Sebastián Garcia‑Zamora1 · José M. Picco2 · Augusto J. Lepori3 · Marcela I. Galello4 · Ariel K. Saad5 · Miguel Ayón6 · Nancy Monga‑Aguilar7 · Issam Shehadeh8 · Carlos F. Manganiello9 · Cintia Izaguirre10 · Luciano N. Fallabrino11 · Matias Clavero12 · Flavia Mansur5 · Sebastián Ghibaudo13 · Daniela Sevilla5,10 · Cesar A. Cado6 · Mauricio Priotti1 · Kiera Liblik14 · Natalio Gastaldello5,7 · Pablo M. Merlo
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has transformed health systems worldwide. There is conficting data regarding the degree of cardiovascular involvement following infection. A registry was designed to evaluate the prevalence of echocardiographic abnormalities in adults recovered from COVID-19. We prospectively evaluated 595 participants (mean age 45.5±14.9 years; 50.8% female) from 10 institutions in Argentina and Brazil. Median time between infection and evaluation was two months, and 82.5% of participants were not hospitalized for their infection. Echocardiographic studies were conducted with General Electric equipment; 2DE imaging and global longitudinal strain (GLS) of both ventricles were performed. A total of 61.7% of the participants denied relevant cardiovascular history and 41.8% had prolonged symptoms after resolution of COVID-19 infection. Mean left ventricular ejection fraction (LVEF) was 61.0±5.5% overall. In patients without prior comorbidities, 8.2% had some echocardiographic abnormality: 5.7% had reduced GLS, 3.0% had a LVEF below normal range, and 1.1% had wall motion abnormalities. The right ventricle (RV) was dilated in 1.6% of participants, 3.1% had a reduced GLS, and 0.27% had reduced RV function. Mild pericardial efusion was observed in 0.82% of participants. Male patients were more likely to have new echocardiographic abnormalities (OR 2.82, p=0.002). Time elapsed since infection resolution (p=0.245), presence of symptoms (p=0.927), or history of hospitalization during infection (p=0.671) did not have any correlation with echocardiographic abnormalities. Cardiovascular abnormalities after COVID-19 infection are rare and usually mild, especially following mild infection, being a low GLS of left and right ventricle, the most common ones in our registry. Post COVID cardiac abnormalities may be more frequent among males.