Recovery of cardiac function following <scp>COVID</scp> ‐19 – <scp>ECHOVID</scp> ‐19: a prospective longitudinal cohort study
Mats Christian Højbjerg Lassen, Kristoffer Grundtvig Skaarup, Jannie Nørgaard Lind, Alia Saed Alhakak, Morten Sengeløv, Anne Bjerg Nielsen, Jakob Øystein Simonsen, Niklas Dyrby Johansen, Filip Soeskov Davidovski, Jacob Christensen, Henning Bundgaard, Christian Hassager, Reza Jabbari, Jørn Carlsen, Ole Kirk, Matias Greve Lindholm, Ole Peter Kristiansen, Olav Wendelboe Nielsen, Charlotte Suppli Ulrik, Pradeesh Sivapalan, Gunnar Gislason, Rasmus Møgelvang, Gorm Boje Jensen, Peter Schnohr, Peter Søgaard, Scott D. Solomon, Kasper Iversen, Jens‐Ulrik Stæhr Jensen, Morten Schou, Tor Biering‐Sørensen
Abstract
AIMS: The degree of cardiovascular sequelae following COVID-19 remains unknown. The aim of this study was to investigate whether cardiac function recovers following COVID-19. METHODS AND RESULTS: A consecutive sample of patients hospitalized with COVID-19 was prospectively included in this longitudinal study. All patients underwent an echocardiographic examination during hospitalization and 2 months later. All participants were successfully matched 1:1 with COVID-19-free controls by age and sex. A total of 91 patients were included (mean age 63 ± 12 years, 59% male). A median of 77 days (interquartile range: 72-92) passed between the two examinations. Right ventricular (RV) function improved following resolution of COVID-19: tricuspid annular plane systolic excursion (TAPSE) (2.28 ± 0.40 cm vs. 2.11 ± 0.38 cm, P < 0.001) and RV longitudinal strain (RVLS) (25.3 ± 5.5% vs. 19.9 ± 5.8%, P < 0.001). In contrast, left ventricular (LV) systolic function assessed by global longitudinal strain (GLS) did not significantly improve (17.4 ± 2.9% vs. 17.6 ± 3.3%, P = 0.6). N-terminal pro-B-type natriuretic peptide decreased between the two examinations [177.6 (80.3-408.0) ng/L vs. 11.7 (5.7-24.0) ng/L, P < 0.001]. None of the participants had elevated troponins at follow-up compared to 18 (27.7%) during hospitalization. Recovered COVID-19 patients had significantly lower GLS (17.4 ± 2.9% vs. 18.8 ± 2.9%, P < 0.001 and adjusted P = 0.004), TAPSE (2.28 ± 0.40 cm vs. 2.67 ± 0.44 cm, P < 0.001 and adjusted P < 0.001), and RVLS (25.3 ± 5.5% vs. 26.6 ± 5.8%, P = 0.50 and adjusted P < 0.001) compared to matched controls. CONCLUSION: Acute COVID-19 affected negatively RV function and cardiac biomarkers but recovered following resolution of COVID-19. In contrast, the observed reduced LV function during acute COVID-19 did not improve post-COVID-19. Compared to the matched controls, both LV and RV function remained impaired.