Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Clin Cardiol. 2022 Oct;45(10):1044-1052. doi: 10.1002/clc.23891. Epub 2022 Aug 3.
Cardiac function may be impaired during and early after hospitalization for COVID-19, but little is known about the progression of cardiac dysfunction and the association with postacute COVID syndrome (PACS).
In a multicenter prospective cohort study, patients who had been hospitalized with COVID-19 were enrolled and comprehensive echocardiography was performed 3 and 12 months after discharge. Twenty-four-hour electrocardiogram (ECG) was performed at 3 and 12 months in patients with arrhythmias at 3 months.
In total, 182 participants attended the 3 and 12 months visits (age 58 ± 14 years, 59% male, body mass index 28.2 ± 4.2 kg/m ). Of these, 35 (20%) had severe COVID-19 (treatment in the intensive care unit) and 74 (52%) had self-reported dyspnea at 3 months. From 3 to 12 months there were no significant overall changes in any measures of left or right ventricle (LV; RV) structure and function (p > .05 for all), including RV strain (from 26.2 ± 3.9% to 26.5 ± 3.1%, p = .29) and LV global longitudinal strain (from 19.2 ± 2.3% to 19.3 ± 2.3%, p = .64). Changes in echocardiographic parameters from 3 to 12 months did not differ by COVID-19 severity or by the presence of persistent dyspnea (p > .05 for all). Among patients with arrhythmia at 3 months, there was no significant change in arrhythmia burden to 12 months.
Following COVID-19, cardiac structure and function remained unchanged from 3 to 12 months after the index hospitalization, irrespective of COVID-19 severity and presence of persistent dyspnea. These results suggest that progression of cardiac dysfunction after COVID-19 is rare and unlikely to play an important role in PACS.
COVID-19 住院期间和出院后早期，心脏功能可能受损，但心脏功能障碍的进展情况以及与急性后 COVID 综合征（PACS）的关系知之甚少。
在一项多中心前瞻性队列研究中，招募了因 COVID-19 住院的患者，并在出院后 3 个月和 12 个月时进行全面超声心动图检查。在 3 个月时有心律失常的患者在 3 个月和 12 个月时进行 24 小时心电图（ECG）检查。
共有 182 名参与者参加了 3 个月和 12 个月的访视（年龄 58±14 岁，59%为男性，体重指数 28.2±4.2kg/m²）。其中，35 名（20%）患有严重 COVID-19（在重症监护病房治疗），74 名（52%）在 3 个月时有自我报告的呼吸困难。从 3 个月到 12 个月，左心室（LV）或右心室（RV）结构和功能的任何测量值均无明显总体变化（所有 p 值均>0.05），包括 RV 应变（从 26.2±3.9%到 26.5±3.1%，p=0.29）和 LV 整体纵向应变（从 19.2±2.3%到 19.3±2.3%，p=0.64）。从 3 个月到 12 个月，超声心动图参数的变化在 COVID-19 严重程度或持续呼吸困难的存在方面没有差异（所有 p 值均>0.05）。在 3 个月时有心律失常的患者中，心律失常负担在 12 个月时没有显著变化。
在 COVID-19 之后，心脏结构和功能在指数住院后 3 至 12 个月内保持不变，无论 COVID-19 严重程度和持续呼吸困难的存在如何。这些结果表明，COVID-19 后心脏功能障碍的进展很少见，不太可能在 PACS 中发挥重要作用。
