Mid-term subclinical myocardial injury detection in patients who recovered from COVID-19 according to pulmonary lesion severity

Ikram Chamtouri; Rania Kaddoussi; Hela Abroug; Mabrouk Abdelaaly; Taha Lassoued; Nesrine Fahem; Saoussen Cheikh'Hmad; Asma Ben Abdallah; Walid Jomaa; Khaldoun Ben Hamda; Faouzi Maatouk

doi:10.3389/fcvm.2022.950334

Mid-term subclinical myocardial injury detection in patients who recovered from COVID-19 according to pulmonary lesion severity

Front Cardiovasc Med. 2022 Oct 18:9:950334. doi: 10.3389/fcvm.2022.950334. eCollection 2022.

Authors

Affiliations

¹ Cardiology B Department, Hôpital Universitaire Fattouma Bourguiba, Monastir, Tunisia.
² Pneumology Department, University of Monastir, Monastir, Tunisia.
³ Preventive Medicine Department, Hospital Fatuma Bourguiba, Monastir, Tunisia.
⁴ Radiology Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) may cause damage to the cardiovascular system during the acute phase of the infection. However, recent studies reported mid- to long-term subtle cardiac injuries after recovering from acute coronavirus disease 2019 (COVID-19). This study aimed to determine the relationship between the severity of chest computed tomography (CT) lesions and the persistence of subtle myocardial injuries at mid-term follow-up of patients who recovered from COVID-19 infection.

Methods: All patients with COVID-19 were enrolled prospectively in this study. Sensitive troponin T (hsTnT) and chest CT scans were performed on all patients during the acute phase of COVID-19 infection. At the mid-term follow-up, conventional transthoracic echocardiograph and global longitudinal strain (GLS) of the left and right ventricles (LV and RV) were determined and compared between patients with chest CT scan lesions of < 50% (Group 1) and those with severe chest CT scan lesions of greater or equal to 50% (Group 2).

Results: The mean age was 55 ± 14 years. Both LV GLS and RV GLS values were significantly decreased in group 2 (p = 0.013 and p = 0.011, respectively). LV GLS value of more than -18 was noted in 43% of all the patients, and an RV GLS value of more than -20 was observed in 48% of them. The group with severe chest CT scan lesions included more patients with reduced LV GLS and reduced RV GLS than the group with mild chest CT scan lesions [(G1:29 vs. G2:57%, p = 0.002) and (G1:36 vs. G2:60 %, p = 0.009), respectively].

Conclusion: Patients with severe chest CT scan lesions are more likely to develop subclinical myocardial damage. Transthoracic echocardiography (TTE) could be recommended in patients recovering from COVID-19 to detect subtle LV and RV lesions.

Keywords: cardiac; coronavirus; injury; recovery; strain.