Changes in cardiac structure and function from 3 to 12 months after hospitalization for COVID-19
Tarjei Øvrebotten1,2, Peder Myhre1,2, Jostein Grimsmo3
1Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.
Insights
Cardiac function remained stable 3 to 12 months post-COVID-19 hospitalization, regardless of illness severity or persistent dyspnea. This suggests cardiac dysfunction progression is rare in post-acute COVID syndrome (PACS).
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- Cardiac dysfunction is a potential complication following COVID-19 hospitalization.
- Limited data exists on the long-term cardiac function progression and its link to post-acute COVID syndrome (PACS).
Purpose of the Study:
- To investigate the progression of cardiac structure and function from 3 to 12 months after COVID-19 hospitalization.
- To determine if COVID-19 severity or persistent dyspnea influences cardiac function changes over time.
Main Methods:
- A multicenter prospective cohort study involving 182 patients hospitalized with COVID-19.
- Comprehensive echocardiography was performed at 3 and 12 months post-discharge.
- 24-hour electrocardiograms (ECG) were conducted at 3 and 12 months for patients with arrhythmias at 3 months.
Main Results:
- No significant changes in left or right ventricle structure and function were observed between 3 and 12 months post-discharge (p > .05 for all measures).
- Specific measures like RV strain and LV global longitudinal strain showed no significant changes.
- Cardiac function changes did not differ based on COVID-19 severity or the presence of persistent dyspnea.
Conclusions:
- Cardiac structure and function remain stable from 3 to 12 months after COVID-19 hospitalization.
- Progression of cardiac dysfunction appears uncommon in the post-acute phase of COVID-19.
- Cardiac dysfunction is unlikely to be a major contributor to post-acute COVID syndrome (PACS).
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/m2 ). 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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