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Short-term echocardiographic follow-up after hospitalization for COVID-19: a focus on early post-acute changes
Oleksii Honchar1, Tetiana Ashcheulova1
1Department of Propedeutics of Internal Medicine, Nursing and Bioethics, Kharkiv National Medical University, Kharkiv, Ukraine.
Insights
COVID-19 survivors often show cardiac remodeling and diastolic dysfunction, impacting long-term health. These heart changes, including impaired systolic function, persist one month post-discharge, highlighting the need for cardiac monitoring in recovered patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- COVID-19 infection is linked to long-term physical functional impairment, affecting quality of life and work capacity.
- Subtle cardiac structural and functional changes in COVID-19 convalescents may contribute to persistent symptoms and long COVID syndrome.
- These cardiac alterations may go undetected without specific monitoring.
Purpose of the Study:
- To investigate the characteristic features of cardiac remodeling following COVID-19 hospitalization.
- To assess the short-term dynamics of cardiac dysfunction in COVID-19 survivors.
- To identify potential early signs of cardiac compromise in the post-COVID-19 period.
Main Methods:
- A combined cross-sectional and longitudinal cohort study involving 176 hospitalized COVID-19 patients.
- Comprehensive transthoracic echocardiography performed pre-discharge and one month later.
- Comparison with a control group of 88 age-, sex-, height-, and weight-matched healthy individuals.
Main Results:
- 59% of patients exhibited concentric left ventricular geometry, including 43% of non-hypertensive subjects.
- Grade I diastolic dysfunction was prevalent (35% overall, 25% non-hypertensive).
- Mild increases in left ventricular wall thickness and worsening of diastolic indices and global longitudinal strain were observed, persisting at 1-month follow-up.
Conclusions:
- Hospitalized COVID-19 patients frequently present with left ventricular concentric remodeling and diastolic dysfunction.
- A mild decrease in longitudinal systolic function was noted in these patients.
- These cardiac changes, observed even in non-hypertensive subgroups, largely persisted one month after discharge.
Background:
Impaired physical functional status is one of the typical long-term sequelae of COVID-19 infection that significantly affects the quality of life and work capacity. Minor changes in cardiac structure and function that are unable to cause the manifestation of overt heart failure may remain undetected in COVID-19 convalescents, at the same time potentially contributing to the persistence of symptoms and development of long COVID syndrome.
Purpose:
To study the typical features and short-term dynamics of cardiac remodeling and possible signs of cardiac dysfunction following hospitalization for COVID-19.
Methods:
This is a combined cross-sectional and longitudinal cohort study in which 176 hospitalized patients (93 female and 83 male, mean age 53.4 ± 13.6 years) with COVID-19 infection underwent comprehensive transthoracic echocardiography pre-discharge (22.6 ± 7.1 days from the onset of symptoms) with repeated evaluation after 1 month. The control group included 88 age-, sex-, height- and weight-matched healthy individuals, with a subset of those (n = 53) matched to the subset of non-hypertensive study participants (n = 106).
Results:
Concentric left ventricular geometry was revealed in 59% of participants, including 43% of non-hypertensive subjects; predominantly Grade I diastolic dysfunction was found in 35 and 25% of patients, respectively. Other findings were naturally following from described phenotype of the left venticle and included a mild increase in the absolute and relative wall thickness (0.45 ± 0.07 vs. 0.39 ± 0.04, p < 0.001), worsening of diastolic indices (e' velocity 9.2 ± 2.2 vs. 11.3 ± 2.6 cm/s, p < 0.001, E/e' ratio 7.5 ± 1.8 vs. 6.8 ± 1.7, p = 0.002) and global longitudinal strain (17.5 ± 2.4 vs. 18.6 ± 2.2, p < 0.001). No significant improvement was found on re-evaluation at 1 month.
Conclusions:
Hospitalized patients recovering from COVID-19 were characterized by a high prevalence of left ventricular concentric remodeling, predominantly Grade I diastolic dysfunction, and a mild decrease in the longitudinal systolic function. These changes were less frequent but still prevalent in the non-hypertensive subgroup and largely persisted throughout the 1-month follow-up.
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