Comparison of echocardiographic parameters of patients with COVID-19 pneumonia in hospital and three months after discharge

Background COVID-19 affects firstly the respiratory system of patients however cardiovascular system is also damaged. To study the impact of a novel coronavirus infection on the cardiovascular system, in particular on echocardiographic parameters after SARS-CoV-2 is very important. Purpose To compare echocardiographic parameters in patients with COVID-19 pneumonia in hospital and 3 months after hospital discharge. Methods A total of 106 patients with confirmed COVID-19 pneumonia were included in the period from April to July 2020 within “One-year Cardiac Follow-up of COVID-19 Pneumonia”. All patients underwent clinical examination including transthoracic echocardiography in hospital and 3 months ± 2 weeks after discharge. Mean age of patients was 47±16 years (19–84 years), mean body mass index was 28.2±5.7 kg/m2, females were 49%. During hospitalization, chest computed tomography detected mild lesions in 29.2%, moderate lesions in 31.1%, severe lesions in 27.4% and critical lesions in 5.7%. Cardiovascular pathology detected in 52% of patients. Results Three months after discharge significant dynamics of mean echocardiographic parameters was observed. Left ventricular end-diastolic, end-systolic and stroke volume decreased (113.8±26.8 vs 93.5±29.4 ml; 37.7±13.0 vs 31.3±14.2 ml; 77.2±17.8 vs 62.2±18.7 ml, respectively; all p<0.001). End-diastolic right ventricular outflow tract diameter, pulmonary artery trunk diameter decreased (26.0 [24.0–9.3] vs 25.0 [23.0–27.0] mm, p=0.004; 21.7±3.6 vs 18.7±2.5 mm, p<0.001), as well as pulmonary artery systolic pressure (28.0 [25.0–32.25] vs 21.5 [17.0–25.0] mmHg) and rate of moderate to severe tricuspid regurgitation (52.4 vs 19.8%, both p<0.001). Right atrium volume (42.0 [37.0–50.0] vs 31.0 [22.0–36.5] ml, p<0.001) and width decreased (36.1±4.6 vs 34.5±6.5 mm, p=0.023), however right atrium length increased (46.7±6.8 vs 48.6±7.1, p=0.021). Conclusions In patients after COVID-19 pneumonia echocardiography showed decrease of the load predominantly on the right heart 3 months after discharge. A subgroup analysis is planned depending on the severity of lung damage and presence of cardiovascular pathology.