Post by Nadica (She/Her) on Sept 21, 2024 2:16:30 GMT
Cardiac Function and Functional Capacity in Patients with Long COVID: a Comparison to Propensity-Matched Community Controls - Preprint Accepted September 5, 2024 (Soon to be published) (PDF)
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Abstract
Background. Cardiac impairment has been associated with acute COVID-19 since the earliest reports
of the pandemic. However, its role in post-acute sequelae of COVID-19 (PASC, or “long COVID”) is
undefined, and many existing observations about cardiovascular involvement in PASC are
uncontrolled.
Objective. To compare the prevalence of cardiac dysfunction in patients with Long COVID, and noninfected controls from the same community, and explore their association with functional capacity.
Methods. Echocardiography was used to assess cardiac structure and function, including the
measurement of global longitudinal strain (GLS), in 190 participants with Long COVID. All underwent
assessment of functional impairment by subjective (Duke Activity Status Index, DASI) and objective
tests (6-minute walk test, 6MWT). The 190 participants from the Long COVID group were matched
with those from 979 patients who underwent the same tests in the pre-COVID-19 era, using a propensity
score.
Results. The 190 patients with Long COVID had similar age and risk factor profiles to those of their
matched controls. LV dimensions and geometry, but not diastolic parameters, were significantly altered
in the Long COVID group. The Long COVID group had subclinical systolic dysfunction (GLS 18.5±2.6
vs 19.3±2.7%, p=0.005), and more Long COVID patients had abnormal (<16%) GLS (13% vs 8%,
p=0.035). The association of Long COVID with abnormal GLS (OR 1.49 [1.04, 2.45]) was independent
of - and had a similar or greater effect size - than age and risk factors. There was no interaction of Long
COVID with the association of risk factors with GLS. As expected, the Long COVID group had
significant subjective (<85% predicted METS; 72% vs 5%, p<0.001) and objective functional
impairment (29% vs 24%, p=0.026), but GLS was only weakly associated with both subjective (r=0.30,
p=0.005) and objective (r=0.21, p=0.05) functional impairment. The presence of Long COVID was
independently associated with subjective (OR=159.7 [95% CI: 61.6-414.2]), and objective functional
impairment (OR=2.8 [95% CI: 1.5-5.2]).
Conclusions. Impaired GLS and LV dimensions are the echocardiographic features that are overrepresented in Long COVID, and this association is similar to, and independent of other risk factors.
Impaired GLS is weakly associated with functional impairment.
Keywords: COVID-19, post-acute sequelae of COVID-19, Long COVID, myocardial dysfunction,
echocardiography and global longitudinal strain
I will try to remember to reformat this later. If you have trouble reading it here, click the PDF link above.
Abstract
Background. Cardiac impairment has been associated with acute COVID-19 since the earliest reports
of the pandemic. However, its role in post-acute sequelae of COVID-19 (PASC, or “long COVID”) is
undefined, and many existing observations about cardiovascular involvement in PASC are
uncontrolled.
Objective. To compare the prevalence of cardiac dysfunction in patients with Long COVID, and noninfected controls from the same community, and explore their association with functional capacity.
Methods. Echocardiography was used to assess cardiac structure and function, including the
measurement of global longitudinal strain (GLS), in 190 participants with Long COVID. All underwent
assessment of functional impairment by subjective (Duke Activity Status Index, DASI) and objective
tests (6-minute walk test, 6MWT). The 190 participants from the Long COVID group were matched
with those from 979 patients who underwent the same tests in the pre-COVID-19 era, using a propensity
score.
Results. The 190 patients with Long COVID had similar age and risk factor profiles to those of their
matched controls. LV dimensions and geometry, but not diastolic parameters, were significantly altered
in the Long COVID group. The Long COVID group had subclinical systolic dysfunction (GLS 18.5±2.6
vs 19.3±2.7%, p=0.005), and more Long COVID patients had abnormal (<16%) GLS (13% vs 8%,
p=0.035). The association of Long COVID with abnormal GLS (OR 1.49 [1.04, 2.45]) was independent
of - and had a similar or greater effect size - than age and risk factors. There was no interaction of Long
COVID with the association of risk factors with GLS. As expected, the Long COVID group had
significant subjective (<85% predicted METS; 72% vs 5%, p<0.001) and objective functional
impairment (29% vs 24%, p=0.026), but GLS was only weakly associated with both subjective (r=0.30,
p=0.005) and objective (r=0.21, p=0.05) functional impairment. The presence of Long COVID was
independently associated with subjective (OR=159.7 [95% CI: 61.6-414.2]), and objective functional
impairment (OR=2.8 [95% CI: 1.5-5.2]).
Conclusions. Impaired GLS and LV dimensions are the echocardiographic features that are overrepresented in Long COVID, and this association is similar to, and independent of other risk factors.
Impaired GLS is weakly associated with functional impairment.
Keywords: COVID-19, post-acute sequelae of COVID-19, Long COVID, myocardial dysfunction,
echocardiography and global longitudinal strain