No Evidence of Cardiac Sequelae 1 Month After Hospital Discharge for Severe COVID-19

No evidence of cardiac sequelae was detected in patients who recovered from coronavirus disease 2019 (COVID-19), according to a study published in Clinical Research in Cardiology.

In this an observational cross-sectional study, the hearts of 105 patients treated at University Hospital-University of Udine in Italy for COVID-19 and of 105 control individuals were examined. Echocardiographic (ECG) data was obtained at a median of 41 days (interquartile range [IQR], 37-44 days) after initial positive test for COVID-19 to assess cardiac structure and function. At time of data collection, 24% of patients still tested positive for COVID-19.

The patients and control participants were well-balanced for demographic characteristics. In this cohort, 30% of participants had hypertension, and other comorbidities were <10%.

Following hospital discharge, lymphocyte and platelet counts were significantly increased and creatine kinase, C-reactive protein, D-dimer, lactate dehydrogenase, and procalcitonin decreased (P <.001 for all).

At ECG, no significant differences were observed between patients with COVID-19 and control participants, including dimensions of the left and right heart chambers and markers of left ventricular diastolic function.

Patients who had severe COVID-19 which required mechanical ventilation (n=27; 26%) vs those who were moderately ill with COVID-19 had lower lymphocyte counts and higher levels of: lactate dehydrogenases, C-reactive protein, procalcitonin, D-dimer, interleukin-6 (P <.001 for all), aspartate aminotransferase (P =.003), and alanine aminotransferase (P =.005) during hospitalization.

Patients who had severe vs moderate COVID-19 had higher lung ultrasound scores (mean, 3.7±3.6 vs  mean, 1.0±1.7, respectively; group difference, -2.7; 95% CI, -3.8 to -1.8; P <.001).

This study was limited by the lack of ECG evaluation during hospitalization for COVID-19.

“[W]e did not identify structural or functional abnormalities in the heart of survivors of COVID-19 more than a month after the first detection of infection. No abnormalities were also observed in the heart of patients who recovered from severe COVID-19,” concluded the study authors. “These findings suggest that patients who recover from COVID-19 do not have considerable cardiac sequelae, but this evidence needs to be further investigated in larger and longer-term studies.”

Reference

Sechi L A, Colussi G, Bulfone L, et al. Short‑term cardiac outcome in survivors of COVID‑19: a systematic study after hospital discharge. Clin Res Cardiol. 2021;1-10. doi:10.1007/s00392-020-01800-z