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Ventricular Changes in Patients With Acute Covid-19 Infection: Follow-Up of the World Alliance Societies of Echocardiography (Wase-Covid) Study Publisher Pubmed



Karagodin I1 ; Singulane CC1 ; Descamps T2 ; Woodward GM2 ; Xie M3 ; Tucay ES4 ; Sarwar R2, 5 ; Vasquezortiz ZY6 ; Alizadehasl A7 ; Monaghan MJ8 ; Ordonez Salazar BA9 ; Soulatdufour L10 ; Mostafavi A11 ; Moreo A12 Show All Authors
Authors
  1. Karagodin I1
  2. Singulane CC1
  3. Descamps T2
  4. Woodward GM2
  5. Xie M3
  6. Tucay ES4
  7. Sarwar R2, 5
  8. Vasquezortiz ZY6
  9. Alizadehasl A7
  10. Monaghan MJ8
  11. Ordonez Salazar BA9
  12. Soulatdufour L10
  13. Mostafavi A11
  14. Moreo A12
  15. Citro R13
  16. Narang A14
  17. Wu C3
  18. Addetia K1
  19. Tude Rodrigues AC15
  20. Lang RM1
  21. Asch FM16
Show Affiliations
Authors Affiliations
  1. 1. University of Chicago, Illinois, Chicago
  2. 2. Ultromics, Oxford, United Kingdom
  3. 3. Union Hospital, Tongji Medical College of HUST, Wuhan, China
  4. 4. Philippine Heart Center, Quezon City, Philippines
  5. 5. Experimental Therapeutics, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
  6. 6. Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Mexico
  7. 7. Rajaie Cardiovascular Medical and Research Center, Echocardiography Research Center, IUMS, Tehran, Iran
  8. 8. King's College Hospital, London, United Kingdom
  9. 9. Centro Medico Nacional 20 de Noviembre, ISSSTE, Ciudad de Mexico, Mexico
  10. 10. Saint Antoine and Tenon Hospital, AP-HP, INSERM UMRS-ICAN 1166 and Sorbonne Universite, Paris, France
  11. 11. Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
  12. 12. De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
  13. 13. University of Salerno, Salerno, Italy
  14. 14. Northwestern University, Illinois, Chicago
  15. 15. Radiology Institute of the University of Sao Paulo Medical School, Sao Paulo, Brazil
  16. 16. MedStar Health Research Institute, DC, Washington

Source: Journal of the American Society of Echocardiography Published:2022


Abstract

Background: COVID-19 infection is known to cause a wide array of clinical chronic sequelae, but little is known regarding the long-term cardiac complications. We aim to report echocardiographic follow-up findings and describe the changes in left (LV) and right ventricular (RV) function that occur following acute infection. Methods: Patients enrolled in the World Alliance Societies of Echocardiography-COVID study with acute COVID-19 infection were asked to return for a follow-up transthoracic echocardiogram. Overall, 198 returned at a mean of 129 days of follow-up, of which 153 had paired baseline and follow-up images that were analyzable, including LV volumes, ejection fraction (LVEF), and longitudinal strain (LVLS). Right-sided echocardiographic parameters included RV global longitudinal strain, RV free wall strain, and RV basal diameter. Paired echocardiographic parameters at baseline and follow-up were compared for the entire cohort and for subgroups based on the baseline LV and RV function. Results: For the entire cohort, echocardiographic markers of LV and RV function at follow-up were not significantly different from baseline (all P > .05). Patients with hyperdynamic LVEF at baseline (>70%), had a significant reduction of LVEF at follow-up (74.3% ± 3.1% vs 64.4% ± 8.1%, P < .001), while patients with reduced LVEF at baseline (<50%) had a significant increase (42.5% ± 5.9% vs 49.3% ± 13.4%, P = .02), and those with normal LVEF had no change. Patients with normal LVLS (<−18%) at baseline had a significant reduction of LVLS at follow-up (−21.6% ± 2.6% vs −20.3% ± 4.0%, P = .006), while patients with impaired LVLS at baseline had a significant improvement at follow-up (−14.5% ± 2.9% vs −16.7% ± 5.2%, P < .001). Patients with abnormal RV global longitudinal strain (>−20%) at baseline had significant improvement at follow-up (−15.2% ± 3.4% vs −17.4% ± 4.9%, P = .004). Patients with abnormal RV basal diameter (>4.5 cm) at baseline had significant improvement at follow-up (4.9 ± 0.7 cm vs 4.6 ± 0.6 cm, P = .019). Conclusions: Overall, there were no significant changes over time in the LV and RV function of patients recovering from COVID-19 infection. However, differences were observed according to baseline LV and RV function, which may reflect recovery from the acute myocardial injury occurring in the acutely ill. Left ventricular and RV function tends to improve in those with impaired baseline function, while it tends to decrease in those with hyperdynamic LV or normal RV function. © 2021 American Society of Echocardiography
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