Clinical and electrocardiographic correlates of myocardial dysfunction after COVID‐19 in nonhospitalised patients in long‐term follow‐up. Data from the polish long‐covid cardiovascular study

Abstract

Clinical evidence indicates that COVID‐19 is a multiorgan disease that significantly impacts the cardiovascular system. However, little is known about the predictors of myocardial dysfunction after SARS‐CoV‐2 infection. Therefore, this research aimed to evaluate the clinical and electrocardiographic correlates of myocardial dysfunction after SARS‐CoV‐2 infection in nonhospitalised patients without previously diagnosed cardiovascular disease. This observational study included 448 patients selected from the database of 4142 patients in the Polish Long‐Covid Cardiovascular study. All patients underwent a 12‐lead electrocardiogram (ECG); 24‐h Holter ECG monitoring, 24/7 ambulatory blood pressure monitoring, echocardiography, and cardiac magnetic resonance imaging. According to the results of diagnostic tests, patients were divided into two groups depending on the occurrence of myocardial dysfunction after COVID‐19. Group 1–without myocardial dysfunction after COVID‐19–consisted of 419 patients, with a mean age of 48.82 (SD ± 11.91), and Group 2 (29 patients)–with myocardial dysfunction after COVID‐19, with a mean age of 51.45 (SD ± 12.92). When comparing the analysed groups, there were significantly more men in Group 2 (p = 0.006). QRS (corresponds to the time of ventricular contraction in an electrocardiographic examination) fragmentation (p = 0.031), arrhythmias (atrial fibrillation, supraventricular extrasystole, ventricular extrasystole) (p = 0.008), and male gender (p = 0.007) were independently associated with myocardial dysfunction after COVID‐19. The study showed that myocardial damage after COVID‐19 affects men more often and is independent of typical clinical factors and the severity of the disease course. The QRS fragmentation and arrhythmias observed in the ECG indicate the possibility of myocardial dysfunction in patients after COVID‐19, which may be a valuable marker for physicians.

Permanent and Persistent Atrial Fibrillations Are Independent Risk Factors of Mortality after Severe COVID-19

“…SARS-CoV-2 virus may induce cardiac complications, myocardial damage or myocarditis, as evidenced by elevated troponin levels and abnormal cardiac magnetic resonance findings. Kapusta et al reported that QRS fragmentation ( p = 0.031), arrhythmias (atrial fibrillation, supraventricular extrasystole, ventricular extrasystole) ( p = 0.008) and male gender ( p = 0.007) were independently associated with myocardial dysfunction after COVID-19, which may represent a valuable marker for physicians [ 24 ]. Our study adds to the understanding of AF in COVID-19 in well-defined groups of patients with severe pneumonia and high CVD burden, and we propose the different prognostic significance of persistent/permanent types of arrythmia.…”

Post COVID-19 Reflections and Questions: How Prepared Are We for the Next Pandemic?

“…Similar approaches have also been considered for the development of drugs for the treatment of the severe acute respiratory syndrome and other life-threatening side effects of the virus, affecting other systems in addition to the respiratory system, such as the cardiovascular, gastrointestinal, nervous, immune and hematopoietic systems [20][21][22][23][24][25]. A different approach has been considered for the development of other drugs that are related to each of the different stages of COVID-19 and also for the "long COVID" side effects [11,[26][27][28][29][30][31][32][33].…”

“…Furthermore, the SARS-CoV-2 virus has not yet been eliminated, and its long-term side effects affect millions of infected patients. For example, the current mortality rate in Europe due to COVID-19 is estimated at 1000 people every week, and in addition, about 1 in 30 Europeans have suffered from "long COVID" side effects in the last 3 years, including 17 million reported only for 2021 and 2022 [26][27][28][29][30][31][32][33].…”