Persisting Adverse Ventricular Remodeling in COVID-19 Survivors: A Longitudinal Echocardiographic Study

Moody, William E.; Liu, Boyang; Mahmoud‐Elsayed, Hani; Senior, J. M.; Lalla, Sasha; Khan-Kheil, Ayisha Mehtab; Brown, Stewart; Saif, Abdullah; Moss, Alastair J; Bradlow, William; Khoo, Jeffrey; Ahamed, M; McAloon, Christopher; Hothi, Sandeep S; Steeds, Richard P.

doi:10.1016/j.echo.2021.01.020

Cited by 64 publications

(70 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In other words, the decrease in LVEF (or the persistence of LV GLS) as a continuous parameter may represent a mixture of some patients improving from the hyper‐dynamic state, with others that indeed have deterioration in LV function. All things considered, it is important to note that similar results, concerning persistence of subtle LV dysfunction in almost a quarter of hospitalized patients months post‐acute COVID‐19 infection, were observed by other research groups as well 9,12 . The sample size was relatively small, and not all participants agreed to participate in the follow‐up examination creating significant bias.…”

Section: Limitations Clinical Implications and Future Perspectivessupporting

confidence: 52%

“…Nevertheless, it is important to note that the reduction in LV functional parameters rarely reached the abnormal range. Because this study, and the recent study published by Baruch et al ., 12 showing a similar prevalence of 25% abnormal LV STE, were done on consecutive hospitalized patients, with all grades of clinical disease, they probably represent a more accurate picture of the level of persisting cardiac pathology in survivors of patients hospitalized for COVID‐19 compared to preliminary reports 6,9 . Another important advantage of the present study was the routine use of STE.…”

Section: Left Ventricular Function Post‐covid‐19mentioning

confidence: 54%

See 1 more Smart Citation

Recovery of cardiac function following COVID‐19

Ghantous

Topilsky

2021

European J of Heart Fail

View full text Add to dashboard Cite

This article refers to 'Recovery of cardiac function following COVID-19 -ECHOVID-19: a prospective longitudinal cohort study' by M.C.H. Lassen et al., published in this issue on pages 1903-1912.There has been a large number of publications concerning cardiac complications in acute coronavirus disease 2019 (COVID-19) infection. [1][2][3][4][5] Myocardial injury during the acute phase of COVID-19 raises the question of potential long-term cardiac implications, however, less is known about these potential consequences. Preliminary magnetic resonance imaging (MRI) based reports described common persistence of subtle cardiac injury in recovered patients. 6,7 However, these studies used extremely sensitive MRI protocols and lacked baseline imaging and comparison to control healthy patients. In an early echocardiographic study on survivors of COVID-19 infection, even patients with prior detection of increased troponin did not have any evidence of persistent cardiac dysfunction. 8 However, the study included mostly patients at low risk for persistent cardiac injury, and lacked baseline imaging obtained during hospitalization. Furthermore, speckle tracking echocardiography (STE), that would detect more subtle cardiac changes, was not performed.The first longitudinal echocardiographic study (including both baseline and follow-up echo exams) analysing the persistence of cardiac pathology following COVID-19 infection had different results. 9 Forty-one percent of patients had right ventricular (RV) remodelling or dysfunction during acute infection, but only ≈15% had either left ventricular (LV) alone, or biventricular involvement. At 3 months post-acute infection, there was reverse RV remodelling in the majority of patients with abnormal right ventricle at baseline, but no significant changes in LV parameters. However, the study was subjected to selection bias because baseline echo during hospitalization was performed only in patients with critical disease, or clinical deterioration.In this issue of the Journal, Lassen et al. 10 used the ECHOVID-19 cohort, which is a large multicentre prospective cohort, including unselected patients with COVID-19 that underwent an echo The opinions expressed in this article are not necessarily those of the Editors of the European Journal of Heart Failure or of the European Society of Cardiology.

show abstract

Section: Limitations Clinical Implications and Future Perspectivessupporting

confidence: 52%

Section: Left Ventricular Function Post‐covid‐19mentioning

confidence: 54%

Recovery of cardiac function following COVID‐19

Ghantous

Topilsky

2021

European J of Heart Fail

View full text Add to dashboard Cite

show abstract

“…In another study of 26 college athletes with asymptomatic SARS-CoV-2 infection, 46% of them also presented with myocardial inflammation [ 89 ]. Even at three-month post-hospital discharge, radiological abnormalities of ventricular remodelling were still evident in 29% of 79 COVID-19 survivors [ 90 ]. However, the long-term clinical significance of these radiological findings remains unclear as symptomatic assessments were not performed, warranting further research and surveillance [ 91 , 92 ].…”

Section: Putative Pathophysiologymentioning

confidence: 99%

Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments

Yong

2021

Infectious Diseases

810

620

View full text Add to dashboard Cite

Long COVID or post-COVID-19 syndrome first gained widespread recognition among social support groups and later in scientific and medical communities. This illness is poorly understood as it affects COVID-19 survivors at all levels of disease severity, even younger adults, children, and those not hospitalized. While the precise definition of long COVID may be lacking, the most common symptoms reported in many studies are fatigue and dyspnoea that last for months after acute COVID-19. Other persistent symptoms may include cognitive and mental impairments, chest and joint pains, palpitations, myalgia, smell and taste dysfunctions, cough, headache, and gastrointestinal and cardiac issues. Presently, there is limited literature discussing the possible pathophysiology, risk factors, and treatments in long COVID, which the current review aims to address. In brief, long COVID may be driven by long-term tissue damage (e.g. lung, brain, and heart) and pathological inflammation (e.g. from viral persistence, immune dysregulation, and autoimmunity). The associated risk factors may include female sex, more than five early symptoms, early dyspnoea, prior psychiatric disorders, and specific biomarkers (e.g. D-dimer, CRP, and lymphocyte count), although more research is required to substantiate such risk factors. While preliminary evidence suggests that personalized rehabilitation training may help certain long COVID cases, therapeutic drugs repurposed from other similar conditions, such as myalgic encephalomyelitis or chronic fatigue syndrome, postural orthostatic tachycardia syndrome, and mast cell activation syndrome, also hold potential. In sum, this review hopes to provide the current understanding of what is known about long COVID.

show abstract

“…Since most COVID-19 patients recover from the illness, the understanding of the late cardiovascular consequences of infection was important. Until now, there are only a few studies on the cardiac outcome of COVID-19 survivors (9)(10)(11)(12)(13). These studies have reported residual cardiac structural and functional abnormalities even after recovery from COVID-19 using cardiac magnetic resonance (CMR) imaging (11)(12)(13) and echocardiography (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

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

Gao

Zhou

Huang

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Background: Coronavirus disease 2019 can result in myocardial injury in the acute phase. However, information on the late cardiac consequences of coronavirus disease 2019 (COVID-19) is limited.Methods: We conducted a prospective observational cohort study to investigate the late cardiac consequences of COVID-19. Standard echocardiography and myocardial strain assessment were performed, and cardiac blood biomarkers were tested in 86 COVID-19 survivors 327 days (IQR 318–337 days) after recovery. Comparisons were made with 28 age-matched and sex-matched healthy controls and 30 risk factor-matched patients.Results: There were no significant differences in all echocardiographic structural and functional parameters, including left ventricular (LV) global longitudinal strain, right ventricular (RV) longitudinal strain, LV end-diastolic volume, RV dimension, and the ratio of peak early velocity in mitral inflow to peak early diastolic velocity in the septal mitral annulus (E/e') among COVID-19 survivors, healthy controls and risk factor-matched controls. Even 26 patients with myocardial injury at admission did not have any echocardiographic structural and functional abnormalities. There were no significant differences among the three groups with respect to serum concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (cTnI).Conclusion: This study showed that COVID-19 survivors, including those with myocardial injury at admission and those with severe and critical types of illness, do not have any echocardiographic evidence of cardiac structural and functional abnormalities 327 days after diagnosis.

show abstract

Persisting Adverse Ventricular Remodeling in COVID-19 Survivors: A Longitudinal Echocardiographic Study

Cited by 64 publications

References 7 publications

Recovery of cardiac function following COVID‐19

Recovery of cardiac function following COVID‐19

Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments

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

Contact Info

Product

Resources

About