Functional outcomes in post Covid-19 patients with persistent dyspnea: multidisciplinary approach

Area of Science:

• Cardiology
• Pulmonology
• Infectious Diseases

Background:

• Post-acute sequelae of SARS-CoV-2 (PASC), or long COVID, presents a significant health challenge.
• Persistent dyspnea is a common and debilitating symptom in COVID-19 survivors.

Purpose of the Study:

• To assess functional outcomes in post-COVID-19 patients with persistent dyspnea.
• Utilized a multidisciplinary approach including clinical evaluation, lab tests, exercise ECG, and advanced echocardiography (including left atrial function).

Main Methods:

• Observational study comparing 60 post-COVID-19 patients with persistent dyspnea to 30 healthy controls.
• Evaluated dyspnea using validated scores, inflammatory markers, stress ECG, and echocardiography (including 2D speckle tracking for left atrial strain).

Main Results:

• Post-COVID-19 patients exhibited elevated inflammatory markers, lower functional capacity (higher NYHA class, mMRC, PCFS scores), and reduced exercise capacity (METs).
• LV diastolic dysfunction and impaired 2D-STE left atrial strain were observed in post-COVID-19 patients compared to controls.
• Left atrial strain negatively correlated with dyspnea scores and inflammatory markers, and positively with exercise capacity.

Conclusions:

• Post-COVID-19 patients with persistent dyspnea have diminished functional capacity and elevated inflammatory biomarkers.
• Left ventricular diastolic dysfunction and impaired left atrial strain are prevalent, correlating with functional limitations and exercise capacity.
• Impaired left atrial strain may be a key factor contributing to persistent post-COVID-19 symptoms.