Evolution of Echocardiographic Abnormalities Identified in Previously Healthy Individuals Recovering from COVID-19

Tudoran, Cristina; Tudoran, Mariana; Cuț, Talida Georgiana; Lăzureanu, Voichiţa Elena; Oancea, Cristian; Marinescu, Adelina Raluca; Pescariu, Silvius Alexandru; Pop, Gheorghe Nicusor; Bende, Felix

doi:10.3390/jpm12010046

Cited by 25 publications

(19 citation statements)

References 33 publications

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“…The high prevalence of cardiac-related PASC and CVD in our study was observed in a relatively young population (sample mean age: 45.4 years). This is consistent with previous studies that have documented several cardiac abnormalities assessed on transthoracic echocardiography in patients diagnosed with PASC, under 55 years, with no prior history of CVD 17 18. However, our findings also showed increasing age was associated with reports of cardiac PASC.…”

Section: Discussionsupporting

confidence: 93%

Cardiac postacute sequelae symptoms of SARS-CoV-2 in community-dwelling adults: cross-sectional study

et al. 2022

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ObjectiveTo examine risk factors for cardiac-related postacute sequelae of SARS-CoV-2 infection (PASC) in community-dwelling adults after acute COVID-19 infection.MethodsWe performed a cross-sectional analysis among adults who tested positive for COVID-19. Outcomes were self-reported cardiac-related PASC. We conducted stepwise multivariable logistic regression to assess association between the risk factors (existing cardiovascular disease (CVD), pre-existing conditions, days since positive test, COVID-19 hospitalisation, age, sex, education, income) and cardiac-related PASC.ResultsIn a sample of 442 persons, mean (SD) age was 45.4 (16.2) years, 71% were women, 13% were black, 46% had pre-existing conditions, 23% had cardiovascular (CV) risk factors and 4% had CVD. Prevalence of cardiac PASC was 43% and newly diagnosed cardiac conditions were 27%. The odds for cardiac-related PASC were higher among persons with underlying pre-existing conditions (adjusted OR (aOR): 2.00, 95% CI: 1.28 to 3.10) and among those who were hospitalised (aOR: 3.03, 95% CI: 1.58 to 5.83).ConclusionsMore than a third of persons with COVID-19 reported cardiac-related PASC symptoms. Underlying CVD, pre-existing diseases, age and COVID-19 hospitalisation are possible risk factors for cardiac-related PASC symptoms. COVID-19 may exacerbate CV risk factors and increase risk of complications.

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Section: Discussionsupporting

confidence: 93%

Cardiac postacute sequelae symptoms of SARS-CoV-2 in community-dwelling adults: cross-sectional study

et al. 2022

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“…Referring to the evolution of DD in patients with post-acute and long COVID-19 syndrome, it is assumed that it becomes less severe as the amount of time elapsed since acute infection increases. There have been several studies on this topic [ 31 , 41 , 45 , 46 ], and others are under development or being planned [ 47 ]. The number and intensity of symptoms defining the post-acute and long COVID-19 syndromes, as well as levels of the PCFS scale, reduced during the 6 months of follow-up in parallel with improvement in DD.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Metabolic Syndrome and Obesity on the Evolution of Diastolic Dysfunction in Apparently Healthy Patients Suffering from Post-COVID-19 Syndrome

Tudoran

Cuț

et al. 2022

Biomedicines

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(1) Background: Coronavirus disease 2019 (COVID-19) has a worse prognosis in individuals with obesity and metabolic syndrome (MS), who often develop cardiovascular complications that last throughout recovery. (2) Methods: This study aimed to analyze the evolution of diastolic dysfunction (DD), assessed by transthoracic echocardiography (TTE), in 203 individuals with and without obesity and/or MS diagnosed with post-COVID-19 syndrome. (3) Results: DD was frequently diagnosed in patients with MS and obesity, but also in those without obesity (62.71% and 56.6%, respectively), in comparison to 21.97% of subjects without MS (p ˂ 0.001). Almost half of the patients with obesity and MS had more severe DD (types 2 and 3). As for evolution, the prevalence and severity of DD, particularly types 1 and 2, decreased gradually, in parallel with the improvement of symptoms, progress being more evident in subjects without MS. DD of type 3 did not show a significant reduction (p = 0.47), suggesting irreversible myocardial damages. Multivariate regression analysis indicated that the number of MS factors, the severity of initial pulmonary injury, and protein C levels could explain DD evolution. (4) Conclusions: DD was commonly diagnosed in individuals with post-COVID-19 syndrome, particularly in those with MS and obesity. After 6 months, DD evolution, excepting that of type 3, showed a significant improvement, mostly in patients without MS.

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“…However, these changes are minor (~6% relative change) and are difficult to utilize on a single patient basis since many patients fall into the “normal” range. In another important study, 383 patients were screened for cardiac involvement in the post-acute phase of COVID-19 [ 29 ]. Approximately a quarter of the patients ( n = 102) had some sort of cardiac sequelae, including left ventricular systolic and diastolic dysfunction, increased pulmonary arterial pressure and pericardial disease, however, most had moderate pulmonary involvement initially.…”

Section: Discussionmentioning

confidence: 99%

Screening for Myocardial Injury after Mild SARS-CoV-2 Infection with Advanced Transthoracic Echocardiography Modalities

et al. 2022

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Although the clinical manifestations of SARS-CoV-2 viral infection affect mainly the respiratory system, cardiac complications are common and are associated with increased morbidity and mortality. While echocardiographic alterations indicating myocardial involvement are widely reported in patients hospitalized for acute COVID-19 infection, much fewer data available in non-hospitalized, mildly symptomatic COVID-19 patients. In our work, we aimed to investigate subclinical cardiac alterations characterized by parameters provided by advanced echocardiographic techniques following mild SARS-CoV-2 viral infection. A total of 86 patients (30 males, age: 39.5 ± 13.0 yrs) were assessed 59 ± 33 days after mild SARS-CoV-2 viral infection (requiring no hospital or <5 days in-hospital treatment) by advanced echocardiographic examination including 2-dimensional (2D) speckle tracking echocardiography and non-invasive myocardial work analysis, and were compared to an age-and sex-matched control group. Altogether, variables from eleven echocardiographic categories representing morphological or functional echocardiographic parameters showed statistical difference between the post-COVID patient group and the control group. The magnitude of change was subtle or mild in the case of these parameters, ranging from 1–11.7% of relative change. Among the parameters, global longitudinal strain [−20.3 (−21.1–−19.0) vs. −19.1 (−20.4–−17.6) %; p = 0.0007], global myocardial work index [1975 (1789–2105) vs. 1829 (1656–2057) Hgmm%; p = 0.007] and right ventricular free wall strain values (−26.6 ± 3.80 vs. −23.8 ± 4.0%; p = 0.0003) showed the most significant differences between the two groups. Subclinical cardiac alterations are present following even mild SARS-CoV-2 viral infection. These more subtle alterations are difficult to detect by routine echocardiography. Extended protocols, involving speckle-tracking echocardiography, non-invasive measurement of cardiac hemodynamics, and possibly myocardial work are necessary for detection and adequate follow-up.

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Evolution of Echocardiographic Abnormalities Identified in Previously Healthy Individuals Recovering from COVID-19

Cited by 25 publications

References 33 publications

Cardiac postacute sequelae symptoms of SARS-CoV-2 in community-dwelling adults: cross-sectional study

Cardiac postacute sequelae symptoms of SARS-CoV-2 in community-dwelling adults: cross-sectional study

The Impact of Metabolic Syndrome and Obesity on the Evolution of Diastolic Dysfunction in Apparently Healthy Patients Suffering from Post-COVID-19 Syndrome

Screening for Myocardial Injury after Mild SARS-CoV-2 Infection with Advanced Transthoracic Echocardiography Modalities

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