Alterations of Left Ventricular Function Persisting during Post-Acute COVID-19 in Subjects without Previously Diagnosed Cardiovascular Pathology

Mariana Tudoran; Cristina Tudoran; Voichita Elena Lazureanu; Adelina Raluca Marinescu; Gheorghe Nicusor Pop; Alexandru Silvius Pescariu; Alexandra Enache; Talida Georgiana Cut

doi:10.3390/jpm11030225

Alterations of Left Ventricular Function Persisting during Post-Acute COVID-19 in Subjects without Previously Diagnosed Cardiovascular Pathology

J Pers Med. 2021 Mar 22;11(3):225. doi: 10.3390/jpm11030225.

Authors

Mariana Tudoran^{1

2

3}, Cristina Tudoran^{1

2}, Voichita Elena Lazureanu⁴, Adelina Raluca Marinescu⁴, Gheorghe Nicusor Pop⁵, Alexandru Silvius Pescariu⁵, Alexandra Enache⁶, Talida Georgiana Cut⁴

Affiliations

¹ Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
² Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041, Timisoara, Romania.
³ County Emergency Hospital Timisoara, 300041 Timisoara, Romania.
⁴ Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
⁵ Department VI, Cardiology, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.
⁶ Department VIII, Discipline of Forensic Medicine, University of Medicine and Pharmacy "Victor Babes" Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.

Abstract

(1) Background: Coronavirus infection (Covid-19) has emerged as a severe medical condition, associated with high pulmonary morbidity and often with cardiovascular (CV) complications. This study aims to evidence the persistence of left ventricular (LV) systolic function (LV-SF) alterations and diastolic dysfunction (DD) in COVID-19 patients without history of cardiovascular (CV) diseases by transthoracic echocardiography (TTE). (2) Methods: 125 patients, aged under 55 years, hospitalized during the first outbreak of Covid-19 for moderate pneumonia, underwent a comprehensive cardiologic examination and TTE at 6-10 weeks after discharge. Their initial in-hospital laboratory data and thorax computer tomography (TCT) were accessed from the electronic database of the hospital. (3) Results: with TTE, we documented alterations of LV-SF and DD in 8.8% of patients and in 16.8% only patterns of DD, statistically correlated with the initial levels of creatin-kinase (CK-MB) and inflammatory factors. Multivariate regression analysis evidenced that CK-MB levels, age, and body mass index (BMI) are responsible for 65% of LV-SF decrease. (4) Conclusions: Alterations of LV-SF and DD are frequent in post-acute COVID-19 infection and are responsible for the persistence of symptoms. Elevated myocardial necrosis markers during the acute phase seem to predict subsequent alteration of cardiac performance.

Keywords: COVID-19; cytokine storm; diastolic dysfunction; heart failure; inflammation; left ventricular systolic dysfunction; transthoracic echocardio-graphy.