Cardiopulmonary Long-Term Sequelae in Patients after Severe COVID-19 Disease
Julia Hanne Niebauer, Christina Binder, Ahmet Iscel, Sarah Schedl, C Capelle, Michael Kahr, Simona Cadjo, Simon Schamilow, R Badr-Eslam, Michael Lichtenauer, Aurel Toma, Alexander Zoufaly, Rosmarie Valenta, Sabine Hoffmann, Silvia Charwat‐Resl, Christian Krestan, Wolfgang Hitzl, Christoph Wenisch, Diana Bonderman
Abstract
We aimed to identify cardiopulmonary long-term effects after severe COVID-19 disease as well as predictors of Long-COVID in a prospective registry. A total of 150 consecutive, hospitalized patients (February 2020 and April 2021) were included six months post hospital discharge for a clinical follow-up. Among them, 49% experienced fatigue, 38% exertional dyspnea and 75% fulfilled criteria for Long-COVID. Echocardiography detected reduced global longitudinal strain (GLS) in 11% and diastolic dysfunction in 4%. Magnetic resonance imaging revealed traces of pericardial effusion in 18% and signs of former pericarditis or myocarditis in 4%. Pulmonary function was impaired in 11%. Chest computed tomography identified post-infectious residues in 22%. Whereas fatigue did not correlate with cardiopulmonary abnormalities, exertional dyspnea was associated with impaired pulmonary function (OR 3.6 [95% CI: 1.2–11], p = 0.026), reduced GLS (OR 5.2 [95% CI: 1.6–16.7], p = 0.003) and/or left ventricular diastolic dysfunction (OR 4.2 [95% CI: 1.03–17], p = 0.04). Predictors of Long-COVID included length of in-hospital stay (OR: 1.15 [95% CI: 1.05–1.26], p = 0.004), admission to intensive care unit (OR cannot be computed, p = 0.001) and higher NT-proBNP (OR: 1.5 [95% CI: 1.05–2.14], p = 0.026). Even 6 months after discharge, a majority fulfilled criteria for Long-COVID. While no associations between fatigue and cardiopulmonary abnormalities were found, exertional dyspnea correlated with impaired pulmonary function, reduced GLS and/or diastolic dysfunction.