Key result
COVID-19 impacts ventricles differently, linking RV changes to pneumonia scores and LV changes to CRP.
Why the study?
Most patients with COVID-19 remain symptomatic months after infection, but long-term outcomes and cardiac sequelae are not yet well defined.
Post-COVID-19 cardiac sequelae show differential impacts on the ventricles, with RV changes associated with pneumonia severity and hemodynamic instability, and LV changes associated with systemic inflammation.
May inform phenotype-specific monitoring in COVID-19; leaves open causal mechanisms and prognostic value for prospective validation.
Most patients who had COVID-19 are still symptomatic after many months post infection, but the long-term outcomes are not yet well defined. The aim of our prospective/retrospective study was to define the cardiac sequelae of COVID-19 infection. This monocentric cohort study included 160 consecutive patients who had been discharged from the ward or from the outpatient clinic after a diagnosis of COVID-19 and subsequently referred for a follow-up visit. Clinical features' data about the acute phase along with information about the follow-up visit, including ECG and Echocardiographic parameters, were recorded. At an average follow-up of 5 months, echocardiography showed morpho-functional characteristics of both right (RV) and left (LV) ventricles, such as RV dilation, increased pressure in the pulmonary circulation, and bi-ventricular systolic-diastolic dysfunction. When examined using multivariate analysis, independent of age, sex, and co-morbidities, RV and LV changes were significantly associated with chest High-Resolution computed tomography score and hemodynamic Instability (HI), and with C-reactive protein, respectively. Our results suggest that COVID-19 may impact RV and LV differently. Notably, the extent of the pneumonia and HI may affect RV, whereas the inflammatory status may influence LV. A long-term follow-up is warranted to refine and customize the most appropriate therapeutic strategies.
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Pelà et al. (2021) studied this question. COVID-19 impacts the ventricles differently, with right ventricular changes linked to CT pneumonia score and hemodynamic instability, and left ventricular changes linked to C-reactive protein.
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