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. 2021 Jun;8(3):2232-2239.
doi: 10.1002/ehf2.13315. Epub 2021 Mar 27.

Cardiac performance in patients hospitalized with COVID-19: a 6 month follow-up study

Antoine Fayol  1   2 , Marine Livrozet  1   2 , Pierre Boutouyrie  1   3 , Hakim Khettab  3 , Maureen Betton  2 , Victoria Tea  4 , Anne Blanchard  2 , Rosa-Maria Bruno  1   3 , Jean-Sébastien Hulot  1   2 ; French COVID cohort study group
Affiliations

Cardiac performance in patients hospitalized with COVID-19: a 6 month follow-up study

Antoine Fayol et al. ESC Heart Fail. 2021 Jun.

Abstract

Aims: Myocardial injury is frequently observed in patients hospitalized with coronavirus disease 2019 (COVID-19) pneumonia. Different cardiac abnormalities have been reported during the acute COVID-19 phase, ranging from infra-clinic elevations of myocardial necrosis biomarkers to acute cardiac dysfunction and myocarditis. There is limited information on late cardiac sequelae in patients who have recovered from acute COVID-19 illness. We aimed to document the presence and quantify the extent of myocardial functional alterations in patients hospitalized 6 months earlier for COVID-19 infection.

Methods and results: We conducted a prospective echocardiographic evaluation of 48 patients (mean age 58 ± 13 years, 69% male) hospitalized 6 ± 1 month earlier for a laboratory-confirmed and symptomatic COVID-19. Thirty-two (66.6%) had pre-existing cardiovascular risks factors (systemic hypertension, diabetes, or dyslipidaemia), and three patients (6.2%) had a known prior myocardial infarction. Sixteen patients (33.3%) experienced myocardial injury during the index COVID-19 hospitalization as identified by a rise in cardiac troponin levels. Six months later, 60.4% of patients still reported clinical symptoms including exercise dyspnoea for 56%. Echocardiographic measurements under resting conditions were not different between patients with versus without myocardial injury during the acute COVID-19 phase. In contrast, low-level exercise (25W for 3 min) induced a significant increase in the average E/e' ratio (10.1 ± 4.3 vs. 7.3 ± 11.5, P = 0.01) and the systolic pulmonary artery pressure (33.4 ± 7.8 vs. 25.6 ± 5.3 mmHg, P = 0.02) in patients with myocardial injury during the acute COVID-19 phase. Sensitivity analyses showed that these alterations of left ventricular diastolic markers were observed regardless of whether of cardiovascular risk factors or established cardiac diseases indicating SARS-CoV-2 infection as a primary cause.

Conclusions: Six months after the acute COVID-19 phase, significant cardiac diastolic abnormalities are observed in patients who experienced myocardial injury but not in patients without cardiac involvement.

Keywords: COVID-19; Diastolic function; Echocardiography; Heart failure; Myocarditis.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Flowchart of the study.
See this image and copyright information in PMC

References

    1. Giustino G, Croft LB, Stefanini GG, Bragato R, Silbiger JJ, Vicenzi M, Danilov T, Kukar N, Shaban N, Kini A, Camaj A, Bienstock SW, Rashed ER, Rahman K, Oates CP, Buckley S, Elbaum LS, Arkonac D, Fiter R, Singh R, Li E, Razuk V, Robinson SE, Miller M, Bier B, Donghi V, Pisaniello M, Mantovani R, Pinto G, Rota I, Baggio S, Chiarito M, Fazzari F, Cusmano I, Curzi M, Ro R, Malick W, Kamran M, Kohli‐Seth R, Bassily‐Marcus AM, Neibart E, Serrao G, Perk G, Mancini D, Reddy VY, Pinney SP, Dangas G, Blasi F, Sharma SK, Mehran R, Condorelli G, Stone GW, Fuster V, Lerakis S, Goldman ME. Characterization of myocardial injury in patients with Covid‐19. J Am Coll Cardiol 2020; 76: 2043–2055. - PMC - PubMed
    1. Lombardi CM, Carubelli V, Iorio A, Inciardi RM, Bellasi A, Canale C, Camporotondo R, Catagnano F, Dalla Vecchia LA, Giovinazzo S, Maccagni G, Mapelli M, Margonato D, Monzo L, Nuzzi V, Oriecuia C, Peveri G, Pozzi A, Provenzale G, Sarullo F, Tomasoni D, Ameri P, Gnecchi M, Leonardi S, Merlo M, Agostoni P, Carugo S, Danzi GB, Guazzi M, La Rovere MT, Mortara A, Piepoli M, Porto I, Sinagra G, Volterrani M, Specchia C, Metra M, Senni M. Association of troponin levels with mortality in italian patients hospitalized with coronavirus disease 2019: results of a multicenter study. JAMA Cardiol 2020; 5: 1274–1280. - PMC - PubMed
    1. Smilowitz NR, Jethani N, Chen J, Aphinyanaphongs Y, Zhang R, Dogra S, Alviar CL, Keller N, Razzouk L, Quinones‐Camacho A, Jung AS, Fishman GI, Hochman JS, Berger JS. Myocardial injury in adults hospitalized with Covid‐19. Circulation 2020; 142: 2393–2395. - PMC - PubMed
    1. Bavishi C, Bonow RO, Trivedi V, Abbott JD, Messerli FH, Bhatt DL. Special article—Acute myocardial injury in patients hospitalized with Covid‐19 infection: a review. Prog Cardiovasc Dis 2020; 63: 682–689. - PMC - PubMed
    1. Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, Shchendrygina A, Escher F, Vasa‐Nicotera M, Zeiher AM, Vehreschild M, Nagel E. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (Covid‐19). JAMA Cardiol 2020; 5: 1265–1273. - PMC - PubMed

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