Long Term Effects of Mild Severity COVID-19 on Left Ventricular Functions

Year 2022, , 422 - 429, 29.09.2022

Osman Bektaş , Ahmet Karagöz , Feyza Nur Topçu Yenerçağ , Seçkin Dereli , Celali Kurt , Yasemin Kaya

https://doi.org/10.31832/smj.1092699

Abstract

Objective: We aimed to evaluate long term effects of COVID-19 disease on left ventricular function using speckle tracking echocardiography.
Methods: In our study, 96 non-hospitalized patients who were diagnosed with COVID-19 disease in our center between 15 August 2020 and 01 September 2020 and 96 age and gender matched control subjects were included.
Results:The mean follow up duration was 137 ± 7 days. White blood cell, neutrophile and lymphocyte were significantly lower and C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) were significantly higher in the COVID-19 group. (6.6 ± 2.8 vs. 24.4 ± 21.8, p <0.001 and 4.1 ± 2.5 vs. 7.1 ± 4, p <0.001, respectively). Global longutinal strain (LV-GLS) and global circumferential strain (LV-GCS) were significantly lower in the COVID-19 group. (-20.1 ± 3.1 vs -15.9 ± 2, p <0.001 and -29.3 ± 2.1 vs -26.3 ± 2.1, p <0.001, respectively). LV-GLS and LV-GCS were found to be negatively correlated with CRP (rs = -0.515, p <0.001 and rs = 0.-466, p <0.001, respectively) and NLR (rs = -0.494, p <0.001 and rs = -434, p <0.001, respectively).
Conclusion: Deteriorating effects of COVID-19 disease on both LV-GCS and LV-GLS can be seen even in the long term. These detrimental effects seem to be associated with CRP levels and NLR measured in the course of active infection.

Keywords

Covid 19, Left ventricular dysfunction, echocardiography

Supporting Institution

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Project Number

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Thanks

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Hafif Şiddette COVID-19'un Sol Ventrikül Fonksiyonları Üzerindeki Uzun Dönem Etkileri

Abstract

Amaç: COVID-19 hastalığının, sol ventrikül fonksiyonu üzerindeki uzun dönem etkilerini speckle tracking ekokardiyografi kullanarak, değerlendirmeyi amaçladık.
Yöntemler: Çalışmamıza 15 Ağustos 2020 - 01 Eylül 2020 tarihleri arasında merkezimizde COVID-19 hastalığı tanısı konan ve hastaneye yatmayan 96 hasta ile yaş ve cinsiyet olarak uyumlu, 96 kontrol olgusu dahil edildi.
Bulgular: Ortalama takip süresi 137 ± 7 gündü. Beyaz kan hücresi, nötrofil ve lenfosit, COVID-19 grubunda önemli ölçüde daha düşüktü ve C-reaktif protein (CRP) ve nötrofil lenfosit oranı (NLR) önemli ölçüde daha yüksekti. (sırasıyla 6,6 ± 2,8 - 24,4 ± 21,8, p <0,001 ve 4,1 ± 2,5 - 7,1 ± 4, p <0,001). Global longutinal strain (LV-GLS) ve global circumferential strain (LV-GCS), COVID-19 grubunda önemli ölçüde daha düşüktü. (-20,1 ± 3,1 vs -15,9 ± 2, p <0,001 ve -29,3 ± 2,1 vs -26.3 ± 2,1, p <0,001). LV-GLS ve LV-GCS'nin CRP (sırasıyla rs = -0.515, p <0.001 ve rs = 0.-466, p <0.001) ve NLR (rs = -0.494, p <0.001 ve rs = -434, p <0,001, sırasıyla).
Sonuç: COVID-19 hastalığının hem LV-GCS hem de LV-GLS üzerindeki olumsuz etkileri uzun süre devam etmektedir. Bu olumsuz etkiler, aktif enfeksiyon sırasında ölçülen CRP seviyeleri ve NLR ile ilişkili görünmektedir.

Keywords

Covid 19,, Sol ventrikül disfonksiyonu, Ekokardiyografi

Project Number

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References

• 1. Atum A, Altan A, Boz E, Çakır B, Çelik E, Yuvacı İ et al. Ocular Diseases in SARS-CoV-2 Infection. Sakarya Med J 2021;11(1):137-141. doi.org/10.31832/smj.801248
• 2. Lee KY, Lee BK, Kim WJ, Kang SH, Park TK, Kim SY, et al; Korean Society of Interventional Cardiology COVID-19 Task Force Team. Consensus Statement on Coronary Intervention during the Coronavirus Disease 2019 (COVID-19) Pandemic: from the Korean Society of Interventional Cardiology (KSIC). Korean Circ J. 2020 Nov;50(11):974-983. doi: 10.4070/kcj.2020.0283.
• 3. Tomasz J Guzik, Saidi A Mohiddin, Anthony Dimarco, Vimal Patel, Kostas Savvatis , Federica M Marelli-Berg et al. COVID-19 and the Cardiovascular System: Implications for Risk Assessment, Diagnosis, and Treatment Options. Cardiovasc Res. 2020 Aug 1;116(10):1666-1687. doi: 10.1093/cvr/cvaa106.
• 4. Cascino GJ, Voss WB, Canaani J, Furiasse N, Rademaker A, Ky B et al. Two-dimensional speckle-tracking strain detects subclinical cardiotoxicity in older patients treated for acute myeloid leukemia. Echocardiography. 2019 Nov;36(11):2033-2040. doi: 10.1111/echo.14518.
• 5. Mombeini H, Parsaee M, Amin A. Speckle tracking echocardiography in hypokinetic non-dilated cardiomyopathy: comparison with dilated cardiomyopathy. ESC Heart Fail. 2020 Aug;7(4):1909-1916. doi: 10.1002/ehf2.12764.
• 6. Biswas M, Sudhakar S, Nanda NC, Buckberg G, Pradhan M, Roomi AU, et al. Two- and three-dimensional speckle tracking echocardiography: clinical applications and future directions. Echocardiography. Echocardiography. 2013 Jan;30(1):88-105. doi: 10.1111/echo.12079.
• 7. Baycan OF, Barman HA, Atici A, Tatlisu A, Bolen F, Ergen P, et al. Evaluation of biventricular function in patients with COVID-19 using speckle tracking echocardiography. Int J Cardiovasc Imaging. 2021 Jan;37(1):135-144. doi: 10.1007/s10554-020-01968-5. Epub 2020 Aug 15.
• 8. Mitchell C, Rahko PS, Blauwet LA, Canaday B, Finstuen JA, Foster MC et al (2019) Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. J Am Soc Echocardiogr. 2019 Jan;32(1):1-64. doi: 10.1016/j.echo.2018.06.004.
• 9. Yenerçağ M, Yüksel S, Çoksevim M, Akçay M, Arslan U. Noninvasive cardiac output measurement based optimization in nonresponders of cardiac resynchronization therapy. Pacing Clin Electrophysiol. 2020 Apr;43(4):394-401. doi: 10.1111/pace.13904.
• 10. de Simone G, Daniels SR, Devereux RB, Meyer RA, Roman MJ, de Divitiis O, et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol. 1992 Nov 1;20(5):1251-60. doi: 10.1016/0735-1097(92)90385-z.
• 11.Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the cardiac imaging committee of the council on clinical cardiology of the American Heart Association. J Nucl Cardiol. 2002 Mar-Apr;9(2):240-5. doi: 10.1067/mnc.2002.123122.
• 12. Iwata-Yoshikawa N, Okamura T, Shimizu Y, Hasegawa H, Takeda M, Nagata N. TMPRSS2 contributes to virus spread and immunopathology in the airways of murine models after coronavirus infection. J Virol 2019 Mar 5;93(6):e01815-18. doi: 10.1128/JVI.01815-18.
• 13. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585.
• 14. Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl). 2020 May 5;133(9):1025-1031. doi: 10.1097/CM9.0000000000000744.
• 15. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020 Mar 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3.
• 16. Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020 Jul;81(1):e6-e12. doi: 10.1016/j.jinf.2020.04.002.
• 17. Williams BA, Merhige ME. Association between neutrophil-lymphocyte ratio and impaired myocardial perfusion in patients with known or suspected coronary disease. Heart Lung. 2013 Nov-Dec;42(6):436-41. doi: 10.1016/j.hrtlng.2013.07.013.
• 18. Adamsson Eryd S, Smith JG, Melander O, Hedblad B, Engström G. et al. Incidence of coronary events and case fatality rate in relation to blood lymphocyte and neutrophil counts. Arterioscler Thromb Vasc Biol. 2012 Feb;32(2):533-9. doi: 10.1161/ATVBAHA.111.240416.
• 19. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020 Jul 28;71(15):762-768. doi: 10.1093/cid/ciaa248.
• 20. Liu Y, Du X, Chen J, , Jin Y, Peng L, Wang HHX, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020 Jul;81(1):e6-e12. doi: 10.1016/j.jinf.2020.04.002.
• 21. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y,et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.
• 22. Wang L. C-reactive protein levels in the early stage of COVID-19. Med Mal Infect. Med Mal Infect. 2020 Jun;50(4):332-334. doi: 10.1016/j.medmal.2020.03.007.
• 23. Tan C, Huang Y, Shi F, Kui Tan, Qionghui Ma , Yong Chen et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J Med Virol. 2020 Jul;92(7):856-862. doi: 10.1002/jmv.25871.