Impairment of right ventricular longitudinal strain associated with severity of pneumonia in patients recovered from COVID-19

Myocardial injury caused by COVID-19 was reported in hospitalized patients previously. But the information about cardiac consequences of COVID-19 after recovery is limited. The aim of the study was comprehensive echocardiography assessment of right ventricular (RV) in patients recovered from COVID-1...

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Bibliographic Details
Published in:The International Journal of Cardiovascular Imaging 2021-08, Vol.37 (8), p.2387-2397
Main Authors: Ozer, Pelin Karaca, Govdeli, Elif Ayduk, Baykiz, Derya, Karaayvaz, Ekrem Bilal, Medetalibeyoglu, Alpay, Catma, Yunus, Elitok, Ali, Cagatay, Atahan, Umman, Berrin, Oncul, Aytac, Tukek, Tufan, Bugra, Zehra
Format: Article
Language:English
Subjects:
Age Factors
Cardiac Imaging
Cardiology
Case-Control Studies
Coronaviruses
COVID-19
COVID-19 - physiopathology
Echocardiography
Female
Gender
Glucocorticoids - therapeutic use
Heart
Heart Ventricles - diagnostic imaging
Heart Ventricles - physiopathology
Humans
Imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Multivariate analysis
Original Paper
Patients
Pneumonia
Prospective Studies
Radiology
Recovery
Risk analysis
Risk factors
Risk management
Severity of Illness Index
Sex Factors
Subgroups
Ventricle
Ventricular Dysfunction, Right - physiopathology
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Summary:Myocardial injury caused by COVID-19 was reported in hospitalized patients previously. But the information about cardiac consequences of COVID-19 after recovery is limited. The aim of the study was comprehensive echocardiography assessment of right ventricular (RV) in patients recovered from COVID-19. This is a prospective, single-center study. After recovery from COVID-19, echocardiography was performed in consecutive 79 patients that attended follow-up visits from July 15 to November 30, 2020. According to the recovery at home vs hospital, patients were divided into two groups: home recovery (n = 43) and hospital recovery (n = 36). Comparisons were made with age, sex and risk factor-matched control group (n = 41). In addition to conventional echocardiography parameters, RV global longitudinal strain (RV-GLS) and RV free wall strain (RV-FWS) were determined using 2D speckle-tracking echocardiography (2D STE). Of the 79 patients recovered from COVID-19, 43 (55%) recovered at home, while 36 (45%) required hospitalization. The median follow-up duration was 133  ±  35 (87–184) days. In patients recovered from hospital, RV-GLS and RV-FWS were impaired compared to control group (RV-GLS: −17.3  ±  6.8 vs. −20.4  ±  4.9, respectively [p = 0.042]; RV-FWS: −19.0  ±  8.2 vs. −23.4  ±  6.2, respectively [p = 0.022]). In subgroup analysis, RV-FWS was impaired in patients severe pneumonia (n = 11) compared to mild-moderate pneumonia (n = 28), without pneumonia (n = 40) and control groups (−15.8  ±  7.6 vs. −21.6  ±  7.6 vs. −20.8  ±  7.7 vs. −23.4  ±  6.2, respectively, [p = 0.001 for each]) and RV-GLS was impaired compared to control group (−15.2  ±  6.9 vs. −20.4  ±  4; respectively, [p = 0.013]). A significant correlation was detected between serum CRP level at hospital admission and both RV-GLS and RV-FWS (r = 0.285, p = 0.006; r = 0.294, p = 0.004, respectively). Age (OR 0.948, p = 0.010), male gender (OR 0.289, p = 0.009), pneumonia on CT (OR 0.019, p = 0.004), and need of steroid in treatment (OR 17.424, p = 0.038) were identifed as independent predictors of impaired RV-FWS (> −18) via multivariate analysis. We demonstrated subclinic dysfunction of RV by 2D-STE in hospitalized patients in relation to the severity of pneumonia after recovery from COVID-19. 2D-STE supplies additional information above standard measures of RV in this cohort and can be used in the follow-up of these patients.
ISSN:1569-5794
1573-0743
1875-8312
DOI:10.1007/s10554-021-02214-2