Subclinical myocardial dysfunction in patients recovered from COVID-19.
BACKGROUND
Myocardial injury (MI) can be detected during the acute phase of Coronavirus disease 19 (COVID-19) and is associated with a dismal prognosis. Recent imaging studies described the persistence of cardiac abnormalities after the recovery. The aim of the study was to investigate the spectrum of cardiac abnormalities at mid-term follow-up in patients recovered from COVID-19 using clinical assessment, laboratory tests, and imaging evaluation with comprehensive echocardiography.


METHODS
This is an observational, cross-sectional study assessing an unselected cohort of consecutive patients recovered from COVID-19. MI was defined by elevated plasma levels of high sensitive troponin T (hsTnT). At the follow-up, a complete examination including echocardiography was performed.


RESULTS
The 123 patients included were divided into two groups according to the presence of MI during hospitalization: group A (without MI) and group B (with MI). After a median of 85 days, group B patients were more frequently symptomatic for dyspnea and had significantly higher values of hsTnT and N-Terminal prohormone of Brain Natriuretic Peptide (NT-proBNP), compared to Group A. No differences between the two groups in left nor right ventricle dimension and ejection fraction were found. However, in group B a significant reduction of mean left ventricle global longitudinal strain was observed (-15.7±.7 vs -18.1± .3 in group A, p < 0.001), together with higher frequency of impaired diastolic function and higher values of pulmonary pressure.


CONCLUSIONS
In patients recovered from COVID-19, echocardiography with speckle-tracking analysis may be an useful imaging tool to identify subclinical myocardial dysfunction and potentially guide management strategies.
['Italia|Leonardo|L|', 'Ingallina|Giacomo|G|', 'Napolano|Antonio|A|', 'Boccellino|Antonio|A|', 'Belli|Martina|M|', 'Cannata|Francesco|F|0000-0002-5842-5293', 'Rolando|Marco|M|', 'Ancona|Francesco|F|', 'Melillo|Francesco|F|', 'Stella|Stefano|S|', 'Ripa|Marco|M|', 'Scarpellini|Paolo|P|', 'Tresoldi|Moreno|M|', 'Ortalda|Alessandro|A|', 'Righetti|Beatrice|B|', 'De Cobelli|Francesco|F|', 'Esposito|Antonio|A|', 'Ciceri|Fabio|F|', 'Castagna|Antonella|A|', 'Rovere|Patrizia Querini|PQ|', 'Fragasso|Gabriele|G|', 'Agricola|Eustachio|E|0000-0002-4834-2187']
COVID-19 echocardiography strain heart failure myocarditis