Recovery of cardiac function following COVID‐19

Abstract

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.