Cardiac Manifestations of Coronavirus Disease 2019 (COVID-19): a Multicenter Cohort Study
Minkwan Kim1, Jong Ho Nam2, Jang Won Son2
1Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
Insights
Severe COVID-19 patients exhibit reduced left ventricular function, specifically lower ejection fraction and impaired global longitudinal strain. Right ventricular function remained unaffected in severe cases compared to non-severe.
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- Coronavirus disease 2019 (COVID-19) can cause cardiac complications.
- Understanding cardiac manifestations is crucial for managing severe COVID-19.
Purpose of the Study:
- To investigate cardiac involvement in COVID-19 patients.
- To compare cardiac function between severe and non-severe COVID-19 cases.
Main Methods:
- Prospective and retrospective enrollment of COVID-19 patients.
- Collection of demographic, clinical, laboratory, and imaging data.
- Echocardiographic assessment including global longitudinal strain (GLS) of both ventricles.
Main Results:
- Severe COVID-19 patients were older with more bilateral pneumonia and leukocytosis.
- Lower left ventricular ejection fraction (LVEF) observed in severe cases (P=0.015).
- Significantly impaired left ventricular global longitudinal strain (LVGLS) in severe COVID-19 patients (P=0.001).
Conclusions:
- Severe COVID-19 is associated with reduced left ventricular systolic function.
- Right ventricular global longitudinal strain (RVGLS) did not differ significantly between severe and non-severe groups.
Background:
This study aimed to investigate the cardiac manifestations of coronavirus disease 2019 (COVID-19).
Methods:
From February to March 2020, we prospectively and retrospectively enrolled consecutive patients diagnosed with COVID-19. Patient's data such as the demographic characteristics, symptoms, vital signs, laboratory and radiologic findings, electrocardiographic, and echocardiographic data, including the global longitudinal strain (GLS) of both ventricles, were obtained.
Results:
Forty patients (median age, 58 years; 50% men) were enrolled in the initial analysis. Patients were classified into severe and nonsevere groups based on the current guidelines. The 13 patients in the severe group were significantly older, had a greater prevalence of bilateral pneumonia and leukocytosis, and higher aspartate transaminase levels than patients in the nonsevere group. Patients in the severe group had a slightly lower left ventricular ejection fraction (LVEF) than those in the nonsevere group (median [interquartile range], 61.0% [58.5%, 62.3%] vs. 66.7% [60.6%, 69.8%], P = 0.015). In a subgroup of 34 patients in whom GLS could be analyzed, patients in the severe group had a significantly impaired left ventricular GLS (LVGLS) than those in the nonsevere group (-18.1% [-18.8%, -17.1%] vs. -21.7% [-22.9%, -19.9%], P = 0.001). There were no significant differences in total wall (RVGLStotal, -19.3% [-23.9%, -18.4%] vs. -24.3% [-26.0%, -22.6%], P = 0.060) and free wall (RVGLSfw, -22.7% [-27.2%, -18.6%] vs. -28.8% [-30.4%, -24.1%], P = 0.066) right ventricle GLS (RVGLS).
Conclusion:
Patients with severe COVID-19 had lower LVEF and LVGLS. RVGLS was not different between patients with severe and nonsevere COVID-19.
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