Recovery of cardiac function following COVID-19 – ECHOVID-19: a prospective longitudinal cohort study

Mats C.H. Lassen; Kristoffer Grundtvig Skaarup; Jannie N. Lind; Alia S. Alhakak; Morten Sengeløv; Anne B. Nielsen; Jakob Simonsen; Niklas D. Johansen; Filip S. Davidovski; Jacob Christensen; Henning Bundgaard; Christian Hassager; Reza Jabbari; Jørn Carlsen; Ole Kirk; Matias G. Lindholm; Ole P. Kristiansen; Olav W. Nielsen; Charlotte S. Ulrik; Pradeesh Sivapalan; Gunnar Gislason; Rasmus Møgelvang; Gorm B. Jensen; Peter Schnohr; Peter Søgaard; Scott D. Solomon; Kasper Iversen; Jens U.S. Jensen; Morten Schou; Tor Biering-Sørensen

doi:10.1002/ejhf.2347

Recovery of cardiac function following COVID-19 – ECHOVID-19: a prospective longitudinal cohort study

Mats C.H. Lassen, Kristoffer Grundtvig Skaarup, Jannie N. Lind, Alia S. Alhakak, Morten Sengeløv, Anne B. Nielsen, Jakob Simonsen, Niklas D. Johansen, Filip S. Davidovski, Jacob Christensen, Henning Bundgaard, Christian Hassager, Reza Jabbari, Jørn Carlsen, Ole Kirk, Matias G. Lindholm, Ole P. Kristiansen, Olav W. Nielsen, Charlotte S. Ulrik, Pradeesh SivapalanGunnar Gislason, Rasmus Møgelvang, Gorm B. Jensen, Peter Schnohr, Peter Søgaard, Scott D. Solomon, Kasper Iversen, Jens U.S. Jensen, Morten Schou, Tor Biering-Sørensen^*

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

41 Citations (Scopus)

Abstract

Aims: The degree of cardiovascular sequelae following COVID-19 remains unknown. The aim of this study was to investigate whether cardiac function recovers following COVID-19. Methods and results: A consecutive sample of patients hospitalized with COVID-19 was prospectively included in this longitudinal study. All patients underwent an echocardiographic examination during hospitalization and 2 months later. All participants were successfully matched 1:1 with COVID-19-free controls by age and sex. A total of 91 patients were included (mean age 63 ± 12 years, 59% male). A median of 77 days (interquartile range: 72–92) passed between the two examinations. Right ventricular (RV) function improved following resolution of COVID-19: tricuspid annular plane systolic excursion (TAPSE) (2.28 ± 0.40 cm vs. 2.11 ± 0.38 cm, P < 0.001) and RV longitudinal strain (RVLS) (25.3 ± 5.5% vs. 19.9 ± 5.8%, P < 0.001). In contrast, left ventricular (LV) systolic function assessed by global longitudinal strain (GLS) did not significantly improve (17.4 ± 2.9% vs. 17.6 ± 3.3%, P = 0.6). N-terminal pro-B-type natriuretic peptide decreased between the two examinations [177.6 (80.3–408.0) ng/L vs. 11.7 (5.7–24.0) ng/L, P < 0.001]. None of the participants had elevated troponins at follow-up compared to 18 (27.7%) during hospitalization. Recovered COVID-19 patients had significantly lower GLS (17.4 ± 2.9% vs. 18.8 ± 2.9%, P < 0.001 and adjusted P = 0.004), TAPSE (2.28 ± 0.40 cm vs. 2.67 ± 0.44 cm, P < 0.001 and adjusted P < 0.001), and RVLS (25.3 ± 5.5% vs. 26.6 ± 5.8%, P = 0.50 and adjusted P < 0.001) compared to matched controls. Conclusion: Acute COVID-19 affected negatively RV function and cardiac biomarkers but recovered following resolution of COVID-19. In contrast, the observed reduced LV function during acute COVID-19 did not improve post-COVID-19. Compared to the matched controls, both LV and RV function remained impaired.

Original language	English
Journal	European Journal of Heart Failure
Volume	23
Issue number	11
Pages (from-to)	1903-1912
Number of pages	10
ISSN	1388-9842
DOIs	https://doi.org/10.1002/ejhf.2347
Publication status	Published - Nov 2021
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2021 European Society of Cardiology

Keywords

COVID-19
Follow-up
Recovery following COVID-19
Strain echocardiography

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Cite this

Lassen, M. C. H., Skaarup, K. G., Lind, J. N., Alhakak, A. S., Sengeløv, M., Nielsen, A. B., Simonsen, J., Johansen, N. D., Davidovski, F. S., Christensen, J., Bundgaard, H., Hassager, C., Jabbari, R., Carlsen, J., Kirk, O., Lindholm, M. G., Kristiansen, O. P., Nielsen, O. W., Ulrik, C. S., ... Biering-Sørensen, T. (2021). Recovery of cardiac function following COVID-19 – ECHOVID-19: a prospective longitudinal cohort study. European Journal of Heart Failure, 23(11), 1903-1912. https://doi.org/10.1002/ejhf.2347

@article{723405265be54494b34b1aa59321c239,

title = "Recovery of cardiac function following COVID-19 – ECHOVID-19: a prospective longitudinal cohort study",

abstract = "Aims: The degree of cardiovascular sequelae following COVID-19 remains unknown. The aim of this study was to investigate whether cardiac function recovers following COVID-19. Methods and results: A consecutive sample of patients hospitalized with COVID-19 was prospectively included in this longitudinal study. All patients underwent an echocardiographic examination during hospitalization and 2 months later. All participants were successfully matched 1:1 with COVID-19-free controls by age and sex. A total of 91 patients were included (mean age 63 ± 12 years, 59% male). A median of 77 days (interquartile range: 72–92) passed between the two examinations. Right ventricular (RV) function improved following resolution of COVID-19: tricuspid annular plane systolic excursion (TAPSE) (2.28 ± 0.40 cm vs. 2.11 ± 0.38 cm, P < 0.001) and RV longitudinal strain (RVLS) (25.3 ± 5.5% vs. 19.9 ± 5.8%, P < 0.001). In contrast, left ventricular (LV) systolic function assessed by global longitudinal strain (GLS) did not significantly improve (17.4 ± 2.9% vs. 17.6 ± 3.3%, P = 0.6). N-terminal pro-B-type natriuretic peptide decreased between the two examinations [177.6 (80.3–408.0) ng/L vs. 11.7 (5.7–24.0) ng/L, P < 0.001]. None of the participants had elevated troponins at follow-up compared to 18 (27.7%) during hospitalization. Recovered COVID-19 patients had significantly lower GLS (17.4 ± 2.9% vs. 18.8 ± 2.9%, P < 0.001 and adjusted P = 0.004), TAPSE (2.28 ± 0.40 cm vs. 2.67 ± 0.44 cm, P < 0.001 and adjusted P < 0.001), and RVLS (25.3 ± 5.5% vs. 26.6 ± 5.8%, P = 0.50 and adjusted P < 0.001) compared to matched controls. Conclusion: Acute COVID-19 affected negatively RV function and cardiac biomarkers but recovered following resolution of COVID-19. In contrast, the observed reduced LV function during acute COVID-19 did not improve post-COVID-19. Compared to the matched controls, both LV and RV function remained impaired.",

keywords = "COVID-19, Follow-up, Recovery following COVID-19, Strain echocardiography",

author = "Lassen, {Mats C.H.} and Skaarup, {Kristoffer Grundtvig} and Lind, {Jannie N.} and Alhakak, {Alia S.} and Morten Sengel{\o}v and Nielsen, {Anne B.} and Jakob Simonsen and Johansen, {Niklas D.} and Davidovski, {Filip S.} and Jacob Christensen and Henning Bundgaard and Christian Hassager and Reza Jabbari and J{\o}rn Carlsen and Ole Kirk and Lindholm, {Matias G.} and Kristiansen, {Ole P.} and Nielsen, {Olav W.} and Ulrik, {Charlotte S.} and Pradeesh Sivapalan and Gunnar Gislason and Rasmus M{\o}gelvang and Jensen, {Gorm B.} and Peter Schnohr and Peter S{\o}gaard and Solomon, {Scott D.} and Kasper Iversen and Jensen, {Jens U.S.} and Morten Schou and Tor Biering-S{\o}rensen",

note = "Publisher Copyright: {\textcopyright} 2021 European Society of Cardiology",

year = "2021",

month = nov,

doi = "10.1002/ejhf.2347",

language = "English",

volume = "23",

pages = "1903--1912",

journal = "European Journal of Heart Failure",

issn = "1388-9842",

publisher = "Wiley",

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Lassen, MCH, Skaarup, KG, Lind, JN, Alhakak, AS, Sengeløv, M, Nielsen, AB, Simonsen, J, Johansen, ND, Davidovski, FS, Christensen, J, Bundgaard, H, Hassager, C, Jabbari, R, Carlsen, J, Kirk, O, Lindholm, MG, Kristiansen, OP, Nielsen, OW, Ulrik, CS, Sivapalan, P, Gislason, G, Møgelvang, R, Jensen, GB, Schnohr, P, Søgaard, P, Solomon, SD, Iversen, K, Jensen, JUS, Schou, M & Biering-Sørensen, T 2021, 'Recovery of cardiac function following COVID-19 – ECHOVID-19: a prospective longitudinal cohort study', European Journal of Heart Failure, vol. 23, no. 11, pp. 1903-1912. https://doi.org/10.1002/ejhf.2347

TY - JOUR

T1 - Recovery of cardiac function following COVID-19 – ECHOVID-19

T2 - a prospective longitudinal cohort study

AU - Lassen, Mats C.H.

AU - Skaarup, Kristoffer Grundtvig

AU - Lind, Jannie N.

AU - Alhakak, Alia S.

AU - Sengeløv, Morten

AU - Nielsen, Anne B.

AU - Simonsen, Jakob

AU - Johansen, Niklas D.

AU - Davidovski, Filip S.

AU - Christensen, Jacob

AU - Bundgaard, Henning

AU - Hassager, Christian

AU - Jabbari, Reza

AU - Carlsen, Jørn

AU - Kirk, Ole

AU - Lindholm, Matias G.

AU - Kristiansen, Ole P.

AU - Nielsen, Olav W.

AU - Ulrik, Charlotte S.

AU - Sivapalan, Pradeesh

AU - Gislason, Gunnar

AU - Møgelvang, Rasmus

AU - Jensen, Gorm B.

AU - Schnohr, Peter

AU - Søgaard, Peter

AU - Solomon, Scott D.

AU - Iversen, Kasper

AU - Jensen, Jens U.S.

AU - Schou, Morten

AU - Biering-Sørensen, Tor

PY - 2021/11

Y1 - 2021/11

N2 - Aims: The degree of cardiovascular sequelae following COVID-19 remains unknown. The aim of this study was to investigate whether cardiac function recovers following COVID-19. Methods and results: A consecutive sample of patients hospitalized with COVID-19 was prospectively included in this longitudinal study. All patients underwent an echocardiographic examination during hospitalization and 2 months later. All participants were successfully matched 1:1 with COVID-19-free controls by age and sex. A total of 91 patients were included (mean age 63 ± 12 years, 59% male). A median of 77 days (interquartile range: 72–92) passed between the two examinations. Right ventricular (RV) function improved following resolution of COVID-19: tricuspid annular plane systolic excursion (TAPSE) (2.28 ± 0.40 cm vs. 2.11 ± 0.38 cm, P < 0.001) and RV longitudinal strain (RVLS) (25.3 ± 5.5% vs. 19.9 ± 5.8%, P < 0.001). In contrast, left ventricular (LV) systolic function assessed by global longitudinal strain (GLS) did not significantly improve (17.4 ± 2.9% vs. 17.6 ± 3.3%, P = 0.6). N-terminal pro-B-type natriuretic peptide decreased between the two examinations [177.6 (80.3–408.0) ng/L vs. 11.7 (5.7–24.0) ng/L, P < 0.001]. None of the participants had elevated troponins at follow-up compared to 18 (27.7%) during hospitalization. Recovered COVID-19 patients had significantly lower GLS (17.4 ± 2.9% vs. 18.8 ± 2.9%, P < 0.001 and adjusted P = 0.004), TAPSE (2.28 ± 0.40 cm vs. 2.67 ± 0.44 cm, P < 0.001 and adjusted P < 0.001), and RVLS (25.3 ± 5.5% vs. 26.6 ± 5.8%, P = 0.50 and adjusted P < 0.001) compared to matched controls. Conclusion: Acute COVID-19 affected negatively RV function and cardiac biomarkers but recovered following resolution of COVID-19. In contrast, the observed reduced LV function during acute COVID-19 did not improve post-COVID-19. Compared to the matched controls, both LV and RV function remained impaired.

AB - Aims: The degree of cardiovascular sequelae following COVID-19 remains unknown. The aim of this study was to investigate whether cardiac function recovers following COVID-19. Methods and results: A consecutive sample of patients hospitalized with COVID-19 was prospectively included in this longitudinal study. All patients underwent an echocardiographic examination during hospitalization and 2 months later. All participants were successfully matched 1:1 with COVID-19-free controls by age and sex. A total of 91 patients were included (mean age 63 ± 12 years, 59% male). A median of 77 days (interquartile range: 72–92) passed between the two examinations. Right ventricular (RV) function improved following resolution of COVID-19: tricuspid annular plane systolic excursion (TAPSE) (2.28 ± 0.40 cm vs. 2.11 ± 0.38 cm, P < 0.001) and RV longitudinal strain (RVLS) (25.3 ± 5.5% vs. 19.9 ± 5.8%, P < 0.001). In contrast, left ventricular (LV) systolic function assessed by global longitudinal strain (GLS) did not significantly improve (17.4 ± 2.9% vs. 17.6 ± 3.3%, P = 0.6). N-terminal pro-B-type natriuretic peptide decreased between the two examinations [177.6 (80.3–408.0) ng/L vs. 11.7 (5.7–24.0) ng/L, P < 0.001]. None of the participants had elevated troponins at follow-up compared to 18 (27.7%) during hospitalization. Recovered COVID-19 patients had significantly lower GLS (17.4 ± 2.9% vs. 18.8 ± 2.9%, P < 0.001 and adjusted P = 0.004), TAPSE (2.28 ± 0.40 cm vs. 2.67 ± 0.44 cm, P < 0.001 and adjusted P < 0.001), and RVLS (25.3 ± 5.5% vs. 26.6 ± 5.8%, P = 0.50 and adjusted P < 0.001) compared to matched controls. Conclusion: Acute COVID-19 affected negatively RV function and cardiac biomarkers but recovered following resolution of COVID-19. In contrast, the observed reduced LV function during acute COVID-19 did not improve post-COVID-19. Compared to the matched controls, both LV and RV function remained impaired.

KW - COVID-19

KW - Follow-up

KW - Recovery following COVID-19

KW - Strain echocardiography

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U2 - 10.1002/ejhf.2347

DO - 10.1002/ejhf.2347

M3 - Journal article

C2 - 34514713

AN - SCOPUS:85117115266

SN - 1388-9842

VL - 23

SP - 1903

EP - 1912

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

IS - 11

ER -