interval between acute COVID-19 infection and CMR was 462 ± 18 days. Patients recovered from COVID-19 had reduced left ventricular ejection fraction (LVEF) (p = 0.003) and increased extracellular volumes (ECVs) (p = 0.023) compared with healthy controls. Focal late gadolinium enhancement (LGE) was found in 22 (68.8%) patients, mainly distributed linearly in the septal mid-wall or patchily in RV insertion point. The LGE extent in patients with severe COVID-19 was higher than that in patients with moderate COVID-19 (p = 0.009).ConclusionThis 1-year follow-up study revealed that patients with persistent cardiac symptoms, after recovering from COVID-19, had decreased cardiac function and increased ECV compared with healthy controls. Patients with COVID-19 predominately had a LGE pattern of septal mid-wall or RV insertion point. Patients with severe COVID-19 had greater LGE extent than patients with moderate COVID-19.

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“…The lack of multicentre cross‐sectional data comprising detailed clinical evaluation, haemodynamic monitorization, and standardized imaging protocols lead to diverse classifications of the disease's severity. Furthermore, the poor correlation between MRI findings and clinical severity, as well as the transient nature of the myocardial involvement in COVID infection, make difficult to link HF functional severity to cardiac structural damage 40–42 …”

Section: Introductionmentioning

confidence: 99%

Heart failure during the COVID‐19 pandemic: clinical, diagnostic, management, and organizational dilemmas

et al. 2022

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The coronavirus 2019 (COVID-19) infection pandemic has affected the care of patients with heart failure (HF). Several consensus documents describe the appropriate diagnostic algorithm and treatment approach for patients with HF and associated COVID-19 infection. However, few questions about the mechanisms by which COVID can exacerbate HF in patients with high-risk (Stage B) or symptomatic HF (Stage C) remain unanswered. Therefore, the type of HF occurring during infection is poorly investigated. The diagnostic differentiation and management should be focused on the identification of the HF phenotype, underlying causes, and subsequent tailored therapy. In this framework, the relationship existing between COVID and onset of acute decompensated HF, isolated right HF, and cardiogenic shock is questioned, and the specific management is mainly based on local hospital organization rather than a standardized model. Similarly, some specific populations such as advanced HF, heart transplant, patients with left ventricular assist device (LVAD), or valve disease remain under investigated. In this systematic review, we examine recent advances regarding the relationships between HF and COVID-19 pandemic with respect to epidemiology, pathogenetic mechanisms, and differential diagnosis. Also, according to the recent HF guidelines definition, we highlight different clinical profile identification, pointing out the main concerns in understudied HF populations.

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Normalized Cardiac Structure and Function in COVID-19 Survivors Late After Recovery

Cited by 8 publications

References 33 publications

Changes in cardiac structure and function from 3 to 12 months after hospitalization for COVID‐19

Changes in cardiac structure and function from 3 to 12 months after hospitalization for COVID‐19

Cardiac involvement in patients 1 year after recovery from moderate and severe COVID-19 infections

Heart failure during the COVID‐19 pandemic: clinical, diagnostic, management, and organizational dilemmas

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