Alternation in follow-up echocardiographic indices in patients with
COVID-19: a prospective cohort study
Abstract
Background Cardiovascular complications are frequently reported
among patients with pulmonary coronavirus disease 2019 (COVID-19)
infection. Echocardiography has been immensely implemented for
diagnosing cardiovascular involvements. We aimed to evaluate the changes
in echocardiographic parameters in health care workers infected with
COVID-19 during follow-up. Methods This prospective study was
conducted during Iran’s third COVID-19 wave in November 2020 among
health care workers who were infected with COVID-19 but otherwise
healthy. A total of 100 patients underwent echocardiographic examination
six to eight weeks following recovery, an early follow-up. Six months
after the COVID-19 diagnosis, as the late follow-up, 63 subjects
underwent echocardiographic evaluations. Moreover, based on clinical and
radiological evidence, individuals were categorized into two groups of
non-severe and severe COVID-19. Results The participants’ mean
age was 40.4±8.1 years. In the non-severe COVID-19 group, Right
Ventricle Free-Wall Global Longitudinal Strain (RVFWGLS) significantly
decreased in the follow-up echocardiogram (-32.3±4.6% vs. -28.8±5.8%,
p-value=0.002). RV Fraction Area Change (RV-FAC) (46.6% [43.6-53]
vs. 39.7% [25-43] , p-value <0.001) and, Tricuspid
Annular Plane Systolic Excursion (TAPSE) (21 mm [19-24] vs. 23 mm
[20-25], p-value=0.09) did not show a significant change. In the
severe COVID-19 group in late echocardiogram, RVFWGLS showed no
statistically significant change (-28.3%±3.5 vs. -28.6%±5.1,
p-value=0.79). The RV-FAC (47.2% [42.3-52.2] vs. 36.4%
[31.1-45], p-value=0.002) showed a significant decrease, and TAPSE
(22.5 mm [19.1-24.2] vs. 23 mm [21-25], p-value= 0.55) was
comparable. Conclusion Although LV and RV functions did not
vary significantly over time in our entire cohort, different patterns of
changes were discovered according to baseline function.