The Incidence of Persistent Symptom and Echocardiographic Findings in Survivors of COVID-19 Infection with Mild Symptoms
Survived from COVID-19 infection, some patients yet have residual symptoms. Multi-organ and mechanisms of disease can be involved. The data regarding echocardiographic dimension and function of the cardiac in the COVID-19 survivors remains scarce.
This was a descriptive cross-sectional study that involves a total of 63 subjects. Subjects were employees and medical residents at National Cardiovascular Center Harapan Kita, who previously get infected by COVID-19. Each subject was examined transthoracic echocardiography once at the time of recruitment. Echocardiographic parameters obtained in this study included dimension and systolic function of the left ventricle and right ventricle, global longitudinal strain by 2D speckle tracking echocardiography, and myocardial work index.
More than a half of the subjects experienced persistent symptoms after recovery from COVID-19 infection and mainly was fatigue (33.3%). The timing of data acquisition on the median was 32 days after the negative of the COVID-19 test result. 2D echocardiography measurement of left ventricle indicated mean of end-diastolic diameter and end-systolic diameter was 45 mm and 27 mm, respectively. The mean ejection fraction (EF) of the left ventricle by Simpson’s biplane method was 61%. The median of tricuspid annular plane systolic excursion (TAPSE) parameter was 23 mm and the fractional area change (FAC) parameter was 39%. The mean of global longitudinal strain (GLS) was -19.6%.
After recovery from COVID-19 infection, some survivors may have post-acute infectious consequences of COVID-19 such as fatigue, dyspnea, and malaise. However, echocardiographic findings in those patients with mild symptoms, including 2D echocardiography, myocardial strain analysis, and myocardial work index, indicate normal dimension and systolic function in both left ventricle and right ventricle.
1. Tahir F, Bin Arif T, Ahmed J, et al. Cardiac manifestations of coronavirus disease 2019 (COVID-19): A comprehensive review. Cureus 12(5): e8021. DOI 10.7759/cureus.8021
2. Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS, et al. Post acute COVID-19 syndrome. Nature medicine. 2021.
3. Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. Covid-19 and cardiovascular disease: from basic mechanism to clinical perspectives. Nature Cardiology. 2020;17: 543-558.
4. Lang, RM, Badano, LP, Mor-Avi V, Afilalo J, Ernande L, Flachskamp FA, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging. JASE. 2015;28(1):1-39e14.
5. Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, et al. Postdischarge symptoms and rehabailition needs in survivors of COVID-19 infection: a cross sectional evaluation. J Med Virol. 2021 Feb;93(2):1013-1022
6. Nodvig, AS. Et al. Potetntial neurologica;l manifestations of COVID-19. Neurol. Clin. Pract. 2020.
7. Carvalho-Schenider C, et al. Follow-up adults with noncritical COVID-19 two months after symptom onset. Clin Microbiol Infect. 2021;27:258-263.
8. Carfi A, Bernabei R, Landi F, et al. Persisite symptoms in patients afteracute COVID-19. J Am Med Assoc. 2020;324:603-605.
9. George PM, Barrat SL, Condlife R, Desar SR, Defaraj A, Forrest I, et al. Respiratory follow-up of patients with COVID-19 pneumonia. 2020. Thorax. 2020;75(11):1009-1016
10. Ogunyakin KO, Liu K, Lloyd-jones DM, Colangelo LA, Gardin JM. Reference values of right ventricular end-diastolic area defined by ethnicity and gender in a young adult population: the CARDIA study). Echocardiography. 2011;28(2):142-149.
11. Shmueli H, Shah M, Ebinger JE, Nguyen LC, Chernomordik F, Flin N, et al. Left ventricular global longitudinal strain in identifying subclinical myocardial dysfunction among patients hospitalized with COVID-19. IJC Heart and Vasculature. 2021.
12. Tadic M, Cuspidi C, Pencic B, Grassi G, Celic V, et al. Myocardial work in hypertensive patients with and without diabetes: an echocardiographic study. The journal of clinical hypertension. 2020;22(11):2121-27.
13. Manganaro R, Marcheta S, Dulgheru R, Ilardi F, Sugimoto T, Robinet S, Cimino S, et al. Echocardiographic reference ranges for normal non-invasive myocardial work indices: result from the EACVI NORRE study. European Heart Journal. 2019;20(2):582-90.
14. Puntmann VO, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronarvirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5:126-1273.
15. Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. 2021;397(10270):220-232.
16. McElvaney, OJ et al. Characterization of the inflammatory response to severe COVID-19 illness. Am. J. Respir. Crit. Care Med. 2020;202:812-21.
Fulltext (PDF) downloads: 37
Copyright (c) 2022 Indonesian Journal of Cardiology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).