Department of Internal Diseases, Rehabilitation, and Physical Medicine, Medical University of Lodz, Lodz, Poland.
Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland.
J Med Virol. 2023 Dec;95(12):e29331. doi: 10.1002/jmv.29331.
Clinical evidence indicates that COVID-19 is a multiorgan disease that significantly impacts the cardiovascular system. However, little is known about the predictors of myocardial dysfunction after SARS-CoV-2 infection. Therefore, this research aimed to evaluate the clinical and electrocardiographic correlates of myocardial dysfunction after SARS-CoV-2 infection in nonhospitalised patients without previously diagnosed cardiovascular disease. This observational study included 448 patients selected from the database of 4142 patients in the Polish Long-Covid Cardiovascular study. All patients underwent a 12-lead electrocardiogram (ECG); 24-h Holter ECG monitoring, 24/7 ambulatory blood pressure monitoring, echocardiography, and cardiac magnetic resonance imaging. According to the results of diagnostic tests, patients were divided into two groups depending on the occurrence of myocardial dysfunction after COVID-19. Group 1-without myocardial dysfunction after COVID-19-consisted of 419 patients, with a mean age of 48.82 (SD ± 11.91), and Group 2 (29 patients)-with myocardial dysfunction after COVID-19, with a mean age of 51.45 (SD ± 12.92). When comparing the analysed groups, there were significantly more men in Group 2 (p = 0.006). QRS (corresponds to the time of ventricular contraction in an electrocardiographic examination) fragmentation (p = 0.031), arrhythmias (atrial fibrillation, supraventricular extrasystole, ventricular extrasystole) (p = 0.008), and male gender (p = 0.007) were independently associated with myocardial dysfunction after COVID-19. The study showed that myocardial damage after COVID-19 affects men more often and is independent of typical clinical factors and the severity of the disease course. The QRS fragmentation and arrhythmias observed in the ECG indicate the possibility of myocardial dysfunction in patients after COVID-19, which may be a valuable marker for physicians.
临床证据表明，COVID-19 是一种多器官疾病，会对心血管系统造成重大影响。然而，人们对 SARS-CoV-2 感染后心肌功能障碍的预测因素知之甚少。因此，本研究旨在评估非住院 COVID-19 患者中无先前诊断心血管疾病的患者感染 SARS-CoV-2 后心肌功能障碍的临床和心电图相关因素。这项观察性研究纳入了波兰长 COVID 心血管研究中 4142 名患者数据库中选择的 448 名患者。所有患者均接受了 12 导联心电图（ECG）检查；24 小时动态心电图监测、24/7 动态血压监测、超声心动图和心脏磁共振成像。根据诊断测试结果，患者根据 COVID-19 后是否发生心肌功能障碍分为两组。第 1 组为 COVID-19 后无心肌功能障碍组，共 419 例，平均年龄为 48.82（SD±11.91）；第 2 组为 COVID-19 后有心肌功能障碍组，共 29 例，平均年龄为 51.45（SD±12.92）。比较分析两组时，第 2 组男性明显更多（p=0.006）。QRS 碎裂（p=0.031）、心律失常（心房颤动、室上性期外收缩、室性期外收缩）（p=0.008）和男性（p=0.007）与 COVID-19 后心肌功能障碍独立相关。该研究表明，COVID-19 后心肌损伤更常影响男性，且与典型临床因素和疾病严重程度无关。心电图中观察到的 QRS 碎裂和心律失常表明 COVID-19 后患者可能存在心肌功能障碍，这可能是医生的一个有价值的标志物。
